Second National Communications lanes, social health insurance funds, house to house recording and case finding for Malaria and TB have been some adaptation mechanisms that provincial health units have been doing. Adaptive capacities have been hard to establish and it is in more recent venues like that of the DOH support for the provincial investments for public health (PIPH) where these can be given their likelihood of being set up. The Intergovernmental Panel on Climate Change (IPCC), in its Second Assessment Report, defines vulnerability as "the extent to which climate change may damage or harm a system." It adds that vulnerability "depends not only on a system's sensitivity, but also on its ability to adapt to new climatic conditions". The NOH states that progress has been made in the past decades to control communicable diseases but their burden is still high. A sustained approach and strategy towards control and later elimination is a must as they pose a burden to development. With industrialization, the shift to non-communicable diseases is becoming more pronounced. This double burden of disease places a great toll on the health and economy of the people and the nation as a whole. Strategies must be in place to address current and future situations on disease burden.20 Infectious diseases that are climate sensitive become vulnerabilities in a population that has the influence of increasing frequency of extreme climate events. Non-communicable diseases can also be climate related as they lower the resistance of the body to respond to the stresses brought about by changes in climate. Previous study [Flavier, et al, 1998], on the characteristics of notifiable diseases (e.g., malaria, dengue, diarrhea, cholera, etc.) showed 10% to 58% association between health and climate variables. The study also revealed that non-infectious diseases are also affected by climate change, variability and extremes such as shellfish poisoning, cardio-vascular and respiratory problems. 21 Recent decades have seen the rise of diseases not yet seen in the country. Of note is the AH1N1 Influenza strain (Swine flu) which has become a pandemic and that of Severe Acute Respiratory Syndrome (SARS) among others. Other diseases have reemerged if not become harder to treat. Treatment protocols for Malaria and Tuberculosis have changed where we now use multiple drugs. These have posed vulnerabilities as adjustments in dosages and drug reactions with the body as much as budgetary considerations are heightened with climate change. The health infrastructure (physical and human) in the Philippines is challenged coping with primary health care as it is. We lack considerations in making our physical infrastructures responsive (climate proof) to the negative effects of extreme events. While the health emergency medical services (HEMS), a mobile health disaster response are around, they have not been installed in our major health facilities. We will have to emphasize that these vulnerabilities should always look at the climate-health relationship as an added perspective to the prevailing infectious disease pathway (dose –response). And after which the climate sensitive health outcomes should be considered as we do our assessment. Non-health determinants that mediate the health vulnerabilities are the disasters themselves, the prevailing socio-economic conditions as well as the geographic set up of the country. We are an 20 21 National Objectives for Health 2005. Perez, Rosa. ADB Climate Change Assessment, 2008. 14