This technical paper discusses the identification and implementation of medium- and long-term adaptation activities in the least developed countries. It builds on the experiences gained from implementing the least developed countries work programme, in particular on the preparation and implementation of national adaptation programmes of action (NAPAs). It provides an account of how elements of the preparation of NAPAs can help inform medium- and long-term adaptation. It contains case studies of the Lao People's Democratic Republic and Malawi, which were performed in order to generate a deeper understanding of considerations regarding medium- and long-term adaptation at the country level. It also contains information on experiences of other developing and developed countries, as well as from other multilateral programmes, in implementing adaptation activities