Those countries emitting the highest amount of greenhouse gases are least vulnerable, researchers said.
The study found that 20 of the 36 highest emitting countries - including US, Canada, Australia, China, and much of Western Europe - were least vulnerable.
Eleven of the 17 countries with low to moderate emissions were most vulnerable to climate change. Most were found in sub-Saharan Africa and South Asia.
The majority of the most vulnerable countries are African and Small Island States. These countries are exposed to serious environmental change such as oceanic inundation or desertification, researchers said.
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They are also generally the least developed nations, having few resources available to cope with these issues.
"There is an enormous global inequality in which those countries most responsible for causing climate change are the least vulnerable to its effects," said lead author Glenn Althor of University of Queensland.
"This is like a non-smoker getting cancer from second-hand smoke, while the heavy smokers continue to puff away," said co-author James Watson of the University of Queensland and WCS.
"Essentially we are calling for the smokers to pay for the health care of the non-smokers they are directly harming," Watson said.
The researchers said the finding acts as a disincentive for high-emitting "free-rider" countries to mitigate their emissions.
The number of acutely vulnerable countries will worsen by 2030 as climate change related pressures such as droughts, floods, biodiversity loss and disease mount, researchers said.