Responding to COVID-19 on the outer islands of Tuvalu.

Problem: Coronavirus disease (COVID-19) reached Tuvalu's shores in November 2022, making Tuvalu one of the last countries in the world to experience community transmission of the disease. With minimal capacity to deliver critical care and a small health workforce that had been further depleted by COVID-19 infection, response priorities rapidly shifted to the outer islands.

Context: The outer islands are accessible only by boat, with travel taking from 6 to 24 hours. The return of high school students to their home islands for the Christmas holidays had the potential to place further pressure on the islands' medical facilities.

Action: A multiorganizational collaboration between the Australian and Fijian governments, the Pacific Community, the Tuvalu Ministry of Social Welfare and Gender Affairs (MoHSWGA) and the World Health Organization facilitated the deployment of two teams to the outer islands to provide support.

Outcome: The team worked with public health and clinical staff to provide technical support for clinical management, infection prevention and control, laboratory, risk communication, community engagement and logistics.

Discussion: The outer islands' response to the pandemic significantly benefited the island communities, the MoHSWGA and the team members who deployed. The key lessons identified relate to the need to strengthen the health workforce and supply chain.