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Shortfalls in the equitable supply of COVID-19 vaccines to low-income and middle-income countries, as discussed by David Durrheim,1 is an abysmal failure of global health governance. We must, however, also recognise that some nations extended assistance across borders in selfless acts of humanity. The Pacific island nation of Nauru—which registered its first COVID-19 case only in April, 2022—is a testament to such solidarity.2 By late 2021, Nauru had recorded a 96% rate of double-dose COVID-19 vaccinations in adults, with efforts underway to immunise everyone 18 years of age and younger.2 All vaccines and associated vaccination devices supporting this effort were donations from the Governments of Australia, India, New Zealand, and Taiwan, who also bore the costs of safe disposal containers and freight, all while navigating the pandemic in their own countries. The high immunisation rate before COVID-19 came onshore was decisive in averting a catastrophe. Comorbidities in Nauru include the highest rates of type 2 diabetes and lung disease found in the world. Living conditions are crowded, multigenerational homes with little separation across compounds. Health facilities have a low surge capacity and transmission of infectious diseases has been swift in the past.

trophe. Comorbidities in Nauru include the highest rates of type 2 diabetes and lung disease found in the world. Living conditions are crowded, multigenerational homes with little separation across compounds. Health facilities have a low surge capacity and transmission of infectious diseases has been swift in the past. Despite rapid community spread since April, 2022, only one COVID-19-induced fatality has occurred in Nauru as of Oct 19, 2022, and in the process, the region has raised resilience to new variants. If rich countries in other parts of the world were to treat their poorer neighbours with the same solidarity, global health would reap rich dividends.