“Without ACT-A, it is virtually guaranteed that low-income countries will be left without adequate supplies of vaccines, diagnostics and treatments that can save lives,” said Jenny Ottenhoff, senior political director for global health at the ONE campaign. “ACT-A was never intended to be a long-term solution, but there is no point in phasing it out until the entire world is ready to transition to a longer-term sustainable response to the virus.”
In a series of recent calls, representatives of the consortium discussed the possibility that the current ACT-A will end or transition in September, two people familiar with the matter said. The calls focused on the future distribution of Covid tests, vaccines and therapeutics, and whether any part of the program would exist after that time, people said. One person described how ACT-A is already transitioning with fewer meetings between persons involved in its coordination. There are also questions about whether something similar to ACT-A will be created to prepare for the next health crisis.
“There seems to be a pretty clear consensus that the ACT-A that we knew about would not exist next year,” said one person familiar with the matter.
An ACT-Accelerator spokesperson said the support provided by the ACT-A agencies will continue, albeit probably in a different form.
“Because the pandemic is not over yet, ACT-A’s work to expand equal access to COVID-19 tools will continue. As countries move from managing COVID-19 as an acute emergency to integrating into long-term disease control programs,” the spokesperson said in a statement, adding that the consortium’s strategic plan was always meant to end in September. “In this context, work is underway to develop a management plan for this transition.”
WHO, along with the European Commission, France and the Bill & Melinda Gates Foundation, formed a consortium in 2020 with organizations such as Gavi, the Vaccine Alliance, the Coalition for Epidemic Innovation and Preparedness, and the Wellcome Trust tasked with taking the lead. to ensure access to vaccines, diagnostics and therapy.
Questions about the fate of ACT-A are emerging at a time when funding for the global fight against Covid is dwindling and governments and major global health organizations are turning their attention to other health issues, including pandemic preparedness. This spring, Congress failed to approve $5 billion in US Agency for International Development funding to help boost vaccination rates in low-income countries. In the EU, work has focused on preparing the bloc for the next crisis, and consultations began on Monday on a new global health strategy.
An Wednesday meeting agenda The ACT-A Council, which provides political leadership to ACT-A, says the last meeting of the council will take place in September. Participants are asked to discuss how they want to be aware of ACT-A’s activities “in transition” and how ACT-A can move towards “long-term control of COVID-19”.
Since early 2022, several countries including Canada, Norway and Sweden have pledged additional billions to ACT-A, some of which will not be available for use until the end of the year, raising questions about what will happen to the money if the consortium declines.
Over the past two years, the ACT-A consortium has raised over $23 billion to fund its efforts. And in February, the consortium asked the world to donate $16.8 billion in 2022 to help end the Covid pandemic. So far, Germany, Sweden, Norway and Canada have pledged to pay the amount demanded of them. WHO Director-General Tedros Adhanom Ghebreyesus on Monday urged others to follow suit, warning: “Our work is not over yet. We must ensure that all countries are equipped to deal with future waves of Covid-19.”
While wealthy Western countries have achieved high rates of distribution and uptake of tests, vaccines, and therapeutics, many low-income countries have lagged far behind. Africa’s vaccination rate is 19 percent, according to the African Centers for Disease Control and Prevention. In addition, some 22 million tests have been carried out in low-income countries. less than 1 percent global total, according to ACT-A. Of the projected demand of $1.7 billion, only $13 million. in Covid medicines were sent, according to latest data.
These percentages have been a source of controversy within ACT-A and in the larger global health community, as people have raised concerns about the consortium’s ability to scale distribution during a pandemic. The Bill & Melinda Gates Foundation acknowledged these shortcomings in a report nearly a year after Covid first emerged.
“It’s an effort still short achieve their goals,” wrote Mark Suzman, CEO of the Bill & Melinda Gates Foundation.
Members of the ACT-A Ethics and Governance Working Group have also raised concerns about ACT-A’s governance and accountability. “The roles of various organizations in ACT-A decision making are unclear, making it unclear who can be accountable to whom and for what.” says a January article in the Lancetauthored by Syuri Moon of the Graduate Institute for International and Development Studies and other members of the working group.