New ACT-Accelerator strategy calls for US$23.4 billion international investment

The Access to COVID-19 Tools (ACT) Accelerator has today launched its strategic plan and budget for the next 12 months, outlining the urgent actions and funding needed to address deep inequities in the COVID-19 response, save millions of lives and end the acute phase of the pandemic.

Inequitable access to COVID-19 tests, treatments and vaccines is prolonging the pandemic everywhere and risking the emergence of new, more dangerous variants that could evade current tools to fight the disease. So far, only 0.4% of tests and 0.5% of vaccines administered worldwide have been used in low-income countries, despite these countries comprising 9% of the global population.

The ACT-Accelerator partnership of leading global health agencies needs US$23.4 billion to help the most at-risk countries secure and deploy COVID-19 tools between now and September 2022. This figure pales in comparison to the trillions of dollars in economic losses caused by the pandemic and the cost of stimulus plans to support national recoveries.

The new strategic plan, which integrates key findings of the recent Strategic Review, will see the ACT-Accelerator leverage its progress to date, to shift to a more targeted focus on addressing access gaps in underserved countries, delivering vaccines, treatments, tests and personal protective equipment where they’re most needed.

Fully funding the new strategic plan and budget will enable the partnership to:

• Support the vaccination objectives of 91 lower-income countries in the COVAX Advance Market Commitment (AMC) and other countries, by delivering sufficient doses and supporting vaccination campaigns to achieve 43% coverage in AMC countries – contributing to the global target of 70% coverage in all countries by mid-2022.
• Assist the 144 countries in the Diagnostics Consortium in reaching a minimum testing rate of at least 1 per 1000 people per day, and ensuring sufficient genetic sequencing capacity globally to rapidly detect new variants of concern.
• Ensure 120 million COVID-19 patients in low- and middle-income countries have access to existing and emerging treatments, including medical oxygen.
• Keep 2.7 million health workers in low- and middle-income countries safe with personal protective equipment (PPE).

Dr Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization, said: “To end the pandemic, governments, manufacturers and donors must fully fund the ACT-Accelerator to address inequities in access to COVID-19 vaccines, tests and treatments. In focusing its energies on addressing the great equity gap for these tools, the ACT-Accelerator is bolstering its role as an ally for countries side-lined by market forces in securing life-saving interventions. Fully funding the ACT-Accelerator is a global health security imperative for us all – the time to act is now.”

The ACT-Accelerator’s plan to address inequities in access to COVID-19 vaccines, tests, and treatments will help avert more than 5 million potential deaths. It is also essential to the global economic recovery. The International Monetary Fund (IMF) estimates a loss of US$5.3 trillion in global revenues by 2026 if large parts of the world remain unprotected from COVID-19.

The ACT-Accelerator Facilitation Council provides high-level political leadership and advice on global advocacy and resource mobilization to the initiative, and is co-chaired by Norway and South Africa.

President Cyril Ramaphosa of South Africa said: “South Africa welcomes the launch of this new strategic plan, which seeks to address the escalating inequities in the global COVID-19 response. Nowhere is this inequity more apparent than on the African continent, where just 8% of the population has received a single dose of COVID-19 vaccine. Every delay in fully funding the ACT-Accelerator will see the pandemic prolonged, more lives will be lost and more livelihoods will be devastated. We need equitable access now to COVID-19 treatments, tests and vaccines, and this is a plan to achieve that.”

Prime Minister Jonas Gahr Støre of Norway said: “While a new normal is emerging for people who have access to COVID-19 tools, this is still a distant prospect for the majority of the world’s population. Without access to COVID-19 tools, we will not be able to achieve full economic and social recovery. The new ACT-Accelerator strategy is key to address inequities in access to COVID-19 tools. This is a collective effort. Now we must ensure inclusive and effective implementation.”

The new strategic plan integrates key recommendations from an independent Strategic Review of the ACT-Accelerator that was published on 8 October 2021, including to extend the mandate of the ACT-Accelerator, enhance focus on delivery, and to further strengthen engagement with low- and middle-income countries and civil society organisations to maximise impact.

A key element of the new plan is the reconfigured Health Systems & Response Connector (HSRC). The connector will ensure closer engagement with countries and that they have the necessary technical, operational, and financial resources to deploy tools.

From research to rollout, the ACT-Accelerator remains the world’s only end-to-end solution for accelerating the development and fair distribution of COVID-19 tools. Through the COVAX pillar – led by Gavi, CEPI and WHO, alongside UNICEF as key delivery partner – and the Diagnostics Pillar – led by FIND and the Global Fund – the ACT-Accelerator is working to address challenges of equitable access and to help the world meet the global targets of 70% vaccination coverage by mid-2022 and minimum testing rates of at least 1 per 1000 people per day in 2022.

Through the Therapeutics Pillar – led by Unitaid and Wellcome – the ACT-Accelerator is working to provide treatments for up to 120 million COVID-19 cases expected in the next 12 months in low-income countries, lower middle-income countries and underserved upper middle-income countries, focused on equitable access to effective tools, including existing and potential new treatments and medical oxygen. The Health Systems & Response Connector priorities for the next year include connecting countries with financing, tracking needs in real time, and addressing surge staffing requirements for vaccine rollouts, with work being led by the Global Fund, the World Bank, WHO, with UNICEF and the Global Financing Facility as implementing partners.

The ACT-Accelerator’s impact so far includes:

• Delivering more than 425 million vaccine doses to 144 countries and territories through COVAX;
• Halving the cost of COVID-19 rapid tests, transferring technology to low and middle-income countries, and delivering more than 128 million tests through the Diagnostics Consortium;
• Increasing essential oxygen, personal protective equipment (PPE) and treatment supplies, including through the advance purchase of nearly 3 million doses of dexamethasone and more than US$4 billion worth of support from the Global Fund’s COVID-19 Response Mechanism (C19RM).

​To provide enough vaccines, tests and treatments for distribution to all in need, the ACT-Accelerator has also helped build a robust development pipeline of COVID-19 tools through investments in areas from research and clinical trials to product development, rapid regulatory approvals and market shaping.