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ACT-Accelerator releases prioritised strategy and budget for 2021 to change the course of the evolving COVID-19 pandemic

Launched in April 2020 by the World Health Organization (WHO), European Commission, France and The Bill & Melinda Gates Foundation, the ACT Accelerator is a partnership of leading public health agencies with equity at its heart.

In under a year, the ACT Accelerator has driven real progress to accelerate the end of the COVID-19 pandemic. It has accelerated the development of COVID-19 tests, treatments, vaccines and health systems and transformed the ability to tackle COVID-19 on a global scale, but only if the world can ensure the equitable distribution of these vital tools.

However, the world continues to face an unprecedented and rapidly evolving threat from COVID-19. Three major shifts in the pandemic and the operating environment for the ACT Accelerator have necessitated a refresh of ACT Accelerator priorities, financing requirements, and investment case. First, COVID-19 vaccines are now available, but face acute supply constraints. Second, virus variants are emerging with increasingly concerning characteristics. Third, despite valuable support from governments, regulators, manufacturers, and other stakeholders, there has been insufficient investment in global solutions to scale COVID-19 tools.

The ACT-Accelerator is well positioned to respond to these challenges. In 2020, a substantial focus was on developing and evaluating a sound product portfolio by investing in R&D, product assessment, and market shaping, while laying the groundwork for large-scale procurement and in-country delivery. Now that an initial set of effective and affordable COVID-19 tools is available, resources are increasingly focused on optimizing their public health impact. In 2021, ACT Accelerator aims to fully leverage these existing tools and available volumes, then expand manufacturing, while continuing to invest in further R&D and product optimization.

The original ACT-Accelerator investment case published in September 2020 outlined a total requirement of US$ 38.1 billion to fully fund its work. Based on the refreshed strategic priorities outlined above, the Pillars have adjusted their resource needs. Despite generous donor contributions amounting to US$ 11.0 billion to date, ACT Accelerator continues to require an additional US$ 22.1 billion in 2021 to deliver on its full promise, and fund its vital work to deliver over 2 billion doses of vaccines, 900 million tests and up to 100 million of new treatment courses. The publication of a more detailed Strategy and Budget outlines the detail behind these numbers.

Tackling COVID-19 requires substantial financial investments, but the financial and economic ramifications of inaction are far greater. In January 2021, a study commissioned by the International Chamber of Commerce demonstrated that even with strong COVID-19 vaccine coverage in high-income countries, inequitable access to COVID-19 tools elsewhere would cost high-income economies an additional US$ 2.4 trillion in 2021 alone. Investing in ACT Accelerator dwarfs the potential multiplier benefits of domestic fiscal support investments. If COVID-19 transmission is uncontrolled anywhere in the world, it remains a threat to everyone everywhere in the world.

Commenting on today’s release of the Strategy and Budget, Dr Tedros Adhanom Ghebreyesus, Director-General of WHO, said: “The ACT Accelerator has made strong progress. But new viral variants, limited vaccine supply, and underinvestment have resulted in the need to refresh the strategy and budget that chart the roadmap out of the pandemic. As we approach the one-year anniversary of the ACT Accelerator, we call on all nations to come together in global solidarity. It isn’t just the right thing to do, it is also the fastest and most effective way to save lives, protect health systems and restore economies.”  

Dr Richard Hatchett, CEO of CEPI, said: “In recent weeks COVAX has begun to turn the tide on the early inequity of the global vaccine rollout. However, with the increased spread of COVID-19 variants, we have entered a new and less predictable phase of the pandemic. It is crucial that the vaccines we have developed are shared globally, as a matter of the greatest urgency, to reduce the prevalence of disease, slow down viral mutation, and bring the pandemic to an end. And in parallel, we must redouble our R&D efforts so we have the tools we need to tackle emerging variants of the virus.” 

Emma Hannay, Chief Access Officer & ACT-Accelerator Lead for FIND, said: “In less than a year, the ACT-Accelerator partnership has spurred the development and delivery of affordable, reliable rapid tests, scaled up manufacturing, and reserved important volumes for LMICs. But while we are moving quickly, so is the virus: the emergence of new variants across the globe underscores the ongoing need for equitable access to testing and strong surveillance systems so that we are not flying blind as the pandemic evolves. Detection of flare-ups and hotspot is key to stop case numbers from rebounding during vaccine roll out.”

Dr Seth Berkley, CEO of Gavi, The Vaccine Alliance, said: “Thanks to the US$6 billion committed by its donors to date, the Gavi COVAX Advance Market Commitment has been able to begin protecting at-risk groups in lower-income countries with life-saving COVID-19 vaccines. While our work is only just beginning, we can now see the benefits of a multilateral solution to this pandemic. I encourage countries and others to continue to support the ACT Accelerator’s critical mission across all pillars,” said Seth Berkley, CEO of Gavi, the Vaccine Alliance.”

Peter Sands, Executive Director of The Global Fund, said: “The ACT-Accelerator partnership has achieved major progress in less than a year, including the procurement of over 50 million COVID-19 tests for low- and middle-income countries. However, we now face a tough battle as new variants emerge, taking us into unknown terrain. Reducing inequities in testing is a critical, if we are to succeed in containing the spread of the virus and monitoring the emergence of new variants. We must continue to scale up the availability and deployment of rapid and affordable tests to support countries in their response to a fast-evolving pandemic.”

Henrietta Fore, UNICEF Executive Director, said: “As the production and availability of the COVID-19 vaccines ramp up, the revised strategy will ensure that countries have the resources and support they need to administer them equitably. As UNICEF supports this historic initiative, we will also continue focusing on other essential maternal and child health services, including immunization, which are critical to saving lives while we work to turn the tide on the pandemic.”

Dr Philippe Duneton, Unitaid Executive Director, said: “This new strategy reflects the epidemiological reality we are all now facing – a mutating virus that doesn’t respect national borders, which threatens the effectiveness of the tools we have to fight this pandemic. Now is the moment to push ahead with a firm commitment to equitable access for all to the treatments and tests we need to defeat COVID-19, alongside the roll-out of vaccines. Research and development, country-preparedness and the procurement of proven treatments, including medical oxygen, will all be vital in the months to come.”

We must ACT now, and ACT together, to end the acute phase of the pandemic.


Notes to Editors

The Access to COVID-19 Tools ACT-Accelerator, is the proven, up-and-running global collaboration to accelerate the development, production, and equitable access to COVID-19 tests, treatments, and vaccines. It was set up in response to a call from G20 leaders in March and launched by the WHO, European Commission, France and The Bill & Melinda Gates Foundation in April 2020.

The ACT-Accelerator is not a decision-making body or a new organization but works to speed up collaborative efforts among existing organizations to end the pandemic. It is a framework for collaboration that has been designed to bring key players around the table with the goal of ending the pandemic as quickly as possible through the accelerated development, equitable allocation, and scaled up delivery of tests, treatments and vaccines, thereby protecting health systems and restoring societies and economies in the near term. It draws on the experience of leading global health organizations which are tackling the world’s toughest health challenges, and who, by working together, are able to unlock new and more ambitious results against COVID-19. Its members share a commitment to ensure all people have access to all the tools needed to defeat COVID-19 and to work with unprecedented levels of partnership to achieve it.

The ACT-Accelerator comprises four pillars: diagnostics, therapeutics, vaccines and health system strengthening. 

  • The diagnostics pillar co-convened by the Global Fund and FIND is focused on ensuring equitable access to new and existing tests, supporting country uptake and deployment and strengthening the diagnostic portfolio with R&D investments in low-cost, easy-to-use and quality tests. In 2021, it is focused on procuring and distributing at least 900 million molecular and AG-RDTs to LMICs.
  • The therapeutics pillar is led by Unitaid and Wellcome. Therapeutics can play a role in all stages of COVID-19 disease: to prevent infection; suppress symptoms and spread of infection to others; treat or prevent symptoms; as a life-saving treatment for severe symptoms; and as a treatment that can speed up recovery. The aim in the next 12 months is to develop, manufacture and distribute millions of treatment doses, helping COVID-19 sufferers to recover from the disease.
  • The vaccines pillar, convened by CEPI, Gavi and WHO, is speeding up the search for an effective vaccine for all countries. At the same time, it is supporting the building of manufacturing capabilities, and buying supply, ahead of time so that at least 2 billion doses can be fairly distributed to the most high risk and highly exposed populations globally by the end of 2021.
  • The health systems connector pillar, led by the World Bank, the Global Fund and WHO, is working to ensure that these tools can reach the people who need them.
  • Cross-cutting all of these is the workstream on Access & Allocation, hosted by the World Health Organisation (WHO).

Since April 2020, the ACT-Accelerator has supported the fastest, most coordinated, and successful global effort in history to develop tools to fight a disease. With significant advances in research and development by academia, private sector and government initiatives, the ACT-Accelerator has advanced our understanding of what works to fight the disease. It has transformed our ability to tackle COVID-19 on a global scale: vaccines are poised to roll-out worldwide, low-cost high-performing antigen rapid diagnostic tests can now detect transmission anywhere, affordable therapy for severe disease can save lives in any setting, and health systems are being prepared for the roll out of tools.

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