Maverick Citizen


‘Solidarity, Solidarity, Solidarity’: The ACT Accelerator and the US$8-billion to fight Covid-19

‘Solidarity, Solidarity, Solidarity’: The ACT Accelerator and the US$8-billion to fight Covid-19
The Covid-19 contagion has brought about a global gut-punch realisation: that health systems in even the wealthiest countries need shoring up, says the writer. (Photo: / Wikipedia)

On 4 May, some of the world’s major global health actors and political powers joined forces and pledged close to $8-billion (€7.5-billion) within a few hours to accelerate the development, production and equitable access to Covid-19 vaccines, diagnostics and therapeutics.

The Coronavirus Global Response pledging conference came on the heels of the 24 April launch of the ACT (Access to Covid-19 Tools) Accelerator, which the $8-billion will fund. (The United States was, unsurprisingly, absent from this collaboration, given its ongoing spat with the World Health Organisation.)

The Accelerator defines the agreement-in-principle to collaborate on the development, production and equitable access to everything that is needed to prevent, detect, and treat Covid-19, and future coronaviruses (or other pandemics) to come. Its main purposes are to hasten – through collaboration – the development of these tools, to rapidly scale up their production when they are ready, and to ensure that the world’s poorest nations, along with the richest, have equitable access to them.

The ACT agreement was signed by 25 countries, and launched under the leadership of the WHO, with European Commission President Ursula von der Leyen, French President Emmanuel Macron, Melinda Gates, and WHO Executive Director Dr Tedros Adhanom Ghebreyesus (the author of the ‘solidarity’ rallying cry) headlining the event.

The pledging conference, just 10 days after the Accelerator launch, was convened and moderated by EC President von der Leyen (a quote from an EU development expert called it a “Eurovision for multilateralism”) and over €4-billion was pledged by EU countries, as well as Japan, Norway, Canada, South Africa, and others. (The US again, unsurprisingly, did not participate, nor did China or Russia.)

Why is this significant? To some, this may look like yet another international organisation talk-shop whose concrete actions are hard to discern – and it is true that the finer points of how funds will be distributed are still to be announced. But this is, to use a much overused word lately, an unprecedented event in the world of global health.

Three things stand out here. First, the speed with which this has happened. Anyone familiar with the global health sector is familiar with multilateral pledging conferences – they are hardly a new phenomenon. (The international media do seem rather breathless about it, though, never having paid enough attention to the replenishments of organisations like the Global Fund and Gavi, the Vaccine Alliance, which will distribute an eventual Covid-19 vaccine.) But normally (in the old ‘normal,’ that is) an event of this scale takes months, if not years, to set up, with protracted bilateral discussions between donors and those raising the funds, to strategise and jostle toward a tacit agreement about what will finally be pledged at a later, much-hyped, heavily publicised conference. Now, galvanised into action by the devastating speed with which this coronavirus is affecting everyone, everywhere, donors are reacting with a velocity commensurate to the pandemic’s trajectory.

The second stand-out feature is the alacrity with which most – if not the biggest – of the world’s most prominent political and economic powers are embracing a collaborative, comprehensive approach to all aspects of the pandemic, all the while staunchly supporting the beleaguered WHO as the leader of this effort – as it should be. Decades of under-funding, under-appreciation and undermining by several of the WHO’s most prominent members laid the very foundations for inadequate global pandemic preparedness and has resulted in the WHO being cornered into a position of damned-if-you-do, damned-if-you-don’t.

The third remarkable feature of this – unarticulated certainly in the popular media – is the role of the Global Fund to Fight AIDS, TB and Malaria in this effort. (The Global Fund finances about $4-billion worth of programs to fight the three diseases in 110+ countries.) Practically, the Global Fund will co-lead, with Unicef, the Diagnostics Consortium, which will negotiate pricing, and procure molecular diagnostic tests for Covid-19, on behalf of countries and partners. (Separately, the Global Fund had already dedicated the equivalent of $1-billion towards the Covid-19 response, in a combination of ‘flexibilities’ to reprogramme savings/underspent funds in existing Global Fund grants, worth $500-million, and new funding of another $500-million through the Covid-19 Response Mechanism, to which implementing countries can apply.)

Ideologically, the world seems finally to be grasping the fact that the Global Fund is a very different – and highly effective – type of global-health financing instrument; one that is capable of deploying funds to where they are needed most with greater (if not perfect) speed and efficiency, and much less waste, than any previous resource of this kind. (All of its funding goes to countries, with the Geneva HQ’s relatively tiny overhead paid for by interest on the capital.) Its creation in 2001 was spurred by the inequitable access to funding for antiretroviral treatment in the developing world. HIV/AIDS became a manageable chronic disease in the wealthy ‘north’, while it remained a death sentence in the poorer ‘south’, because those countries could not afford the medication to treat it.

Though the Fund has been at pains in recent years to confirm that it is not changing its mandate to fight the pandemics of HIV/AIDS, TB and malaria, the Covid-19 pandemic is exemplifying the concept that everything is interconnected. Donor funding of individual disease programmes can be impactful but is not optimal, and countries competing voraciously for scarce medical supplies – with the result that poorer ones can’t obtain them – does not serve the global good. The Covid-19 contagion has brought about a global gut-punch realisation: that health systems in even the wealthiest countries need shoring up, and this may be what it takes to start to dissolve the boundaries that have underpinned global inequities for far too long.

On May 4, WHO’s Dr Tedros said, “The ultimate measure of success will not be how fast we can develop tools – it will be how equally we can distribute them.” The fact that this is a primary goal of the ACT Accelerator is a sign, as the Economist said, “that the grown-ups are coming to the table”. And lest it escape no one, a few of the children are not. DM/MC

Adèle Sulcas writes about global health and food systems. She worked previously at the Global Fund to Fight AIDS, TB and Malaria, and the World Health Organisation, and is former Editor of the Global Fund Observer. A version of this article will also be published in International Health Policies,


"Information pertaining to Covid-19, vaccines, how to control the spread of the virus and potential treatments is ever-changing. Under the South African Disaster Management Act Regulation 11(5)(c) it is prohibited to publish information through any medium with the intention to deceive people on government measures to address COVID-19. We are therefore disabling the comment section on this article in order to protect both the commenting member and ourselves from potential liability. Should you have additional information that you think we should know, please email [email protected]"

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