New ACT-Accelerator strategic plan sets out urgent actions to address crucial gaps in access to COVID-19 tests, treatments, vaccines and personal protective equipment in low- and middle-income countries, using the latest epidemiological, supply and market information.

Delivering this plan is crucial to reaching globally agreed targets for COVID-19 tools, to help prevent at least 5 million potential additional deaths, save the global economy more than US$5.3 trillion, and accelerate the end of the pandemic everywhere.

The ACT-Accelerator needs US$23.4 billion until September 2022 to implement this plan, reflecting a fresh scope, advances in science and supply, and new actors joining the pandemic response.

The new plan also responds to the recent independent Strategic Review’s key recommendations and will be implemented alongside global health, government, civil society and private sector partners.

GENEVA, 28th October 2021 – 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.

QUOTE SHEET

Carl Bildt, WHO Special Envoy for the ACT-Accelerator, said: “Fully funding the ACT-Accelerator is the best way for the world to avert further economic losses caused by the pandemic. Vaccine inequity kills. Efforts on tests and treatments are seriously underfunded, blinding and weakening us in fighting this virus. We have the tools to end this pandemic, but they will only succeed in doing so if every community in every country has access to them. Equitable pandemic policy is also good economic policy and will help minimise the costs of this crisis. The time for warm words is over, the deadline to act is now.”

Dr Richard Hatchett, CEO of CEPI, said: “The pandemic is far from over so the ACT-Accelerator, as the only global initiative dedicated to equitable access, remains critical to global health security. However, the ACT-Accelerator cannot deliver on its promises unless it receives dramatically more funding. The global community must step up and support our mission to get life-saving tools to people who need them, wherever they are in the world, so we can finally put an end to this pandemic.”

Dr Bill Rodriguez, CEO of FIND, said: “The ACT-Accelerator has made critical updates to its strategy and plan to confront the COVID-19 pandemic. These changes acknowledge the reality of the two-track pandemic we are now fighting, and the ongoing inequity of access to the tests, treatments, and vaccines that were so quick to be developed and so slow to reach billions of people. It is also clear that no single tool is a panacea – while the roll out of vaccines must continue, it is equally important to hit the new testing targets so that we can track and defeat variants, break chains of transmission, and link people to new treatments and life-saving care.”

Dr Seth Berkley, CEO of Gavi, the Vaccine Alliance, said: “It is vitally important that governments, donors, industry and others support the ACT-Accelerator and its efforts to remedy the inequity in access to vaccines, diagnostics, and treatments. In 2022, COVAX will be supporting countries’ vaccination objectives, focusing particularly on those that rely on it for access to safe and effective vaccines. We have seen the consequences of not having resources in place to make deals for doses: with the race to secure doses for 2022 already underway, early funding will be essential to ensuring COVAX participants can achieve equitable coverage.”

Peter Sands, Executive Director of the Global Fund, said: “Inequity in access to COVID-19 tools remains unacceptably high while we face new variants, acute oxygen shortages and the urgent need to protect health workers in low- and middle-income countries. Only by fully funding the ACT-Accelerator and working even more closely with the countries and communities can we fill those gaps and make vaccines, personal protective equipment, tests and treatments accessible to everyone. As long as the poorest are left behind, the pandemic will not go away and any progress against COVID-19 will be at risk."

Henrietta Fore, Executive Director of UNICEF, said: "The pathway out of the pandemic is paved by equal access to vaccines, treatments and tests. Until we achieve this, we all remain at risk. UNICEF is delivering these vital supplies where they are most needed, and helping countries prepare for their vaccination efforts. However, we cannot do this without the help and support of our donors and partners. Together, we can stop the pandemic from continuing to upend the lives of children and their families everywhere."

Dr Philippe Duneton, Executive Director of Unitaid, said: “To fight COVID-19 we need medicines such as oral antivirals, tests and vaccines. Unitaid, the co-lead of the ACT Accelerator’s Therapeutics Pillar, is committed to rapidly bring state-of-the-art treatments to those in need, when approved by WHO. Getting new lifesaving medicines available to low- and middle-income countries at the same time as they come to wealthy countries, is not just key to speeding up an end to the pandemic; it’s a moral imperative. For that we need to create a quality generic market.”

Juan Pablo Uribe, Global Director for Health, Nutrition and Population, World Bank; Director for Global Financing Facility (GFF), said: “The World Bank is an active partner of ACT-A and we fully support the newly restructured Health Systems & Response Connector (HSRC). While vaccines, tests and treatments are key to fight the pandemic, it is as important to help countries be able to effectively deploy these tools to the people who need them. That’s what the HSRC will be focusing on.”