SEATTLE, Washington — The COVID-19 pandemic, from one view, has illustrated the perils of the interconnected and globalized world. A disease that sprouted in a Wuhan wet market has circled the globe, killing 1.4 million people in the process. Some countries, in response, have eschewed international organizations and tried to reduce their dependence on multinational supply chains. In the global health arena, however, the response to the COVID-19 pandemic has illustrated the great potential of international cooperation. Here is some information about how the COVID-19 pandemic has united the biggest international health organizations.
The Access to COVID-19 Tools (ACT) Accelerator
The Access to COVID-19 Tools (ACT) Accelerator, an alliance of governments, international health organizations, civil society organizations and industry partners, is groundbreaking in scope and ambition. Founded in April with the overarching goal of speeding up the end of the pandemic, its partners and international health organizations include CEPI, GAVI, the Global Fund, UNITAID, FIND, Wellcome, the Gates Foundation, the World Bank and the World Health Organization (WHO). These partners bring billions of dollars of collective investment and enormous reserves of expertise to the issue, attacking the pandemic through four pillars: diagnostics, therapeutics, vaccines and health system strengthening.
Diagnostics: Managing the Course of the Pandemic
Early on in the course of the pandemic, the importance of rapid and effective testing became clear. Advanced economies that rapidly developed and mobilized diagnostic tests, such as Germany and South Korea, were able to control the first wave of COVID-19 cases while countries without comprehensive testing strategies struggled. The diagnostics pillar of the Accelerator seeks to bring these crucial tools to low and middle-income countries (LMICs). Its leaders are FIND, which has supported 50 million product launches in LMICs over the past five years, and the Global Fund, which has honed its procurement and delivery acumen by fighting malaria, HIV and tuberculosis. A number of other partners, including Unitaid and the Gates Foundation, are also participating.
So far, the diagnostics arm of the Accelerator has dramatically expanded access to laboratory tests. In fact, 17 million laboratory tests have undergone procurement for distribution and the WHO Emergency Use Listing Procedure has added 18 types of tests. In September 2020, the Accelerator also broke ground on new front in the diagnostic campaign: antigen-based rapid diagnostic tests (RDTs). These tests give results in just 15-30 minutes and cost as little as $5 per unit, hopefully allowing for broad-based testing in developing countries. The Gates Foundation secured the supply of 120 million RDTs, and the Global Fund subsequently committed $50 million to fund initial orders for LMICs. Sarah Sheppard, the Communications Lead for the ACT-Accelerator at WHO, told The Borgen Project that the division of roles within each pillar exemplifies how each partner is able to “play to their strengths.”
Therapeutics: Finding Diamonds in the Rough
Unlike the diagnostic pillar, the therapeutics pillar demanded a significant amount of R&D before it could reach a breakthrough. In June 2020, research revealed that dexamethasone, a common steroid, could save the lives of some severely ill COVID-19 patients. The study that revealed the drug’s potential received partial funding from Wellcome and the Gates Foundation. These two organizations, along with Unitaid, lead the ACT-Accelerator’s therapeutics pillar.
Shortly after the release of those study results, Unitaid purchased millions of oral and injectable doses of dexamethasone to bolster LMIC’s treatment abilities. UNICEF, an example of one of the Accelerator’s ancillary civil society partners that contributes to the venture’s progress, joined Unitaid. Additionally, Wellcome is closely monitoring the results of over 1,700 clinical trials, while Unitaid is prepared to promptly acquire novel treatments, such as monoclonal antibodies and antivirals if the trials deliver promising results. The organizations are laying a foundation that is delivering dividends today and will continue to do so even as the next pillar transforms the pandemic landscape.
Vaccines: How the Pandemic Ends
An effective coronavirus vaccine has been on the minds of pandemic-weary citizens since COVID-19 emerged. In early November 2020, Moderna and Pfizer (along with its partner BioNTech) announced results from their COVID-19 vaccine trials demonstrating 95% efficacy. Moderna, along with AstraZeneca, which announced that its vaccine was 90% effective in late November, is a member of CEPI’s vaccine portfolio. In other words, CEPI has partnered with these companies and provided crucial funding; in AstraZeneca’s case, CEPI gave $380 million.
The vaccine portfolio will stay active as other companies catch up to the current leaders. Simultaneously, Accelerator partners are preparing to equitably distribute vaccines — and have been since the vaccine trials began. The COVID-19 Global Vaccine Access Facility (Covax) has convinced 161 countries to pool their resources and share risk to distribute a vaccine worldwide. The first building block of Covax is the Gavi Advanced Market Commitment, which directs manufacturers to install capacity sufficient to produce two billion doses of vaccine by the end of 2021. This is an ambitious goal, but the groundbreaking pace of vaccine discovery shows that ambition is in no short supply throughout the international pandemic response.
WHO and the Underpinning Principles
The last pillar of the Accelerator, strengthening health systems, cuts across the other three by focusing on the health environments within individual LMICs. This division provides PPE and oxygen, identifies potential bottlenecks and gaps in capacity, and generally supports the delivery of COVID-19 tools. Another unsung hero of the ACT-Accelerator is the Access & Allocation workstream. Led by WHO, this group is the ultimate conscience of the endeavor, striving for equitable access and allocation for all of the COVID-19 tools that emerge from the pillars.
In Sheppard’s view, this undertaking was perfect for WHO, as equity is a fundamental principle of the organization. WHO also hosts the ACT-Accelerator Hub, a support structure that presents unified information about all four pillars and compiles a consolidated investment case for the Accelerator. The most recent investment case reports that the Accelerator needs an additional $35 billion in addition to what others have pledged in order to accomplish its full goals. This number is less than 1% of the total value of stimulus packages G20 countries have passed since the start of the pandemic. Therefore, if the world’s rich governments and international health organizations hope to escape this pandemic without further losses, redoubling their commitments to the ACT-Accelerator would be a safe bet.
– Jack Silvers