ACT-Accelerator calls for fair share-based financing of US$23B to end pandemic as global emergency in 2022

World leaders launched on Feb 9, 2022 a call to end the pandemic as a global emergency in 2022 by funding the Access to COVID-19 Tools (ACT) Accelerator, a partnership of leading agencies that is providing low and middle-income countries with tests, treatments, vaccines, and personal protective equipment.

With a significant proportion of the global population still unable to get vaccinated, tested or treated, US$ 16 billion in grant funding is urgently required from governments to fund the work of the ACT-Accelerator agencies. This investment will allow them to procure essential tools to fight COVID-19 and provide them to low- and middle-income countries.

The ACT-Accelerator is calling for the support of higher income countries, at a time when vast global disparities in access to COVID-19 tools persist. Over 4.7 billion COVID-19 tests have been administered globally since the beginning of the pandemic.

However, only about 22 million tests have been administered in low-income countries, comprising only 0.4% of the global total. Only 10% of people in low-income countries have received at least one vaccine dose.

This massive inequity not only costs lives, it also hurts economies and risks the emergence of new, more dangerous variants that could rob current tools of their effectiveness and set even highly-vaccinated populations back many months.

The ACT-Accelerator Facilitation Council’s Finance and Resource Mobilization Working Group, comprised of countries across income groups and chaired by Norway, has agreed a new financing framework to help overcome this inequity. The framework sets out guidance on the ‘fair share’ of financing that richer countries should each contribute to the ACT-Accelerator’s global response. ‘Fair shares’ are calculated based on the size of their national economy and what they would gain from a faster recovery of the global economy and trade.

Supporting the rollout of tools to fight COVID-19 globally will help to curb virus transmission, break the cycle of variants, relieve overburdened health workers and systems, and save lives. With every month of delay, the global economy stands to lose almost four times the investment the ACT-Accelerator needs.

Closing the US$ 16 billion gap facing the ACT-Accelerator will enable the partnership to:

• Drive in-country rollouts to get vaccines into arms, create a Pandemic Vaccine Pool of 600 million doses, support community engagement and cover ancillary costs for donations – contributing to countries’ national vaccination objectives towards the global target of 70% coverage in all countries by mid-2022.
• Purchase 700 million tests – of the total 988 million targeted in the overall ACT-Accelerator budget – and expand sequencing capacity, enabling countries to direct public health measures, deliver more effective ‘test & treat’ strategies, and track how the virus evolves.
• Procure treatments for 120 million patients, as well as 433 million cubic metres of oxygen, including 100% of the oxygen needs of low-income countries.
• Protect 1.7 million health workers with PPE – of the total 2.7 million targeted in the overall ACT-Accelerator budget – as well as budget and monitor ongoing needs in real-time to help identify and address bottlenecks facing rollouts of products.
• Support clinical trials for treatments and vaccines, to help address variants of concern and initiate the development of broadly protective coronavirus vaccines.

Dr Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization, said: “The rapid spread of Omicron makes it even more urgent to ensure tests, treatments and vaccines are distributed equitably globally. If higher-income countries pay their fair share of the ACT-Accelerator costs, the partnership can support low- and middle-income countries to overcome low COVID-19 vaccination levels, weak testing, and medicine shortages. Science gave us the tools to fight COVID-19; if they are shared globally in solidarity, we can end COVID-19 as a global health emergency this year.”

The ACT-Accelerator is asking donor countries to contribute US$ 16.8 billion of the US$ 23.4 billion total budget in immediate grant funding for October 2021 to September 2022 – with all funding figures rounded to the closest decimal. With US$ 814 million of this US$ 16.8 billion already pledged, US$ 16 billion is now needed to close the immediate financing gap.

Closing this immediate US$ 16 billion financing gap would cover the most urgent work of the ACT-Accelerator’s constituent agencies, as set out in the initiative’s Strategic Plan and Budget, published in October 2021. It would cover procurement, research and development, product assessment, and rolling out vaccines, tests, and treatments, meeting the needs of low-income countries and the most vulnerable lower-middle income countries.

The aim is for the remaining US$ 6.5 billion of the US$ 23.4 billion budget to be self-financed by middle-income countries, using domestic resources to cover certain procurement needs, supported by multilateral development banks.

Separate to the ACT-Accelerator budget of US$ 23.4 billion, US$ 6.8 billion is needed for in-country delivery needs of vaccines and diagnostics, from a combination of domestic resources, multilateral development bank support, and further international grant financing support.

Key ACT-Accelerator achievements to date include:

• Funding vital research and development of new therapeutics, vaccines, and diagnostics.
• Supporting the market entry of new, affordable rapid tests.
• Delivering over 1 billion COVID-19 vaccine doses via its vaccines pillar, COVAX, with a huge surge in shipments at the close of 2021, through which more vaccines were shipped in the last quarter of 2021 than in the first 9 months of the year combined.
• Procuring over 200 million tests (as of 10 January), US$ 519 million worth of medical oxygen supplies (as of 31 January 2021), and US$ 764 million worth of personal protective equipment.
• Building capacity to expand the use of next-generation sequencing for genomic surveillance in Southern Africa that enabled the early detection of the Omicron variant.

The ACT-Accelerator Facilitation Council provides high-level political leadership, global advocacy and assistance with resource mobilization to the initiative and is co-chaired by Norway and South Africa. The co-chairs recently wrote to all high-income countries, G20 upper middle-income countries, and two additional middle-income countries who are contributors to the ACT-Accelerator, encouraging ‘fair share’ contributions.

‘Fair share’ contributions were calculated for each of these countries and collectively cover the total immediate grant funding need of US$ 16.8 billion, assuming that the private sector and philanthropic institutions can cover US$ 0.5 billion. For the 2020-21 ACT-Accelerator budget, six countries (Canada, Germany, Kuwait, Norway, Saudi Arabia and Sweden) met or exceeded their fair share commitments.

President Cyril Ramaphosa of South Africa said: “South Africa has proudly co-chaired the ACT-Accelerator Facilitation Council from the very beginning, and we will continue to champion this initiative, as the best solution to the inequities the world – and Africa in particular – faces. As co-chairs, South Africa and Norway have written to more than 50 heads of state and government, asking them to contribute their fair share of financing to ACT-Accelerator agencies. The longer inequitable access to COVID-19 vaccines, tests and treatments persists, the longer the pandemic will persist. I urge my fellow leaders to step up in solidarity, meet their fair shares, and help reclaim our lives from this virus.”

Prime Minister Jonas Gahr Støre of Norway said: “What we have learned from this pandemic is that it can’t be fought off by countries working alone. A broad collective effort is required. A fully financed ACT-Accelerator is in the mutual interest of all countries. As co-chair of the ACT-Accelerator, we call upon the world’s leaders to join us in acting urgently because as we’ve seen time and time again throughout this pandemic – no-one is safe until everyone is.”