The questions about ACT-A’s fate come at a time when funding for the global Covid fight is winding down and as governments and major global health organizations turn their attention to other health issues, including pandemic preparedness. This spring, Congress failed to approve $5 billion in funding for the U.S. Agency for International Development to help ramp up vaccination rates in low-income countries. In the EU, work has pivoted to readying the bloc for the next crisis, with a consultation on a new global health strategy launching Monday.
An agenda for a Wednesday meeting of the ACT-A council that provides political leadership for ACT-A states that the last meeting of the council will be in September. Participants are asked to discuss how they want to keep abreast of ACT-A activities “during the transition phase” and how ACT-A can transition to “long-term COVID-19 control.”
Since the beginning of 2022, several countries, including Canada, Norway and Sweden, have pledged billions more to ACT-A — some of which will not be available for use until later in the year, raising questions about what will happen to the money should the consortium sunset.
Over the last two years, the ACT-A consortium has raised more than $23 billion to fund its efforts. And in February, representatives of the consortium asked the world to donate $16.8 billion in 2022 to help end the Covid pandemic. So far, Germany, Sweden, Norway and Canada have promised to pay the amount requested of them. WHO Director General Tedros Adhanom Ghebreyesus on Monday called on others to follow their lead, warning: “Our job is not over. We must ensure that all countries are equipped to fight future waves of Covid-19.”
While wealthy western countries have achieved high rates of distribution and administration of tests, vaccine and therapeutics, many low-income countries have fallen far behind. In Africa, the vaccination rate is 19 percent, according to the Africa Centres for Disease Control and Prevention. In addition, about 22 million tests have been administered in low-income countries — less than 1 percent of the global total, according to ACT-A data. Out of the projected demand of $1.7 billion, only $13 million in Covid drugs have been shipped, according to the latest figures.
Those percentages have been a source of controversy within ACT-A and in the large global health community as people have raised concerns about the consortium’s ability to scale distribution during the pandemic. The Bill & Melinda Gates Foundation recognized those shortfalls in a report almost a year after Covid first emerged.
“This effort is still well short of meeting its goals,” Bill & Melinda Gates Foundation CEO Mark Suzman wrote.
Members of the ACT-A ethics and governance working group also have raised concerns about ACT-A’s governance and accountability. “The roles of the various organizations in ACT-A decision making are unclear, obscuring who might be accountable to whom and for what,” states a January paper in the Lancet, authored by the Graduate Institute of International and Development Studies’ Suerie Moon and other members of the working group.