COVID-19 summit a ‘win against complacency,’ but still falls short

Global leaders committed about $3.1 billion in new funding to the global COVID-19 pandemic response on Thursday, among other commitments related to licensing agreements and a generic agreement to lower the price of oral antiviral treatment.

This includes over $2 billion in funding for the immediate response, and $962 million for the new pandemic preparedness and global health security fund at the World Bank. About $2.5 billion came from over 35 governments, and approximately $700 million from the private sector, foundations, and other nongovernmental entities.

These commitments were made at the second global COVID-19 summit — hosted virtually by the United States, Belize, Germany, Indonesia, and Senegal — as countries across the world experience slowing vaccination efforts, plunging testing rates, concerns about inequitable access to antiviral pills, and failed discussions around vaccine intellectual property at the World Trade Organization.

The outcomes of the summit were better than expected and could help revive the global COVID-19 response, Carolyn Reynolds, the co-founder of Pandemic Action Network, told Devex.

“It certainly was a win against complacency, which we’ve seen too much of. It provided a much-needed shot in the arm for both the global COVID response but also importantly, to begin to prepare the world for the next pandemic,” she said.

Still, the funding committed fell far short of the goal set for the conference — which included $10 billion to support access to vaccinations, and $3 billion for access to therapeutics and oxygen.

“Even though it is substantial funding, it is not enough to cover the financing gap,” Javier Guzman, director of global health policy at the Center for Global Development, told Devex.

The big winner: A new global health security fund

World leaders had previously agreed to establish a global health security financial intermediary fund to prepare for future pandemics, which will be established in the coming months at the World Bank.

“It's a global public good that solves the problem of pandemic preparedness funding being too low, too fragmented, too unreliable for too many years,” said Daleep Singh, deputy national security adviser for international economics in Biden’s administration.

A total of $962 million was committed on Thursday as seed funding to the fund. This included $200 million from the U.S.; €50 million ($ 51.9 million) from Germany;  $450 million from the European Union; and £10 million ($12.2 million) from Wellcome.

“Today's commitments are good, but they're just a downpayment on the $10 billion a year needed to seed this fund. So we hope to see more commitments, more of it coming,” said of the WTO Director-General Ngozi Okonjo-Iweala.  

License to fulfill

The U.S. National Institutes of Health also announced that it had finalized a licensing agreement with WHO’s COVID-19 Technology Access Pool and the Medicines Patent Pool for 11 technologies for the development of therapeutics, early-stage vaccines, and diagnostic tools for COVID-19. The agreement is expected to help to encourage more vaccine manufacturing globally.

But participants also voiced concern about the sustainability of existing efforts to ramp up vaccine manufacturing, saying that Gavi, the Vaccine Alliance, is not purchasing COVID-19 vaccines from manufacturers on the African continent, even when they are destined for African countries. South Africa's Aspen Pharmacare expects it might be forced to shut down production of COVID-19 vaccines due to a lack of orders.

“This immediately just devalues the whole process of local manufacturing,” said South African President Cyril Ramaphosa.

Packing Paxlovid

Pfizer’s antiviral drug Paxlovid is not widely accessible, and WHO said in April that “availability, lack of price transparency in bilateral deals made by the producer, and the need for prompt and accurate testing before administering it, are turning this life-saving medicine into a major challenge for low- and middle-income countries.”

At the summit, the Clinton Health Access Initiative announced agreements to make generic versions of this drug “available to low- and middle-income countries at under US$25 per treatment course for treatment of COVID-19 in high-risk patients.”

“... the companies will guarantee production of an affordable generic version of the drug and dedicate capacity for 4.5 million treatment courses per month for low- and middle-income countries covered under their licensing agreements with the Medicines Patents Pool (MPP), pending provision of demand forecasts,” according to the initiative.

ACT-A and other commitments

ACT-Accelerator, which coordinates the global pandemic response, has called for $16.8 billion in grants through September, but prior to the summit it had received less than $3 billion. Of this, only $6.5 million has been allocated toward diagnostics, which is less than 1% of the requested funding. Therapeutics has only received 3.3% of the requested funding.

While the ACT-A Facilitation Council’s finance and resource mobilization working group created a framework of what is fair for countries to contribute, before the summit no country had come close to meeting these targets. Canada announced at the summit that it met this target, providing 732 million Canadian dollars ($561.1 million) in new funding for ACT-A.

Some other key commitments to ACT-A and efforts include the European Union committing €300 million to vaccine delivery, as well as €100 million to the ACT-A pillars on diagnostic, therapeutics, and health systems. France committed to providing €100 million to COVAX, the vaccine sharing initiative, €50 million to ACT-A, and €70 million to strengthen vaccine production capacity in low- and middle-income countries. Spain committed €100 million for COVID-19-related bilateral projects; South Korea committed $300 million for ACT-A; Italy committed €200 million for ACT-A; while Japan gave $500 million to COVAX and $300 million to CEPI.

The Bill & Melinda Gates Foundation committed up to $125 million toward “vaccine research and development, enhanced integrated disease surveillance, workforce capacity development, and expanded access to pandemic tools in low- and middle-income countries.”Open Society Foundation’s Soros Economic Development Fund committed to a $100 million procurement guarantee “designed to strengthen COVAX’s capacity to increase the distribution of COVID-19 vaccines to low- and middle-income countries.” Google donated $150 million in search ads to ensure users are connected to credible sources.

The missing $5 billion 

A major disappointment at the summit was that the U.S. couldn’t add $5 billion for the global COVID-19 response to the conference’s tally, after the U.S. Congress failed to approve the funding. It would have been used to help deliver vaccines and other life-saving tools. On Tuesday, Congress stripped pandemic response funding out of a Ukraine assistance package. U.S. President Joe Biden said he had “been informed by Congressional leaders in both parties that such an addition would slow down action on the urgently needed Ukrainian aid.”

The U.S. has led the COVID-19 vaccination donation efforts, committing to share 1.2 billion doses. At the last summit, Biden committed to delivering these doses by September 2022. But only 45% have been shipped so far. 

Global supply of vaccines currently exceeds demand, but actual vaccinations have been slow.  There is still a need for funding around cold storage of vaccines, workforce, transport in countries, and other delivery logistics — but that funding has slowed.

According to Dr. Ashish Jha, White House COVID-19 response coordinator: “All of this work that we have done, the millions and millions of vaccines we have obtained. All of it is at risk without further funding from Congress funding we requested months ago.”