Devex CheckUp: What ACT-A’s new strategy can’t ignore

With the Access to COVID-19 Tools Accelerator expected to launch a new strategy in the coming weeks, experts say the multilateral mechanism needs to more meaningfully engage with low- and middle-income countries and with civil society organizations if it is to address inequities around access to COVID-19 technology.

• Fifa Rahman, a civil society representative with ACT-A, says a key drawback of the mechanism is “the failure to integrate LMIC expertise in equal intellectual partnership.” In addition, she highlights a misunderstanding around meaningful civil society engagement, which she says is not just about having access to meetings

• A recent independent review of ACT-A also underlined the need to build countries’ capacity to make COVID-19 tools available. Experts welcome this but said ACT-A also needs to make sure there are tests, vaccines, and treatments available in a timely manner — a challenge so far for COVAX, its vaccine distribution arm, which revised its 2021 supply forecast down by 30% last month to just 1.4 billion doses.

• The biggest challenge for ACT-A is funding. It will need over $20 billion in the next 12 months, according to Dr. Bruce Aylward, who coordinates ACT-A’s work. This money will be crucial to get not just vaccines, but also new treatments such as Merck’s molnupiravir — which the company hopes will be the first oral antiviral drug approved to treat COVID-19, following promising results from a phase 3 clinical trial analysis.

• Richard Hatchett, CEO at CEPI, says ACT-A won’t be able to deliver on its promises “until it receives dramatically more funding.” But raising enough resources has been one of its biggest failures. ACT-A still has a deficit of over $16 billion.

Read more: A review says ACT-A should continue. Experts say changes are needed

Let it WASH over you

Tomorrow is Global Handwashing Day, and we’re washing our hands of … not doing a podcast. Co-hosted by Amruta and Rebecca Root, the series will explore how WASH — which has its own Sustainable Development Goal — is connected to all the other SDGs, from health to peace.

Our first episode will be streamed Friday. You can listen or download it through Apple Podcasts and Spotify and make sure to follow to be updated on future episodes. In the meantime, read Rebecca’s story on why WASH is missing from recent global events on food and climate.

SAGO genesis

On Wednesday, WHO listed 26 scientists nominated for its new Scientific Advisory Group for the Origins of Novel Pathogens, or SAGO, whose job will be to advise WHO in developing a “global framework to define and guide studies” into pathogens that could potentially cause epidemics and pandemics.

Part of SAGO’s work will be to provide an independent evaluation of all available findings of global studies on COVID-19’s origins and advise WHO on the next series of studies.

The 26 proposed members — 11 of whom are women — come from 26 different countries, including China. So does this mean another mission is happening in China?

Dr. Maria Van Kerkhove, WHO technical lead for COVID-19, told reporters: “... SAGO, in its discussions about the urgent next steps for understanding … the origins of the current pandemic, will recommend further studies in China and potentially elsewhere. And I very much hope, we very much hope, that there will be further missions to China and other countries.” But she clarified that SAGO “is not the next mission team.”

Learning their lessons

Last week, a new Ebola case was reported in the Democratic Republic of Congo’s North Kivu province, which was one of the epicenters of an outbreak from 2018 to 2020. The World Health Organization has announced that it will include a focal point for the prevention of sexual exploitation and abuse as part of its response team.

This follows a recent report detailing the extent of abuse allegedly committed by responders, including at least 21 WHO staff, during the response to the 2018-2020 outbreak.

WHO has said it will ensure “mandatory pre-deployment training and refresher training” for any further staff deployment in the response, as well as “reporting channels for alerts or complaints; prompt investigation of complaints; and monitoring.”

Read: WHO includes sexual abuse prevention staff in new DRC Ebola response

Local power

In January, the U.S. President’s Malaria Initiative, or PMI, announced $30 million in new funding for PATH to support a consortium of institutions aimed at improving the use of data for malaria eradication. But local organizations were conspicuously absent, as none of the consortium partners is from Africa.

Amruta interviewed Chatham House fellow Ngozi Erondu after she and a group of African global health experts wrote an open letter calling attention to funding structures that undermine local agencies. “Funders have to go deeper to make sure that we’re not having this tokenistic approach to partnership, which is what we normally do,” she said at the time.

In response to the backlash, PMI has reiterated its commitment to investing locally. Last week, the initiative released a new five-year strategy, which centers localization in three of its five focus areas.

While Erondu has suggested that this is a big win, she says there’s still a long way to go in terms of implementation.

What other wins have you seen in decolonizing global health? Let us know at checkup@devex.com.

What we’re reading

Over a year and a half into the COVID-19 pandemic, people still aren’t getting the vocabulary right. [The Atlantic]

An app aimed at tackling India’s malnutrition problems is failing. [Scroll.in]

Pfizer’s CEO recently blamed low COVID-19 immunization rates in Africa on vaccine hesitancy — but that’s not what the data shows. [Bhekisisa - Centre for Health Journalism]