The ACT-Accelerator needs $35B more funding. Here's what's at stake if it fails

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A COVID-19 detection center in Cuiaba, Brazil, one of the countries participating in COVAX, part of the ACT-Accelerator. Photo by: Christiano Antonucci / SECOM / Latin America News Agency / REUTERS

MANILA — The World Health Organization has published an updated investment case for the Access to COVID-19 Tools Accelerator and a detailed plan for how the money will be used in the next three months — or what will happen if immediate funding fails to materialize.

The investment case now includes costing for the ACT-Accelerator’s “fourth pillar,” known as the health systems connector, which has a total requirement of $9 billion. This fourth pillar is essentially meant to ensure the availability of oxygen and personal protective equipment in countries, as well as support countries in building their capacities and health systems to deploy COVID-19 tools effectively and efficiently.

In addition to a reduction in costings for the vaccines pillar, this brings the initiative’s total ask from $31 billion to $38 billion, with $15 billion in funding needed immediately.

The biggest share of the money, or $16 billion, is for vaccines. That includes money to support the research and development of the most promising vaccine candidates, to help increase global manufacturing capacity for the vaccines, and to allow for the procurement and delivery of potential vaccines to low-income countries. The goal under the COVAX Facility is to secure and deliver 2 billion vaccine doses in 2021.

Of the total funding needed however, roughly only $3 billion has been pledged to date, leaving a significant gap of $35 billion. Prior to the release of the updated investment case, United Nations Secretary-General António Guterres had already highlighted the urgency of filling the financing gap.

“There is real urgency in these numbers. Without an infusion of $15 billion over the next three months, beginning immediately, we will lose the window of opportunity,” he said.

Of the $16 billion needed for the vaccines pillar, only $2 billion has been pledged to date. The other three pillars, meanwhile, have received significantly less than $1 billion each.

The cost of failing to mobilize resources

The plan identifies some of the results that have been achieved to date through the ACT-Accelerator — for example, the launch of the COVAX Facility, evidence of dexamethasone as a treatment for severely ill patients, the evaluation of several potential rapid diagnostic tests, and the mapping of over 100 countries for potential bottlenecks and capacity gaps in the efficient delivery of COVID-19 tools.

To build on these results, however, funding will be critical. By December, the ACT-Accelerator anticipates it will have a firmer understanding of which candidate vaccines and treatments currently in trials will be successful. But to be ready to make use of that, manufacturing capacities must already be set up and procurement deals established ahead.

“Without these, the global supply of vaccine will be secured by a small number of wealthy economies, and no vaccine will be available for the majority of countries or populations worldwide,” according to the plan.

On Monday, Seth Berkley, CEO at Gavi, the Vaccine Alliance — one of the accelerator’s key partners — said it has signed agreements for up to 850 million vaccine doses as part of the advance market commitments for COVAX — the vaccines pillar of the ACT-Accelerator — but that it needs to secure more deals to ensure 2 billion vaccine doses by 2021.

“There is real urgency in these numbers. Without an infusion of $15 billion over the next three months, beginning immediately, we will lose the window of opportunity.”

— António Guterres, secretary-general, U.N.

“We know the failure rate for vaccines historically is quite high, with 4 out of 5 even in clinical trials failing. So what this means is we’re going to have to cut many more deals to get to the numbers we want,” he said during a WHO press conference.

In addition, the plan points out the need to tackle early emerging regulatory challenges and intellectual property issues, invest in manufacturing capacity and technology transfers, and prepare countries for the deployment of new COVID-19 tools such as the vaccines and rapid diagnostic tests once they become available. Failing to do so would lead to delays in production and delivery, as well as unequal access to these products as individual countries snatch up available supplies.

But mobilizing the needed resources is already a major challenge for the ACT-Accelerator, coupled with bilateral and multilateral deals being made by some high-income countries. The U.S., for instance, has been making its own deals on vaccine doses and refuses to join the COVAX Facility. China, which has repeatedly outlined its intent to make its vaccines available as a global public good, has nonetheless not signed up to the facility.

Jamie Drummond, co-founder of ONE, wrote in an email to Devex that there are a number of ways to raise funds fast and not rely on already stretched donor aid budgets.

“Firstly there are over 100 [billion dollars] in unused special drawing rights which with a bit of creativity could be converted to fight COVID through the ACT accelerator. The [International Monetary Fund and World Bank] meetings in a few weeks must sort this step. Secondly this is a perfect case for government borrowing to front load finance given the huge returns on beating coronavirus sooner rather than later,” he wrote.

Special Drawing Rights are international reserves maintained by IMF members. Countries can exchange SDRs for their needed currency.

Multibillionaires who have experienced windfall profits from the pandemic could also be “encouraged and expected to invest,” he wrote. He did not name anyone in particular.

“The clue’s in the name. It’s the ACT Accelerator - not The ACT Later,” he wrote.

About the author

  • Jenny Lei Ravelo

    Jenny Lei Ravelo is a Devex Senior Reporter based in Manila. She covers global health, with a particular focus on the World Health Organization, and other development and humanitarian aid trends in Asia Pacific. Prior to Devex, she wrote for ABS-CBN, one of the largest broadcasting networks in the Philippines, and was a copy editor for various international scientific journals. She received her journalism degree from the University of Santo Tomas.