The ACT-A diagnostics team has set a goal of making 500 million tests available to low- and middle-income countries by mid-2021. It has only purchased 84 million tests by June 2021, just 16% of its target, according to the report. . The therapeutics team initially set a goal of delivering 245 million treatments to low- and middle-income countries by 2021, but later changed the target to 100 million new treatments by the end of 2021. By June of that year, the therapy team had allocated only about 1.8 million treatments.
COVAX has set a goal of delivering 2 billion doses of the vaccine by the end of 2021. By September of that year, it had only delivered 319 million doses.
Although COVAX significantly accelerated the delivery of doses later in 2021 and 2022, governments have struggled to get shot. As of August 2022, only around 20% of Africans were vaccinated – a dangerously low percentage – according to the Africa CDC.
Leaders of the groups say they have been unable to achieve their goals largely because wealthy Western governments have been slow to step in and make available the huge tranches of vaccines and treatments needed to protect the world. The groups say they have provided a crucial voice for the suffering and needs of poorer countries, without which progress might have been much slower.
“The Gates Foundation has been focused on supporting a global response that would ensure low- and middle-income countries have affordable and equitable access to the best data and tools available to address the crisis,” said Mark Suzman, CEO of the Gates Foundation, in a statement. statement. “In some areas we have seen success. On the most critical issue of equitable access to vaccines, the world as a whole has failed as high-income countries initially monopolized the available supply. The foundation declined to make Gates available for comment.
On the struggle to deliver vaccine doses to low- and middle-income countries on time, Gavi CEO Seth Berkley said in an interview that the organization had in fact met one of its initial vaccine distribution targets. 950 million doses by the end of 2021. to low-income countries, even though it has not delivered on one of its initial promises to distribute 2 billion doses. (COVAX has delivered all 950 million doses by January 2022.)
“It’s very easy to sit outside and criticize what we do. What we need to do is be evaluated fairly based on the actions we took at the time with the knowledge we had at the time,” Berkley said.
A CEPI spokesperson put it this way: “While we can improve many things, it would be inaccurate to assign all the blame for the failures of the global response to the very organizations that have done more than anyone else to try to address issues of vaccine supply and inequality.
“The challenge we faced was the need to ensure access to vaccines for poor countries just when companies were able to sell promising products to the highest bidder,” the spokesperson said.
Jeremy Farrar, the director of the Wellcome Trust, made a similar note. “Global pandemic preparedness and response requires the kind of funding and international cooperation that only governments can muster,” he said.
Farrar, however, championed the ACT-A partnership as “the best mechanism we have to deliver life-saving Covid-19 tools across the world.”
“Prior to the creation of ACT-A, there was no formal mechanism in place to coordinate and accelerate the development, production and equitable access to Covid-19 interventions around the world,” he said. . “While ACT-A may not be perfect… the global response would have been poorer and much more fragmented without it.”
The POLITICO and WELT investigation, however, found that ACT-A’s structure diminished accountability. ACT-A representatives set fundraising priorities and campaigned for donations. But the money – $23 billion in total – went directly to entities involved in the initiative, such as Gavi and CEPI. Although the ACT-A website keeps track of how much money was raised, it’s almost impossible to tell exactly where it all went.
Based on each organization’s individual Covid database, it is not possible to determine exactly how the groups spent the money raised through ACT-A. It is also difficult to determine from the organization’s grants and investment data how much they have given specifically for ACT-A programming. For example, organizations do not use “ACT-A” or similar terminology in their descriptions of their grants and investments.
“In theory, I think it was a great idea,” said Gayle Smith, who led the US State Department’s global Covid-19 response last year, referring to ACT-A. But she wonders about her responsibility.
“In practice…there was no single director,” Smith said. “Who is the big boss of this whole business? In a global emergency like this, we need to be able to get the countermeasures to everyone everywhere as quickly as possible. »
Bruce Aylward, who coordinates the work of the ACT-Accelerator at the WHO, said ACT-A was deliberately set up with a decentralized structure to reduce bureaucracy. He said each agency was responsible for its own accounting and for consolidating agreements directly with donors.
Smith and others closely involved in the global fight against Covid say there should have been a stronger hand at the helm.
When vaccine doses began flowing to COVAX, many poor countries and provinces were ill-equipped to handle them. And during the long delays, many potential beneficiaries have lost faith in the global health system.
“I think if we had had the vaccine sooner the coverage would have been much, much, much better,” said Stephen Bordotsiah, the municipal director of health services for the Bolgatanga region in Ghana, who received doses. important to COVAX.
