ACT-Accelerator calls for fair share-based financing of US$ 23 billion to end pandemic as global emergency in 2022

09 February 2022
Un médecin porte une tenue de protection
UNICEF
  • World leaders launch campaign to meet the US$ 16 billion ACT-Accelerator funding gap and US$ 6.8 billion in-country delivery costs to take vital steps towards ending the pandemic as a global emergency in 2022. 
  • The ACT-Accelerator initiative works to overcome vast global inequities by providing low- and middle-income countries with access to COVID-19 tests, treatments, vaccines and personal protective equipment. 
  • The ACT-Accelerator agencies urgently need new funding to scale up their work to develop and deliver the COVID-19 countermeasures essential to address the threat of Omicron and prevent even more dangerous variants from emerging. 
  • A diverse group of governments have agreed on a new financing framework developed in support of the ACT-Accelerator, which makes ‘fair share’ requests of richer countries to contribute to the global fight against COVID-19. 

GENEVA, February 9, 2022 - World leaders will today launch a call to end the pandemic as a global emergency in 2022 by funding the Access to COVID-19 Tools (ACT) Accelerator, a partnership of leading agencies that is providing low and middle-income countries with tests, treatments, vaccines, and personal protective equipment.

With a significant proportion of the global population still unable to get vaccinated, tested or treated, US$ 16 billion in grant funding is urgently required from governments to fund the work of the ACT-Accelerator agencies. This investment will allow them to procure essential tools to fight COVID-19 and provide them to low- and middle-income countries. 

The ACT-Accelerator is calling for the support of higher income countries, at a time when vast global disparities in access to COVID-19 tools persist. Over 4.7 billion COVID-19 tests have been administered globally since the beginning of the pandemic. However, only about 22 million tests have been administered in low-income countries, comprising only 0.4% of the global total. Only 10% of people in low-income countries have received at least one vaccine dose. This massive inequity not only costs lives, it also hurts economies and risks the emergence of new, more dangerous variants that could rob current tools of their effectiveness and set even highly-vaccinated populations back many months.  

The ACT-Accelerator Facilitation Council’s Finance and Resource Mobilization Working Group, comprised of countries across income groups and chaired by Norway, has agreed a new financing framework to help overcome this inequity. The framework sets out guidance on the ‘fair share’ of financing that richer countries should each contribute to the ACT-Accelerator’s global response. ‘Fair shares’ are calculated based on the size of their national economy and what they would gain from a faster recovery of the global economy and trade. 

Supporting the rollout of tools to fight COVID-19 globally will help to curb virus transmission, break the cycle of variants, relieve overburdened health workers and systems, and save lives. With every month of delay, the global economy stands to lose almost four times the investment the ACT-Accelerator needs.

Closing the US$ 16 billion gap facing the ACT-Accelerator will enable the partnership to:

  • Drive in-country rollouts to get vaccines into arms, create a Pandemic Vaccine Pool of 600 million doses, support community engagement and cover ancillary costs for donations – contributing to countries’ national vaccination objectives towards the global target of 70% coverage in all countries by mid-2022. 
  • Purchase 700 million tests – of the total 988 million targeted in the overall ACT-Accelerator budget – and expand sequencing capacity, enabling countries to direct public health measures, deliver more effective ‘test & treat’ strategies, and track how the virus evolves. 
  • Procure treatments for 120 million patients, as well as 433 million cubic metres of oxygen, including 100% of the oxygen needs of low-income countries. 
  • Protect 1.7 million health workers with PPE – of the total 2.7 million targeted in the overall ACT-Accelerator budget – as well as budget and monitor ongoing needs in real-time to help identify and address bottlenecks facing rollouts of products. 
  • Support clinical trials for treatments and vaccines, to help address variants of concern and initiate the development of broadly protective coronavirus vaccines. 

Dr Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization, said: “The rapid spread of Omicron makes it even more urgent to ensure tests, treatments and vaccines are distributed equitably globally. If higher-income countries pay their fair share of the ACT-Accelerator costs, the partnership can support low- and middle-income countries to overcome low COVID-19 vaccination levels, weak testing, and medicine shortages. Science gave us the tools to fight COVID-19; if they are shared globally in solidarity, we can end COVID-19 as a global health emergency this year.”

The ACT-Accelerator is asking donor countries to contribute US$ 16.8 billion of the US$ 23.4 billion total budget in immediate grant funding for October 2021 to September 2022 – with all funding figures rounded to the closest decimal. With US$ 814 million of this US$ 16.8 billion already pledged, US$ 16 billion is now needed to close the immediate financing gap.

Closing this immediate US$ 16 billion financing gap would cover the most urgent work of the ACT-Accelerator’s constituent agencies, as set out in the initiative’s Strategic Plan and Budget, published in October 2021. It would cover procurement, research and development, product assessment, and rolling out vaccines, tests, and treatments, meeting the needs of low-income countries and the most vulnerable lower-middle income countries. 

The aim is for the remaining US$ 6.5 billion of the US$ 23.4 billion budget to be self-financed by middle-income countries, using domestic resources to cover certain procurement needs, supported by multilateral development banks.

Separate to the ACT-Accelerator budget of US$ 23.4 billion, US$ 6.8 billion is needed for in-country delivery needs of vaccines and diagnostics, from a combination of domestic resources, multilateral development bank support, and further international grant financing support.

Key ACT-Accelerator achievements to date include:

  • Funding vital research and development of new therapeutics, vaccines, and diagnostics.
  • Supporting the market entry of new, affordable rapid tests.
  • Delivering over 1 billion COVID-19 vaccine doses via its vaccines pillar, COVAX, with a huge surge in shipments at the close of 2021, through which more vaccines were shipped in the last quarter of 2021 than in the first 9 months of the year combined. 
  • Procuring over 200 million tests (as of 10 January), US$ 519 million worth of medical oxygen supplies (as of 31 January 2021), and US$ 764 million worth of personal protective equipment.
  • Building capacity to expand the use of next-generation sequencing for genomic surveillance in Southern Africa that enabled the early detection of the Omicron variant. 

The ACT-Accelerator Facilitation Council provides high-level political leadership, global advocacy and assistance with resource mobilization to the initiative and is co-chaired by Norway and South Africa. The co-chairs recently wrote to all high-income countries, G20 upper middle-income countries, and two additional middle-income countries who are contributors to the ACT-Accelerator, encouraging ‘fair share’ contributions. 

‘Fair share' contributions were calculated for each of these countries and collectively cover the total immediate grant funding need of US$ 16.8 billion, assuming that the private sector and philanthropic institutions can cover US$ 0.5 billion. For the 2020-21 ACT-Accelerator budget, six countries (Canada, Germany, Kuwait, Norway, Saudi Arabia and Sweden) met or exceeded their fair share commitments.

President Cyril Ramaphosa of South Africa said: “South Africa has proudly co-chaired the ACT-Accelerator Facilitation Council from the very beginning, and we will continue to champion this initiative, as the best solution to the inequities the world – and Africa in particular – faces. As co-chairs, South Africa and Norway have written to more than 50 heads of state and government, asking them to contribute their fair share of financing to ACT-Accelerator agencies. The longer inequitable access to COVID-19 vaccines, tests and treatments persists, the longer the pandemic will persist. I urge my fellow leaders to step up in solidarity, meet their fair shares, and help reclaim our lives from this virus.” 

Prime Minister Jonas Gahr Støre of Norway said: “What we have learned from this pandemic is that it can't be fought off by countries working alone. A broad collective effort is required. A fully financed ACT-Accelerator is in the mutual interest of all countries. As co-chair of the ACT-Accelerator, we call upon the world’s leaders to join us in acting urgently because as we’ve seen time and time again throughout this pandemic – no-one is safe until everyone is.”

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Notes to Editors 

Please see links below:

UNICEF’S role in accelerating equitable access to COVID-19 tools
https://www.unicef.org/coronavirus/UNICEF-role-accelerating-equitable-access-COVID-19-tools

UNICEF ACT-A appeal donors and partners
https://www.unicef.org/coronavirus/donors-and-partners

Consolidated Financing Framework for ACT-A Agency & In-Country Needs: www.who.int/publications/m/item/consolidated-financing-framework-for-act-a-agency-in-country-needs

ACT-Accelerator 'fair share asks' - by country: www.who.int/publications/m/item/act-accelerator-fair-share-asks---by-country

The ACT-Accelerator is the only global, end-to-end solution to the pandemic, supporting access to COVID-19 tests, treatments and vaccines from research to rollout. The initiative is structured around the three pillars of Diagnostics, Therapeutics and Vaccines (COVAX), with a cross-cutting Health Systems and Response Connector.

The lead partner agencies of the ACT-Accelerator are: CEPI, FIND, Gavi, The Global Fund, UNICEF, Unitaid, Wellcome, WHO, the World Bank and The Bill & Melinda Gates Foundation.

‘Fair share’ asks were calculated using a 4-step approach. First, wealth is accounted for, with a minimum threshold set, so only countries in the economically strongest position are called to contribute to the ACT-Accelerator, to help end the acute phase of the pandemic and restore global trade. Second, countries set to benefit most from a faster global economic and trade recovery are asked to contribute more, as their returns will be higher. Third, countries with higher incomes per capita are asked to contribute proportionally more. Fourth, a ‘risk buffer’ was factored in to anticipate some countries contributing less than requested. In-kind contributions, such as vaccine donations, are accounted for outside of the fair share model.

ACT-Accelerator October 2021 to September 2022 budget and complementary support needed for delivery, with all asks rounded to the closest decimal:

  1. US$ 23.4 billion (rounded from 23.369bn) for ACT-Accelerator agencies, as outlined in the ACT-A Strategic Plan and Budget (October 2021 - September 2022), which can be further broken down into:     
    • US$ 16.8 billion (rounded from 16.847bn) of immediate grant financing, with       US$ 814 million raised so far, leaving a funding gap of 16 billion (rounded from 15.986bn), as of 8 February 2022. 
    • US$ 6.5 billion (rounded from 6.522bn) to be financed with domestic resources, including support by multilateral development bank funds.
  2. US$ 6.8 billion (rounded from 6.756bn) in complementary in-country delivery needs.

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ACT-ACCELERATOR AGENCY PRINCIPAL QUOTES

Catherine Russell, Executive Director of UNICEF, said: "We cannot accept persistent inequity of this scale, especially when we have the power to avert it. As a key agency in the ACT-Accelerator, UNICEF is calling for donor support to allow us to continue to procure COVID-19 vaccines, tests, treatments and personal protective equipment, and assist in rolling them out around the world. We must act now to defeat this virus and build a fairer and more resilient world for children everywhere."

Dr Richard Hatchett, CEO of CEPI, said: “Science has consistently delivered throughout the course of the COVID-19 pandemic, but tragically the world’s scientific achievements have not yet been matched by equity. A fully funded ACT-Accelerator will enable COVAX and the other ACT-A pillars to redouble their efforts to get vaccines, diagnostics, therapeutics and other countermeasures to those who need them, while also continuing vital R&D which will address current gaps in scientific knowledge and strengthen the world’s defences against the virus and its variants.”

Dr Bill Rodriguez, CEO of FIND, said: "There are times when people of good will are called to act together to defeat a common threat, even if that threat does not seem to be on their own doorstep. Entering our third pandemic year, we all see, with utmost clarity, how important it is to make sure everyone in the world, everywhere in the world, has what he or she needs to protect themselves, their families, and their communities from further harm. Understandably, many countries have shifted focus to their exit strategy from this pandemic. The truth is, major inequities persist. The truth is, more than 90 out of 100 people in the farthest reaches of the world still lack the ability to get a test, get vaccinated, and look ahead to a post-pandemic time. Fully funding the ACT-Accelerator will ensure that the tools we now have can finally be guaranteed for the whole world."

Dr Seth Berkley, CEO of Gavi, the Vaccine Alliance, said: “As we seek to raise urgent additional funding of at least US$5.2 billion to support lower-income countries’ vaccination objectives through COVAX, the vaccine pillar of the ACT-Accelerator, we also call on donors to support the ACT-Accelerator as a whole to provide the full range of funding needs for the different tools necessary to control the pandemic. Countries need access to all the tools required to fight this pandemic and mitigate its impact, both for their own benefit and to contribute to the global effort to manage this public health crisis: that means equitable access to vaccines, therapeutics, testing, diagnostics, oxygen, and other tools.”

Peter Sands, Executive Director of the Global Fund, said: “Fully funding the four pillars of the ACT-Accelerator is critical to ending the acute phase of the COVID-19 pandemic. By working together, we have helped low- and middle- income countries access lifesaving tests, treatments, medical oxygen, vaccines, and personal protective equipment; but we cannot slow the momentum. The pandemic is far from over, and only a coordinated, multilateral effort can ensure an effective and equitable global response. Funding the ACT-Accelerator is not only the right thing to do, it is also the best way to prevent new variants from emerging, and the only way to get back on track against other infectious diseases such as HIV, tuberculosis and malaria."

Dr Philippe Duneton, Executive Director of Unitaid, said: “Global equitable access to all COVID-19 tools, for everyone, everywhere, is the only way out of the pandemic. Fully funded, the ACT-Accelerator would ensure that all countries can access essential volumes of safe and effective vaccines, tests, medicines and oxygen needed. Testing and treating people at risk of developing severe COVID-19 is a key component of the response. We need governments to contribute their fair share now to finance all pillars of ACT-A and bring an end to the pandemic in 2022.”

Dr Jeremy Farrar, Director of Wellcome, said: “The ACT-Accelerator is the best mechanism we have for delivering lifesaving tests, treatments and vaccines for COVID-19 patients around the world. Despite critical advances, we remain in a world of ‘haves’ and ‘have nots’. A domestically-focused outlook in many higher-income countries continues to slow down the global response. To give us all the best chance of moving on from the horror of the last two years and living in a safer world, rich countries, including the G20, must contribute their fair share as soon as possible."

Juan Pablo Uribe, Global Director for Health, Nutrition and Population, World Bank; Director for Global Financing Facility (GFF) said: “In addition to responding to the immediate needs of the pandemic, countries also need to address disruptions of lifesaving health services. As part of the ACT-Accelerator Health Systems and Response Connector,the World Bank and Global Financing Facility (GFF), working together with other partners, are helping countries to address the pandemic while preserving essential care and supporting frontline health services. The goal is to make health systems stronger, more resilient and more equitable.”

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