2021-10-07-世界卫生组织-ACT-Accelerator_Strategic_Review_92页_1mb

ACT-Accelerator Strategic Review Summary

Core Content

The ACT-Accelerator (ACT-A) is a global partnership launched in April 2020 to accelerate the development, production, and equitable distribution of medical countermeasures against COVID-19, including vaccines, diagnostics, and therapeutics. It was established under urgent circumstances with the goal of coordinating efforts across various stakeholders to address the pandemic more effectively than any single entity could.

ACT-A operates as a voluntary, informal, and agile partnership, leveraging existing global health structures and organizations. It has been instrumental in speeding up the availability of critical tools, responding to country needs, and aligning with national priorities. However, it faces both external and internal challenges that affect its ability to achieve its goals, particularly in the context of geopolitical tensions, emerging variants, and inequitable access to tools.

Main Objectives of the Review

The review aimed to:

• Assess ACT-A's achievements and identify areas for improvement
• Surface strengths and weaknesses of the partnership's structure and operations
• Evaluate the financing of ACT-A and its partners
• Understand the broader ecosystem in which ACT-A operates
• Provide strategic recommendations to enhance its effectiveness, inclusiveness, and transparency

The review was not focused on evaluating results, conducting an audit, or assessing impact, but rather on identifying short-term changes that could improve ACT-A's performance.

Key Findings

1. Scope and Objectives

• ACT-A's initial scope was to accelerate development and delivery of medical countermeasures along the entire value chain.
• It covers upstream (R&D, manufacturing, procurement) and downstream (distribution, access, uptake) activities.
• The partnership was structured around three product pillars (Vaccines, Diagnostics, Therapeutics) and a horizontal Health Systems Connector (HSC) to support non-product-specific areas such as PPE and oxygen.
• There is a need for greater downstream focus and outcomes-based indicators to better monitor the impact on end-users.

2. Operating Model

• The informal and agile model enabled rapid response but led to unclear mandates and complex internal coordination.
• There was a lack of clear and accessible information tailored to donors, recipients, and communities.
• The coordination across pillars was inconsistent, and there were opportunities for more strategic alignment and cross-pillar collaboration.

3. Resourcing

• The financial model of ACT-A has been successful in mobilizing resources, but donor support and recipient capacity remain critical challenges.
• Concessional finance and other alternative funding mechanisms should be further utilized to support equitable access.
• The resource mobilisation process needs refinement to ensure it supports the most vulnerable countries effectively.

4. Broader Ecosystem

• The global health landscape has been transformed by ACT-A, with improved coordination among agencies and adaptation of mandates.
• However, geopolitical tensions and domestic-focused policies in higher-income countries have hindered global coordination and equitable distribution.
• Emerging variants pose a continuous threat to the effectiveness of current tools, requiring ongoing adaptation and innovation.

Key Recommendations

Conclusion

ACT-A has played a crucial role in accelerating the development and delivery of essential tools for the global response to the pandemic. However, to maximize its impact in the coming months, the partnership must:

• Clarify structures and strengthen external engagement
• Focus more on country needs and health systems support
• Improve communication and data sharing
• Enhance inclusiveness by involving more L/MICs, civil society, and community representatives

By implementing these recommendations, ACT-A can become more effective, transparent, and equitable in its efforts to end the acute phase of the pandemic and support long-term global health security.