Lessons learned from the independent evaluation of the ACT-Accelerator – need a reformed platform for the future

A future pandemic response must enable immediate access to initial funding for at-risk populations, broad inclusion from low- and middle-income countries and technology transfer, and build on prepared and robust health systems in countries.

These are some of the findings in the newly published external evaluation of the Access To Covid-19 Tools Accelerator (ACT-A). The evaluation was set out to learn from ACT-A experiences.

"ACT-A is the first global initiative of its kind, responding to the need for unprecedented global collaboration to mitigate the Covid-19 pandemic. This report identifies important lessons learned from ACT-A," said Minister of International Development of Norway, Anne Beathe Tvinnereim.

"The ACT-A Facilitation Council set up the independent evaluation to provide lessons to enhance equitable access to medical countermeasures in future health emergencies. Unfortunately, this pandemic has shown that we must do better to deliver on equity," said the Minister of Health of South Africa, Dr Joe Phaahla.

ACT-A was established as an informal coordinating mechanism, leveraging the existing global health architecture to mobilize a rapid global response to the pandemic. While most surveyed stakeholders were satisfied with ACT-A, the evaluation highlights several areas where improvements are needed. ACT-A's mandate was highly relevant to low and lower-middle-income countries, but they should have been included from the start. It is critical to strengthen the country and regional health systems to respond better to new outbreaks.

"ACT-A and its pillars made substantial contributions. More than 1,7 billion vaccines have been delivered. Yet, we are far from our goal of timely and equitable access to vaccines, tests and treatments. About 15 million people are estimated to have died during the pandemic until now. We must use lessons learned to do better," said Minister Phaahla.

"The report highlights that funding needs to be available on day zero when the next pandemic hits. As co-chairs of the ACT-A Facilitation Council, we have helped to mobilize US$23.5 billion. But it was insufficient, and the financing was not made available soon enough. This hindered a faster and stronger global Covid-19 response by ACT-A, which has caused many lives lost and delays in countries' economic recovery," said Minister Tvinnereim.

The evaluation suggests establishing more permanent structures to coordinate research and development for medical countermeasures. In addition, there was significant agreement across stakeholder groups to invest in local and regional manufacturing capacity and the need for technology transfer.

"There needs to be a pre-arranged platform for surge finance and ability to develop and procure countermeasures for at-risk populations and with robust, transparent and inclusive governance and accountability", says Minister Phaahla.

"As co-chairs, we thank ACT-A partners, countries, philanthropies, civil society, private sector, academia, health workers and others who have contributed to ACT-A. We also want to thank those who contributed to evaluating our efforts. We expect additional evaluations of the work of ACT-A agencies, the multilateral system and country responses, which should be used as we enter the final phase of the pandemic. We must integrate Covid-19 efforts into global, regional and national health systems. In doing so, we also prepare for future outbreaks," said Minister Phaahla.

"By assessing the lessons learned from how we have handled this pandemic, we will be better prepared when the next pandemic hits. This includes that also future pandemics can only be overcome by global cooperation. Therefore, it is crucial to include low- and middle-income partners and civil society on equal terms from the start," said Minister Tvinnereim.

The external evaluation was commissioned by the co-chairs of the ACT-A Facilitation Council. Open Consultants carried it out between July 11th and October 10th, 2022. In addition, the Facilitation Council co-chairs – Norway and South Africa – invited six other countries and four civil society representatives to join the ACT-A External Evaluation Reference Group to oversee the evaluation. More than 100 interviews, 71 survey responses and 13 open submissions from different stakeholders informed the evaluation. Stakeholders included representatives from countries, regional organizations, civil society, industry and global health agencies.

At the ACT-A Facilitation Council meeting on October 28th, the plan is to discuss the evaluation findings. At the ACT-A technical briefing on October 6th, the consultants briefed member states about its findings ACT-Accelerator Facilitation Council technical briefing (who.int).

The external evaluation is available on the ACT-A website External Evaluation of the Access To COVID-19 Tools Accelerator (ACT-A) (who.int).

More information about ACT-A is found here: ACT-Accelerator Website: Global Equitable Access to Covid-19 Tests, Vaccines, Treatments

Note to editors:

All enquiries on the external evaluation should be directed to:
Evaluators (Open Consultants): Marco Schaeferhoff mschaeferhoff@openconsultants.org
Facilitation Council (client): John-Arne Røttingen John-Arne.Rottingen@mfa.no and Olive Shisana olive@presidency.gov.za