The development of tools and countermeasures such as diagnostics, vaccines and treatments is a vital part of tackling the coronavirus pandemic, but these efforts will only succeed if the technologies are made available to all who need them through a coordinated global response.
This will involve sharing data, jointly mobilizing resources, and setting aside politics, with action and investment spread across all sectors and countries, underpinned by the imperatives of social justice and equity.
Those were some of the key messages to emerge from an event held virtually on 24 April to launch what the World Health Organization calls a “landmark collaboration” – the Access to COVID-19 Tools (ACT) Accelerator. The initiative is intended to ensure that to ensure that “all people have access to all the tools to prevent, detect, treat and defeat COVID-19.”
“No country and no organization can do this alone,” said WHO director general Tedros Adhanom Ghebreyesus, declaring that the ACT Accelerator “brings together the combined power of several organizations to work with speed and scale.”
The WHO said it was working with researchers from “hundreds of institutions” to standardize assays, outline regulatory approaches to innovative trial designs and define criteria for prioritizing vaccine candidates.
“The Organization has prequalified diagnostics that are being used all over the world, and more are in the pipeline… and it is coordinating a global trial to assess the safety and efficacy of four therapeutics against COVID-19,” it stated. “The challenge is to speed up and harmonize processes to ensure that once products are deemed safe and effective, they can be brought to the billions of people in the world who need them.”
“Everyone must have access to the tools and countermeasures – including vaccines – that we will develop through the ACT Accelerator” – Peter Hatchett, CEPI
Peter Hatchett, chief executive of the international Coalition for Epidemic Preparedness Innovations (CEPI), said the establishment of the ACT Accelerator was “a watershed moment in the world coming together to develop a global exit strategy from the COVID-19 pandemic.” Everyone must have access to the tools and countermeasures – including vaccines – that we will develop through the ACT Accelerator,” Hatchett said. “By bringing together the collective strengths, resources and expertise of the institutions that will contribute to the ACT Accelerator we can end this pandemic together.”
The launch event for the Accelerator was attended by representatives of bodies including the WHO, the UN, the EU, international donor and aid organizations, the pharmaceutical industry, and countries including France, South Africa, Germany, Vietnam, Costa Rica, Italy, Rwanda, Norway, Spain, Malaysia and the UK.
A number of major countries had no official speakers at the event, including the US, China, Japan and Russia. US president Donald Trump said recently that he would withdraw US funding for the WHO, accusing it of making errors in its response to the pandemic, an announcement that was criticized by the likes of Gutteres, Bill Gates and the EU’s foreign policy head, Josep Borrell.
“Data must be shared, production capacity prepared, resources mobilized, communities engaged, and politics set aside – António Guterres, UN general secretary
António Guterres secretary general of the UN, said a world free of COVID-19 required “the most massive public health effort in global history,” and called for global sharing of both effort and information. “Data must be shared, production capacity prepared, resources mobilized, communities engaged, and politics set aside. I know we can do it. I know we can put people first”.
Representing the pharma sector at the event was the international industry federation, the IFPMA, which said that industry had been “working flat out to marshal its unique expertise to find a durable solution to the spread of COVID-19 and stands ready to scale up its work on an even more unprecedented scale in line with its previously expressed commitments.”
By joining the global collaboration, the biopharmaceutical industry could “work on an equal footing with all stakeholders to help speed up the development of safe and effective therapeutics and vaccines, share tools and insights to test potential therapies and vaccines, increase manufacturing capabilities and share available capacities and share real-time clinical trial data with governments and other companies around the world,” the federation declared.
Representatives of political bodies and governments stressed the need to make sure that any tools developed to tackle the coronavirus were equitably distributed across all countries.
The president of the European Commission, Ursula von der Leyen, said a COVID-19 vaccine was needed that could be deployed “in every single corner of the world” and made available “at affordable prices.”
She noted that the commission is to host the launch of a global pledging effort on 4 May when the commission will also announced the next milestones in a global campaign to raise €7.5bn ($8.1bn) to “ramp up work on prevention, diagnostics and treatment.” However, she noted that this was “a first step only” as more resources would be needed for sustained actions on many fronts to beat the coronavirus.
“COVID-19 knows no borders and defeating it will require action and investment across sectors and countries” – Melinda Gates
Others stressed that, like the coronavirus, global efforts must recognize no borders. As new diagnostics, treatments and vaccines become available, “we have a responsibility to get them out equitably with the understanding that all lives have equal value,” said Melinda Gates of the Bill and Melinda Gates Foundation.
“COVID-19 knows no borders and defeating it will require action and investment across sectors and countries. The collaboration we're seeing today along with the commitments we make at the upcoming Global Response Summit will help the world rise up to meet this big challenge,” she added.
Muhyiddin Muhammad Yassin, prime minister of Malaysia, said: “The only way we can destroy this common invisible enemy of ours is through solidarity and co-operation. The world needs to come together to co-ordinate our efforts and expedite the development of effective tools to stop the spread of this disease.”
Spain’s prime minister, Pedro Sanchez, said his country was “firmly committed to the leadership of the United Nations and to the central role of the World Health Organization in dealing with the global efforts to fight the pandemic and its impacts on people and prosperity.”
He said it was important to “move away from fragmented, individual efforts towards a collaborative approach. The magnitude of investment needed, the risks attached, the fear of regulatory and market change are all real obstacles in the quest for a vaccine. No private company, no government, no country alone can escape them. Partnerships are the only solution.”
UK To Host Virtual Vaccine Meeting
Deputizing for UK prime minister Boris Johnson, who returned to work on 27 April following his hospitalization with COVID-19, the foreign secretary, Dominic Raab, flagged up the support the government was giving to the development of vaccines by the University of Oxford and Imperial College. He noted that Phase I trials with the Oxford vaccine began on 23 April. “We also look forward to working with Sir Andrew Witty and Ngozi Okonjo-Iweala in their roles as the new vaccine Envoys," he added. (Also see "Coronavirus Update: A Key Vaccine Partnership, Promising Treatments, And A Rocky First Quarter" - Pink Sheet, 22 Apr, 2020.)
“The UK is one of the biggest donors to the international response,” Raab said. “We've already pledged £744 million and that includes £250 million of UK aid for the Coalition for Epidemic Preparedness Innovations to rapidly develop a coronavirus vaccine.” He added that the 4 May pledging event would “ensure that desperately-needed resources for research and development of new vaccine, therapeutics and diagnostics are made available so that we can overcome this disease.”
Raab noted that the UK would be hosting an event of its own: the virtual Global Vaccine Summit on 4 June, “where we need to fully fund GAVI and make sure GAVI's expertise and capacity are at the heart of our efforts to ensure equitable access for any vaccine.”
The GAVI vaccines alliance was one of the numerous international organizations represented at the event, which also heard from the likes of Unitaid, the Bill and Melinda Gates Foundation, the Global Fund to Fight AIDS, Tuberculosis and Malaria, and Wellcome.
Global Fund director Peter Sands said that developing new tools was “essential but not enough” and that “the lessons from AIDS must be learnt. Too many millions died before antiretroviral medicines were made widely accessible, in large part through the creation of the Global Fund.”
Access to drugs was also not enough, Sands continued, pointing out that they had to be delivered within a system of care. “This takes money, infrastructure, capacities. For example, less than a third of the cost of the fight against AIDS, TB and malaria is the cost of the biomedical tools.”
Unitaid, which founded the Medicines Patent Pool, said it and its partners were enhancing grant projects midstream to speed up fast molecular testing and clinical trials of medicines. “Unitaid’s pre-COVID-19 work provides us with well-established facilities, longstanding partners and the experience to make a unique contribution to fighting the pandemic, especially in diagnostics, triage tools and gathering evidence on treatments,” said its executive director, Philippe Duneton.
“For Unitaid, it’s all about making the tools accessible, available and affordable in a shorter time than ever," Duneton continued. "The expanded initiatives will add clear value to the global response to COVID-19, especially in creating prompt access to new COVID-19 commodities in places where health systems are fragile. This is the first wave of the Unitaid response in the ACT Accelerator.”
“This is now a human-endemic infection: it will not disappear; this is not SARS” – Jeremy Farrar, Wellcome Trust
Jeremy Farrar, director of the Wellcome Trust, said the solution lay in science, manufacturing, and equitable distribution. “Amidst the horror of this pandemic this partnership does offer us our greatest hope and also, by bringing everybody together, the greatest chance to deliver. Physical distancing, testing, isolation and the best clinical care are absolutely crucial now but this is now a human-endemic infection; it will not disappear; this is not SARS.”
The only true exit strategy, Farrar said, was through “science and the manufacturing of that science and the equitable distribution to the world to make sure everybody receives it, independent of their ability to pay.”
There was, he said, a chance to end this pandemic through multilateralism, and “out of this pandemic and out of this crisis the chance to actually forge a better world, a better world which is more equitable and which commits to public health. That is the prize of our time: yes for COVID but actually beyond COVID to the whole of public health and it's a question of social justice and equity; it's a question of the sort of world that we want to live in.”