TY - JOUR
T1 - Governing the Access to COVID-19 Tools Accelerator
T2 - towards greater participation, transparency, and accountability
AU - Moon, Suerie
AU - Armstrong, Jana
AU - Hutler, Brian
AU - Upshur, Ross
AU - Katz, Rachel
AU - Atuire, Caesar
AU - Bhan, Anant
AU - Emanuel, Ezekiel
AU - Faden, Ruth
AU - Ghimire, Prakash
AU - Greco, Dirceu
AU - Ho, Calvin WL
AU - Kochhar, Sonali
AU - Schaefer, G. Owen
AU - Shamsi-Gooshki, Ehsan
AU - Singh, Jerome Amir
AU - Smith, Maxwell J.
AU - Wolff, Jonathan
N1 - Publisher Copyright:
© 2022 Elsevier Ltd
PY - 2022/1/29
Y1 - 2022/1/29
N2 - The Access to COVID-19 Tools Accelerator (ACT-A) is a multistakeholder initiative quickly constructed in the early months of the COVID-19 pandemic to respond to a catastrophic breakdown in global cooperation. ACT-A is now the largest international effort to achieve equitable access to COVID-19 health technologies, and its governance is a matter of broad public importance. We traced the evolution of ACT-A's governance through publicly available documents and analysed it against three principles embedded in the founding mission statement of ACT-A: participation, transparency, and accountability. We found three challenges to realising these principles. First, the roles of the various organisations in ACT-A decision making are unclear, obscuring who might be accountable to whom and for what. Second, the absence of a clearly defined decision making body; ACT-A instead has multiple centres of legally binding decision making and uneven arrangements for information transparency, inhibiting meaningful participation. Third, the nearly indiscernible role of governments in ACT-A, raising key questions about political legitimacy and channels for public accountability. With global public health and billions in public funding at stake, short-term improvements to governance arrangements can and should now be made. Efforts to strengthen pandemic preparedness for the future require attention to ethical, legitimate arrangements for governance.
AB - The Access to COVID-19 Tools Accelerator (ACT-A) is a multistakeholder initiative quickly constructed in the early months of the COVID-19 pandemic to respond to a catastrophic breakdown in global cooperation. ACT-A is now the largest international effort to achieve equitable access to COVID-19 health technologies, and its governance is a matter of broad public importance. We traced the evolution of ACT-A's governance through publicly available documents and analysed it against three principles embedded in the founding mission statement of ACT-A: participation, transparency, and accountability. We found three challenges to realising these principles. First, the roles of the various organisations in ACT-A decision making are unclear, obscuring who might be accountable to whom and for what. Second, the absence of a clearly defined decision making body; ACT-A instead has multiple centres of legally binding decision making and uneven arrangements for information transparency, inhibiting meaningful participation. Third, the nearly indiscernible role of governments in ACT-A, raising key questions about political legitimacy and channels for public accountability. With global public health and billions in public funding at stake, short-term improvements to governance arrangements can and should now be made. Efforts to strengthen pandemic preparedness for the future require attention to ethical, legitimate arrangements for governance.
UR - http://www.scopus.com/inward/record.url?scp=85122914801&partnerID=8YFLogxK
U2 - 10.1016/S0140-6736(21)02344-8
DO - 10.1016/S0140-6736(21)02344-8
M3 - Review article
C2 - 34902308
AN - SCOPUS:85122914801
SN - 0140-6736
VL - 399
SP - 487
EP - 494
JO - The Lancet
JF - The Lancet
IS - 10323
ER -