●Partnership & Pandemics (COVID-19)

The COVID-19 pandemic marked the first time that a public-private partnership governed the acute phase of a global health emergency response. Learn more about who governed it below.

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The Access to COVID-19 Tools Accelerator

The public-private partnership that governed the global COVID-19 response between April 2020 and December 2023 is called the Access to COVID-19 Tools Accelerator (ACT-A). While the ACT-A is no longer operational like it was during the COVID-19 pandemic, it has been used as a forum for partners to discuss emerging infectious disease threats like mpox and H5N1 (Avian influenza).

ACT-A is a super public-private partnership. One criticism of the ACT-A is its limited representation of low and middle-income country governments and civil society in its governance. Because ACT-A is not a legal entity, there was also confusion about how to hold the partnership accountable for its governing decisions.

While case study research is needed to better understand ACT-A governance, mapping the representation of actors involved can give a clue as to who held power during the COVID-19 response.

ACT-A Core Governors

The Principals Group was the main overarching venue for partners to problem-solve and discuss the direction of ACT-A. It met weekly, with the option for non-core members like civil society and industry associations to join every other week. The core governors include: CEPI, FIND, Gates Foundation, Gavi, Global Fund, UNICEF, Unitaid, Wellcome Trust, World Bank, World Health Organization. Existing public-private partnerships held the most number of governing seats in the ACT-A.

Country Summary

The chart on the right shows the countries with the most indirect influence in ACT-A via the boards of the 5 public-private partnerships in the Principals Group of ACT-A. Data shows that during the COVID-19 response, the United States held 17% of seats with indirect influence. In contrast, most other countries represented only had 1% of board seats. Note: these are seats held by representatives from any constituency.

Indirect Influence from Partnership Boards

Five of the ACT-A members were existing public-private partnerships. At least in theory, board members of these partnerships would have had indirect influence in the ACT-A Principals Group via the directions they give to their Secretariats. So, which constituencies had the most indirect influence on the ACT-A via existing partnership boards? By far, states and independent representatives have the most number of seats. But once again, most of these seats are held by high-income country representatives.