Governing the Access to COVID-19 Tools Accelerator: towards greater participation, transparency, and accountability Academic Article uri icon

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  • 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.


  • Moon, Suerie
  • Armstrong, Jana
  • Hutler, Brian
  • Upshur, Ross
  • Katz, Rachel
  • Atuire, Caesar
  • Bhan, Anant
  • Emanuel, Ezekiel
  • Faden, Ruth
  • Ghimire, Prakash
  • Greco, Dirceu
  • Ho, Calvin WL
  • Kochhar, Sonali
  • Schaefer, G Owen
  • Shamsi-Gooshki, Ehsan
  • Singh, Jerome Amir
  • Smith, Maxwell J
  • Wolff, Jonathan

publication date

  • January 2022