Latin American Dialogue on the Access to Covid-19 Tools Accelerator

On Thursday, April 21, Corresponsales Clave, LAC Platform, LAC Vaccine Access, and the Platform for ACT-A Civil Society and Communities organized a webinar for Latin America and the Caribbean, focusing on the Access to COVID-19 Tools Accelerator (ACT-A) strategy. The meeting aimed to hear from civil society and communities on their experiences and perspectives of COVID-19 tools (diagnostics, therapeutics and vaccines) to inform the work of civil society and community representatives in ACT-A.

Keren Dunaway, from the LAC Platform, moderated the event that featured presentations by Katy Kydd Wright (ACT-A Platform), Javier Hourcade, executive coordinator for the HIV 2025 Platform, and Lídice López, deputy executive coordinator for HIV 2025.

Katy Kydd Wright highlighted that the ACT-Accelerator is a global collaboration initiative to accelerate the development, production, and equitable access to COVID-19 diagnostics, therapeutics, and vaccines. This initiative focuses on low- and middle-income countries and also addresses inequities within high-income regions.

One of its strengths, as mentioned by the speaker, is that it brings together a large number of stakeholders: governments, scientists, corporations, civil society organizations, philanthropists, and global health organizations (such as the Bill and Melinda Gates Foundation, CEPI, FIND, Gavi Alliance, the Global Fund, Unitaid, Wellcome, WHO, and the World Bank). The work teams, in turn, are composed of leaders, coordinators, and focal points.

The priorities published in October 2021 include, among others: closely track barriers and overall gap to access vaccines, tests, and treatments; advance testing rates to a minimum of 100 / 100K people / day; treat 120 million people, and protect 2.7 million health care workers; increase scaled delivery of new and existing therapeutics (including oxygen and access to PPE); fully integrate Pillar delivery with COVID-19 national responses.

The ACT-Accelerator is organized into four pillars of work:

Diagnostics, co-led by the Global Fund and FIND. It aims to promote equity in access to diagnostic tests.
Therapeutics for infection prevention, symptom relief and prevention of transmission to others, life-saving treatments for severe cases, and accelerated recovery. This pillar is led by Wellcome Trust and Unitaid and considers different factors such as pricing, regulatory issues, and the fair distribution of knowledge.
Vaccines (Immunization), led by CEPI, Gavi Alliance, and WHO. This pillar is in charge of expediting the search for an effective vaccine and promoting vaccines manufacture and equitable distribution to all countries.
Health Systems Connector, led by the World Bank and the Global Fund. It aims to make certain that these tools reach the people who need them, and strengthen health systems over the long term to guarantee sustainable progress.

Kydd Wright pointed out that the platform is conceived as a “collaborative space that looks forward to receiving feedback on key points.” Throughout her presentation, she emphasized that the core of the entire initiative is concerned with securing equitable access to life-saving advances.

The situation in Latin America

Following this, Lídice López shared some significant findings from the consultation on priorities and challenges in the response to COVID-19 in communities. The outcomes were presented in relation to diagnostics, therapeutics, and vaccines.

López opened her presentation by noting that “the news is reporting that there are fewer cases, fewer deaths and that vaccination rates are increasing, despite the fact that almost half of the countries still have not reached the 70% of complete vaccination.”

As regards testing, participants observed that access to diagnostic tests is limited and costly. “Some governments have washed their hands regarding the availability (of tests) in the public health system. Here in Peru, for example, at-home tests cost US$5,” López asserted.

In this regard, Hourcade added that, in the countries of the Region, “testing rates were very poor (…) Health ministries became COVID ministries. The follow-up of oncological conditions, diabetes, and other non-transmissible diseases was highly affected, and consequently, there was a significant increase of morbimortality. However, we can only claim this anecdotally. For a long time, there will be no studies in our countries that show the impact COVID had on the early diagnosis of oncological complications in patients.”

Most countries in the Region lack a broad testing network throughout the primary care systems. In addition to the cultural barriers that some countries face, not all have the resources to provide all communities with high-performing, comprehensive diagnostics.

Furthermore, the world pays little attention to Latin America and the Caribbean nowadays. “We were in the news until last year when deaths overwhelmed us. But funding and attention to the Region has already decreased,” López stated. In this regard, Hourcade added that in spaces of power where decisions “are discussed in another language,” our Region is underrepresented, threatening the access to new technologies and financing.

Another aspect highlighted in the consultation and common to all the areas addressed during the meeting was corruption at all healthcare system levels.

As for therapeutics, several countries have fortunately managed to solve the problem of access to oxygen. However, few countries have access to recently developed therapeutics recommended by WHO (e.g., molnupiravir or paxlovid) due to high prices and lack of generic distribution in the region. Participants stressed the need to combat patents and ensure spending transparency to eradicate corruption in purchasing medicines.

Thus, the Region requires effective and safe drugs to be available, at a fair price, in a timely and sustained manner, for all those who need them. In the consultation, there was a call to standardize treatments, avoid the inappropriate use of medicines, and monitor private practice (rational use of medicines), “always with protocols and clear guidelines that guarantee the best recovery.”

Concerning vaccines, the consultation showed that the persistence of myths and prejudices about them acts as a significant barrier to access. This aversion stems, among other causes, from religious fundamentalism, poor campaigns from the Ministries of Health in the countries, and cultural barriers, or, as López put it, “massive campaigns coming from the city that ignore the indigenous peoples’ worldviews.” In this light, a more significant promotion and dissemination of mass vaccination programs (together with studies on their efficacy and impact) and an acceleration of local production of vaccines are necessary.Hourdace, in turn, pointed out that “the COVID-19 crisis is not over (…) and low vaccination is the breeding ground for new strains of interest.” Therefore, it is necessary to increase and strengthen various initiatives. Among them, the speaker highlighted a regional WhatsApp group that had been created to disseminate information about what was happening to the region, communities, and people. Participants (143 activists and people in general) use this group to spread information and share experiences related to COVID. Hourcade believes that this is a “mechanism to be followed” since “community-building has an added effect: it does not only help to manage knowledge, but also to generate it. From the individual to the political level, you can see the whole response spectrum.”