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Title: Governing the Access to COVID-19 Tools Accelerator: towards greater participation, transparency, and accountability
Authors: Moon, S
Armstrong, J
Hutler, B
Upshur, R
Katz, R
Atuire, C
Bhan, A
Emanuel, E
Faden, R
Ghimire, P
Greco, D
Ho, CW
Kochhar, S
Schaefer, GO 
Shamsi-Gooshki, E
Singh, JA
Smith, MJ
Wolff, J
Keywords: COVID-19
Clinical Governance
Decision Making, Organizational
Global Health
International Cooperation
Public Health Administration
Issue Date: 29-Jan-2022
Publisher: Elsevier BV
Citation: Moon, S, Armstrong, J, Hutler, B, Upshur, R, Katz, R, Atuire, C, Bhan, A, Emanuel, E, Faden, R, Ghimire, P, Greco, D, Ho, CW, Kochhar, S, Schaefer, GO, Shamsi-Gooshki, E, Singh, JA, Smith, MJ, Wolff, J (2022-01-29). Governing the Access to COVID-19 Tools Accelerator: towards greater participation, transparency, and accountability. The Lancet 399 (10323) : 487-494. ScholarBank@NUS Repository.
Abstract: 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.
Source Title: The Lancet
ISSN: 01406736
DOI: 10.1016/S0140-6736(21)02344-8
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