In February 2021, WHO hosted an agenda-setting Global Research and Innovation Forum on this new virus

l it and the tools required to evaluate would-be vaccines.
In February 2020, WHO hosted an agenda-setting Global Research and Innovation Forum on this new virus, attended by nearly 900 experts and funders from more than 40 countries, who took stock of what was known so far and set the agenda going forward.
The Forum catalyzed research into the spread of the virus, how to control it, its severity and who is most susceptible. Priorities were set: assessing approaches to care, making optimum use of PPE and identifying animal hosts to prevent spill-over.
On testing, the Forum established the use of rapid tests at a community level as a key area for follow-up. On treatments and vaccines, the evaluation of investigational therapeutics and vaccines was to be accelerated using ‘core protocols’ and platform trials.
The Forum also set the stage for: mobilizing funders; integrating the social sciences into the outbreak response; and sharing virus materials, clinical samples and data across borders.

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On vaccines, WHO set the bar for success. We identified the key attributes vaccines would need, using them to promote clinical trial designs for generating the efficacy and safety data vital to making the best decisions about policies, regulation and deployment.
WHO has provided the world with a reliable and authoritative guide to candidate vaccines, tracking each one as they progress through the preclinical and clinical phases.
Illustration of the vaccine landscape at the end of 2020Illustration of the vaccine landscape at the end of 2020
On treatments, in June, WHO welcomed clinical results from the UK that showed dexamethasone, a corticosteroid, could be lifesaving for patients critically ill with COVID-19.
WHO’s international collaborative efforts led the world in implementing a global trial for rapidly finding the right therapeutics.
Launched in March, WHO’s Solidarity trial became one of the largest clinical trials for COVID-19 therapeutics in the world and the largest looking at remdesivir and interferon beta 1a as potential treatments.
At its peak, the trial has involved more than 30 countries, over 14 000 patients and nearly 500 hospitals. An independent group of experts is reviewing potential drugs — including monoclonal antibodies — for the next stage of the trial, after an initial four drugs were found to have little or no effect on: mortality, the need for ventilation, or duration of hospital stay.
The ACT-Accelerator
Since the start of the pandemic, WHO has worked with partners to facilitate timely, fair and affordable access to the tools needed to beat COVID-19.
Launched in April 2020 by WHO and partners, the Access to COVID-19 Tools (ACT) Accelerator partnership has led the fastest and most coordinated global effort in history to develop tools to fight a disease.
The ACT-Accelerator aims to ensure equitable access to COVID-19 diagnostic tests, therapeutics and vaccines, underpinned by a commitment to strengthening health systems.

Diagnostics:
Reserved 120 million rapid antigen tests for low- and middle-income countries
Procured over 27 million molecular tests and 12 million rapid antigen tests for low- and middle-income countries
Provided training for over 23 000 people in over 190 countries
2021 aim: 500 million tests by mid-year
Therapeutics:
Procured 2.9 million doses of dexamethasone — the only WHO-approved treatment for COVID-19
Supported 15 clinical trials, investigating 21 therapies in 47 countries, with 85 000 patients enrolled
2021 aim: 245 million courses of treatment throughout the year
Vaccines:
190 countries signed up to the COVAX Facility
US$ 2.4 billion raised for the Advance Market Commitment: more funds needed
2021 aim: 2 billion safe and effective doses aimed for by the end of the year
A deep dive on vaccines
One of the ACT-Accelerator’s key goals is to speed up the safe development and manufacturing of COVID-19 vaccines, and to guarantee fair and equitable access for every country in the world. The COVAX facility plays a vital role in achieving that goal.
WHO partners with the Coalition for Epidemic Preparedness Innovations (CEPI) and Gavi, the Vaccine Alliance in managing COVAX.
At the end of 2020, economies representing 90% of the global population are eligible to receive vaccines through COVAX. US$ 2.4 billion had been raised for the Advance Market Commitment (AMC), the innovative financial mechanism that will secure access to COVID-19 vaccines for the world’s poorest countries. Yet despite this success, US$ 4.6 billion is still needed for the AMC in 2021 alone.
Rising to the challenges of 2021
WHO’s COVID-19 response built on lessons learned from previous outbreaks.
Our early guidance on COVID-19 was adapted from documents on Middle East Respiratory Syndrome (MERS). Reforms pursued since the 2014 Ebola outbreak in West Africa — such as ways to help countries prepare for emergencies and accelerate research when new diseases emerge — underpinned the speed, flexibility and effectiveness of the COVID-19 response.
But there is much more to do in 2021. The pandemic still rages in large parts of the world. There are massive funding gaps.
There is a real risk of vaccine nationalism, and the best tools against COVID-19 not being shared fairly among countries. Many health systems will struggle to roll out COVID-19 vaccines, tests and treatments while managing all other areas of health.
Overcoming these challenges to ensure COVID-19 releases its grip on our lives in 2021 will require us all to come together with humility, humanity and generosity.