Governing the Access to COVID-19 Tools Accelerator: towards greater participation, transparency, and accountability.
Governing the Access to COVID-19 Tools Accelerator: towards greater participation, transparency, and accountability.
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DOI：
10.1016/s0140-6736(21)02344-8
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发表时间：
2022-01-29
期刊：
影响因子：
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通讯作者：
Wolff J
中科院分区：
文献类型：
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作者：
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
获取新冠肺炎工具加速器(ACT-A)是一项多方利益攸关方倡议，在新冠肺炎大流行的头几个月迅速建立，以应对全球合作的灾难性崩溃。ACT-A法案现在是实现平等获得新冠肺炎卫生技术的最大国际努力，其治理是一个具有广泛公共重要性的问题。我们通过可公开获得的文件追踪了ACT-A治理的演变，并对照ACT-A创始使命声明中嵌入的三项原则进行了分析：参与、透明和问责。我们发现了实现这些原则的三个挑战。首先，不同组织在ACT-A决策中的角色不明确，不清楚谁可能对谁负责，对什么负责。第二，缺乏明确界定的决策机构；ACT-A有多个具有法律约束力的决策中心，信息透明度安排参差不齐，阻碍了有意义的参与。第三，政府在ACT-A中的作用几乎难以辨别，这引发了关于政治合法性和公共问责渠道的关键问题。在全球公共卫生和数十亿公共资金岌岌可危的情况下，治理安排的短期改善可以而且现在就应该进行。为加强对未来大流行的准备工作，需要注意合乎道德的、合法的治理安排。
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.