. 2021 Dec 11;399(10323):487–494. doi: 10.1016/S0140-6736(21)02344-8

Table 1.

ACT-A governance arrangements

	Description	Composition	Governance statements
Pillars	Operational implementation	Eight coconvenors or leads (Gavi, the Vaccine Alliance, Coalition for Epidemic Preparedness Innovations, Unitaid, Wellcome, the Global Fund to Fight AIDS, Tuberculosis and Malaria, WHO, the Foundation for Innovative New Diagnostics, and the World Bank)	Formal governance for each of the Pillars, including transparency of administration, financial management, and accountability for resources raised and used, is provided by the existing Boards and governing bodies of the coconvening and lead organisations²
Facilitation Council	High-level advice and guidance, global leadership and advocacy, to communicate progress, and to act in support of the partners in each pillar¹⁰	Cochairs are the South African Government and Norwegian Government; cohosts are WHO and the European Commission; members are 27 governments representing regional cooperation groups, donor countries, and market shaping countries; three partners are the Gates Foundation, Wellcome, and World Economic Forum; two WHO Special Envoys, World Bank (as observer); and a standing invitation to civil society, communities, and industry	Four key governance principles: (1) motivated, flexible, agile, and diverse group of influential world leaders who are committed to creative collaboration and supporting the ACT-A vision in the global interest; (2) no legal status and no duplication of existing multilateral bodies; (3) time-limited, outcome focused, and restricted to COVID-19-related products; and (4) subsidiarity applies—the Council acts in support of the partners in each pillar, who are the central actors of the ACT-A framework and are responsible for delivery of their objectives¹⁰
Principals Group	Discuss key developments and challenges, the overall strategic direction of ACT-A and pillar-specific priorities, and address and align on cross-cutting issues and key bottlenecks²	Comprised of the Principals of the coconvening agencies and lead agencies, such as UNICEF, the Gates Foundation, and industry associations²	No reference to governance
ACT-A Hub	Plays a central coordination function and aims to facilitate synergies across the partnership; Facilitation Council secretariat, hosts pillar coordination, and Principals Group meetings²	WHO staffed	No reference to governance

ACT-A=Access to COVID-19 Tools Accelerator.