6 charts that show how money and influence shaped the global Covid plan

There are dozens of global health organizations that have worked on Covid; those included in the POLITICO-WELT financial analysis have played a major role in designing and creating critical programs, including at the World Health Organization, to develop, secure and distribute tests, vaccines and treatments .

money and power

Jhe four organizations have collectively spent just under $10 billion since January 2020 to fight Covid – the same amount as the US Agency for International Development, the main agency supporting US Covid efforts overseas. Their financial power has given them access to some of the highest levels of government in the United States and Europe.

Gavi has spent more than any of the other three organizations operating COVAX, the initiative to help low- and middle-income countries obtain doses of the Covid vaccine. Well over 90% of the group’s $6 billion in Covid spending took place in 2021, after it lobbied the US and European governments for donations to help deliver doses to low-income countries. The organization has helped vaccinate millions of people around the world, but fell short of its overall goal of providing 2 billion doses by the end of 2021.

POLITICO-WELT financial analysis showed the Gates Foundation spent a total of $2.1 billion. A foundation spokesperson confirmed the POLITICO and WELT team’s findings on its Covid investments, but said the broader financial analysis was not “fully aligned” with its own breakdown of Covid spending. Earlier this year, the foundation released some of the details of his spending on his website.

In addition to their massive contributions to global health efforts, the lobbying resources of these organizations have given them easy access to some of the top officials in the United States and Europe. Over the past two years, leaders of the four organizations have spent at least $8.3 million lobbying lawmakers and officials in the United States and Europe, according to lobbying reports. They have held dozens of meetings with health and political leaders, not only to raise more funding for their organizations, but also to push governments to think differently about how they approach the fight against Covid.

For example, all the leaders of the organizations urged governments to increase funding and donations for the distribution of vaccine doses in low-income countries. The Gates Foundation has also pushed the United States to publicly share immune correlates of protection — immune markers that could help other institutions develop their own vaccines.

Organizations also have significant influence at WHO. Their funding at the WHO, including helping to pay for staff positions there, gives them access to the leaders of the multilateral organization, to whom they often talk about how to improve pandemic preparedness. The WHO sets international policy on how countries should respond to large-scale infectious disease outbreaks like Covid.

Collectively, the four organizations donate billions of dollars to the WHO each year. The Gates Foundation has been the second largest donor to the WHO, behind Germany, from 2020 to 2021. Gavi has also donated a significant amount of money to the organization – a total of $432 million from 2020 to 2021. Jeremy Farrar, the director of Wellcome, used to chair a scientific advisory group for research and development at the WHO, and advised its director-general on how to fight Covid around the world .

CEPI is the only organization out of the four that has not donated to the WHO.

Because all three organizations were already connected to the WHO, they were able to help set up a program at the WHO that enabled increased funding for their operations during Covid. The Gates Foundation has written white papers on its training.

In 2020, the groups, along with several other global health organizations and WHO officials, created the Covid-19 Tools Accelerator, also known as ACT-A. The move, which leaders of the four organizations describe as a loose collaboration, was aimed at accelerating the development and distribution of tests, treatments and vaccines. The WHO oversaw the effort, but leaders from partner agencies, including Gavi and CEPI, played a crucial role in the day-to-day operations of the initiative. Wellcome staff, including Farrar, were also heavily involved in ACT-A meetings.

Representatives from the organizations, WHO, as well as government officials from Norway and South Africa, developed a budget and funding framework for ACT-A that encouraged donors to donate money for the development of medical countermeasures.

CEPI and Gavi would continue to receive billions of dollars in funding, primarily from governments, to work on the development, procurement, and distribution of vaccine doses to low- and middle-income countries through the COVAX effort.

Of the $23 billion that ACT-A partners — such as Gavi and CEPI — have received, the vast majority has gone to vaccine development and distribution, including COVAX. Only $2.2 billion went to strengthening health systems.

COVAX fell short of its promise to deliver 2 billion doses to the world by the end of 2021, but it did meet its goal of vaccinating 20% ​​of populations in the low-income countries it serves. Due to manufacturing delays and vaccine hoarding by Western countries, leaders of the ACT-A vaccine initiative say millions of people in low-income countries have missed doses. Today, only about 20% of Africans have been fully immunized.

Links between money

Jhe power of these organizations is rooted, in part, in the way they support each other’s missions.

The four organizations are different in the way they raise funds, grant money and operate in general. Two of them – Wellcome and the Gates Foundation – are philanthropic organizations that leverage multi-billion dollar trusts. They rank among the largest charitable foundations in the world.

CEPI uses both public and private funds to finance its research and development operations. And Gavi, an organization with a narrow focus on immunization, receives mostly public funding – its board is made up of government representatives from both donor and recipient countries.

Three of the organizations are directly connected. The Gates Foundation helped fund the creation of Gavi and CEPI. The Wellcome Trust, established in the 1930s in the UK, partnered with the Gates Foundation for the development of Covid treatments and separately gave $22 million to CEPI to help accelerate the development of vaccine doses.

The Gates Foundation and Wellcome Trust have financially supported the COVAX effort – led by Gavi, CEPI and UNICEF – to expand access to Covid vaccines.

Organizations often work together on pandemic-related initiatives and coordinate strategies to address infectious disease outbreaks around the world. During the Covid pandemic, they also overlapped on investments and subsidies, according to POLITICO-WELT financial analysis. They have given millions of dollars to dozens of the same organizations, including pharmaceutical companies and academic institutions.

The overlap highlights how the decisions of the four organizations have benefited some groups more than others. This shows, for example, how they viewed certain pharmaceutical organizations as critical, such as China-based Clover Biopharmaceuticals and UK-based AstraZeneca.

Vaccine priority

Jhe four organizations invested heavily in the development and supply of the Covid vaccine, spending $2.4 billion. About 75% of the funding spent on the development and procurement of medical countermeasures – including injections, tests and drugs – was for the vaccine.

CEPI committed the most, funding more than $1.7 billion in vaccine development and supply, according to the financial analysis. Almost his entire Covid portfolio has been concentrated there. More than 30% of the Gates Foundation’s total Covid spending went to vaccine development, including $400 million in loans and volume guarantees to secure doses for distribution around the world.

(Important Note: POLITICO and WELT could not independently verify how much Gavi spent on purchasing vaccine doses for COVAX. It has not released any details of how much it paid pharmaceutical companies. for its advance dose purchase agreements. See our methodology for more information).

Far fewer resources have gone into developing and procuring treatments and tests, showing just how much the four organizations are putting their financial clout behind the vaccine. Several leaders of organizations, including Bill Gates in a February 2022 interview with POLITICO, said more should have been done worldwide to invest in both the development and distribution of therapeutics.

The four organizations are currently lobbying lawmakers and officials in the United States and Europe to devote more resources to pandemic preparedness efforts, including funding for a next-generation vaccine. In his new book, Gates calls on governments to fund a team of pandemic experts, including epidemiologists and other public health scientists and experts who can travel to help countries respond to health crises. He also called on the world to do more to strengthen health systems across the world to ensure they are ready for the next large-scale infectious disease outbreak.