Equitable access to good-quality health products is a global priority, given the high prices of new products, changing markets and the percentage of health spending on medicines.

In 2020, momentous progress was made in improving access to health products. In April 2020, nine leading global health organizations, including WHO, launched an unparalleled effort to accelerate the development and allocation of vaccines, therapeutics and diagnostics: the Access to COVID-19 Tools (ACT) Accelerator. This global collaborative framework – which brings together governments, scientists and civil society – is working to end the acute phase of the pandemic by deploying tests, treatments and vaccines.

One pillar of the ACT Accelerator is COVAX, an initiative to accelerate the development and manufacture of COVID-19 vaccines and to ensure equitable access. The COVAX Facility, which is part of this endeavour, is set to be the largest vaccine procurement and supply operation ever: it will have delivered about two billion doses to participating countries and economies by the end of 2021. The first doses were shipped by COVAX in February 2021, about one year after WHO declared COVID-19 a pandemic.

ACT Accelerator partners are working to make 120 million high-quality COVID-19 rapid tests available and are analysing over 1700 clinical trials to identify promising treatments. ACT Accelerator supported identification of the dexamethasone as the first life-saving therapy. About 2.9 million treatment courses have been secured for patients in low- and middle-income countries. In addition, 262 million items of personal protective equipment have been shipped to 152 countries in all six WHO regions.

Massive challenges remain, however, to achieving the objectives of this initiative. There is a financing gap of US$ 22.1 billion for 2021 alone. Furthermore, there is a huge, growing divide between high- and low-income countries in vaccine delivery: in early February, 75% of all administered doses had been given in only 10 countries, while 130 countries had yet to give a single dose. Licensing deals and lack of technology transfers continue to limit the global response to the pandemic.

Despite the challenges faced in 2020 as a result of the COVID-19 pandemic, WHO has achieved many milestones in improving access to quality-assured health products globally. These include the new pricing policy guidelines, which provide countries with guidance on increasing the affordability of medicines. A digital version was launched of the WHO Model list of Essential Medicines, a key reference tool since 1978, which guides Member States' selection, use and procurement policies for medicines. WHO is supporting countries in adopting the AWaRe (Access, Watch, Reserve) classification of antibiotics, which guides appropriate policies for use of antibiotics and stewardship programmes to ensure optimal use of these life-saving medicines. In 2020, WHO also updated the Essential Diagnostics List, an evidence-based guide for countries in the use of accurate, high-quality diagnostics in strategies for treatment, control and, in many cases, prevention of disease and outbreaks. An important contribution to control of the global pandemic was assessment of the quality, safety and efficacy of COVID-19-related products for release under the emergency use listing and prequalification procedures. Pharmacovigilance systems in countries were strengthened as well as alert systems for substandard and falsified medical products.

To address antimicrobial resistance (AMR), which further threatens access to essential medicines, WHO supported creation of the AMR Action Fund, which was launched in July 2020 to invest in innovative treatments. Furthermore, WHO published its first overview of the preclinical antibacterial pipeline as well as target product profiles for necessary new antibiotics. A new indicator for achievement of the Sustainable Development Goals was approved, which will encourage AMR surveillance in countries and strengthen infection prevention in health-care facilities. The 2020 report of the Global Antimicrobial Resistance and Use Surveillance System included data from 66 countries, three times more than two years previously, while the number of surveillance sites increased from 729 to 64 000. By the end of 2020, 143 countries had established AMR national action plans and 136 countries had completed and submitted the Tripartite AMR country self-assessment survey. The data are published on a public website and in the annual report.

To find progress on health outcome indicators, visit the World health statistics