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Project EACT: Equitable Access to Essential Health Technologies in the context of COVID 19

Introduction to EACT Project                                                 

Posted 18 August 2020

The EACT Project is currently one of the main engagements of PHM under the Trade and Health thematic.  Background information, objectives and activities of the project below.

Specific immediate barriers and larger scale structural barriers

The Covid pandemic has brought into focus the barriers to ensuring equitable access to essential health technologies: PPE, ICU capacity, diagnostics, medicines and vaccines. Thousands of have been infected for lack of PPE; thousands have died because they did not have access to properly equipped ICUs; and the epidemic has surged where public health officials did not have access to fast, cheap, reliable diagnostics.

The threats and barriers to equitable access are diverse and complex, including supply chain dislocations and price barriers (including price gouging associated with shortages).  The absence of effective medicines and vaccines is presently the major barrier to accessing these technologies but as medicines and vaccines research scales up as never before, so does ‘medicines and vaccine nationalism’ (including trade restrictions and large advanced purchase agreements by rich countries), threatening the possibility of equitable access.

Behind these immediate barriers are features of the political, economic institutional and legal systems within which health technologies are developed, produced, distributed and utilised. These include global inequalities in access to decent health care and public health protection; and in the distribution of research and production capacity. These structural features are reproduced by: the dominance of the global pharmaceutical industry by huge hyper-profitable transnational corporations; the regime of extreme intellectual property protection driven through TRIPS and other trade agreements; the political forces driving the privatisation and marketisation of health care.

Graphic from Scientific American

The challenge of overcoming these barriers and assuring equitable access

The specific and immediate barriers need to be addressed through institutional, legal and economic initiatives but in ways which also address the larger scale structural factors.

There are significant forces calling for a range of reforms to this regime, including both the specific and more general issues. These include civil society organisations such as Health Action International, Third World Network, Knowledge Ecology International, Health GAP, Treatment Action Campaign, Section 27, All India Drug Action Network and many more. Many developing countries have also called for key reforms including South Africa and Costa Rica as outstanding examples. Likewise, the South Centre has produced a range of significant policy briefs.

What the People’s Health Movement brings to this engagement

While PHM has experts within its ranks and close relations with many of the civil society organisations active in this field; its organisational focus encompasses a wide range of issues. What sets PHM apart is its breadth of scope, its strong political economic analysis, and its commitment to building a global movement directed to achieving Health for All. PHM has an organised presence in over 70 countries with ramifying networks and a broad overview of health care and the right to health.

PHM has embarked on the EACT Project with confidence that we can contribute to the struggle for equitable access building on our existing strengths, in particular: our links to a myriad of grass roots organisations in many countries; our breadth of scope in relation to the right to health; and our political economic perspectives.

Accordingly, the EACT Project is focused on monitoring and reporting what is happening at the community, health service and national levels; mobilising around access issues of particular importance in their jurisdictions; and educating and advocating around policy reform, institutional innovation and underlying structural reform. In mounting such actions the National EACT teams are drawing on more specialised policy analysis and are supported by capacity building initiatives organised both locally and globally.

See two recent webinars organised by PHM in conjunction with TWN:

Project objectives

Project EACT aims to:

  • Monitor people’s access to health technologies, both Covid related and more general, and analysis and publicise these findings;
  • Mobilise community and civil society networks around identified barriers to equitable access;
  • Advocate at institutional and governmental levels for both institutional and structural reform, including for implementation nationally and internationally; and
  • Prepare and distribute such educational and informational resources as are needed to support such mobilisation and advocacy.

Project structure

The EACT enterprise is presently based on three pilot teams (South Africa, India and South Korea) and a global support team. Each team has a small budget for part time staffing and activities.

The project is also recruiting volunteers from other countries to participate in project activities, building on the lessons from the three pilot teams.

While the project presently has only one global support team, funding is being sought to establish a network of such teams, dealing in major languages other than English. The global team is based on the Trade and Health Thematic Circle of PHM, supported by PHM’s Global Secretariat. The global team includes a project coordinator and has funding for a limited range of activities.

As well as providing support and coordination for the pilot country teams the global arm is also reaching out to more specialised networks whose technical and policy expertise is enriching the monitoring and advocacy activities of the project.

The project is governed by a coordinating committee with representation from the three participating countries and the Trade and Health Circle as well as PHM’s global coordinator.

Further information: [email protected]

Support the Covid TRIPS Waiver Proposal

Updated 8 December 2020

The Covid pandemic continues, out of control in many countries. There are several vaccine candidates that may be approved by WHO in the next few months. However, huge advanced purchases by the US, UK, Europe and some other wealthy countries, could mean that the availability of vaccines for low and middle income countries is delayed for several years.

In May 2020 WHO proposed a Covid – Technology Access Pool (C-TAP) designed to share knowledge to rapidly scale up vaccine production but the vaccine companies refused to participate.

In October 2020, at the WTO’s TRIPS Council, India and South Africa proposed that the WTO waive the application of certain provisions of the TRIPS Agreement for the duration of the pandemic with a view to facilitating wider access to technologies necessary for the production of vaccines and medicines. The rapid scaling up of local production will be critical in order to ensure wide access to affordable and effective vaccines.

The waiver proposal was blocked at the TRIPS Council meeting but will return within weeks. If the waiver is to be adopted strong clear advocacy is needed now, particularly directed to those governments who were uncertain or apprehensive about supporting the proposal in the TRIPS Council.

More about the proposed TRIPS Waiver here

Barriers and Enablers to Equitable Access to COVID-19 Health Technologies in South Africa

Posted 12 December 2020

This rapid situational analysis was conducted by PHM SA (and endorsed by SECTION27, RHAP, Cancer Alliance, 80+ SA affiliated academics and researchers) during October 2020 to gain insight into the current situation with respect to access to quality health technologies (PPE, diagnostic tests, ventilators) for COVID-19 in South Africa, as well as potential barriers and enablers to access to health technologies currently under development (vaccines, treatments). The situational analysis further sought to understand how regulatory frameworks, health financing, local manufacturing capacity and domestic research activities impact/may impact health technology access in the country.


The EACT Project commends the report for wide distribution and consideration. It provides a very useful case study of the barriers and enablers to equitable access and provides an invaluable foundation for further organizing and advocacy.

The EACT Project urges PHM networks and circles around the world to consider undertaking similar situational analyses regarding barriers and enablers to equitable access to Covid technologies. If you are interested in undertaking such an exercise please let us know (write to [email protected]).

See also EACT Resources