SEATTLE, United States — The Bill & Melinda Gates Foundation Friday announced an expansion of its funding for the global response to COVID-19. The increase includes an additional $150 million of grant funding plus a commitment to leverage the resources of the foundation"s Strategic Investment Fund, which could be deployed to catalyze the rapid procurement of essential medical supplies and help life sciences companies secure financing to produce COVID-19 products. In announcing the funding, the foundation called on world leaders to unite in a global response to COVID-19 to ensure equitable access to diagnostics, treatments, and vaccines. "It is increasingly clear that the world"s response to this pandemic will not be effective unless it is also equitable," said Gates Foundation co-chair Melinda Gates. "We have a responsibility to meet this global crisis with global solidarity. In addition to contributing to the development of diagnostics, therapeutics, and vaccines, these funds will support efforts against COVID-19 in low-and-middle-income countries, where local leaders and healthcare workers are doing heroic work to protect vulnerable communities and slow the spread of the disease." The foundation"s new $150 million commitment will fund the development of diagnostics, therapeutics, and vaccines, as well as new efforts to provide partners in Africa and South Asia with resources to scale their COVID-19 detection, treatment, and isolation efforts. The foundation will also leverage a portion of its $2.5 billion Strategic Investment Fund, which uses a suite of financial tools to address market failures and incentivize private enterprise to develop affordable and accessible health products. These funds, which can include equity investments, loans, and volume guarantees, will be used to help health systems in low- and middle-income countries (LMICs) facilitate the rapid procurement of personal protective equipment for health care workers, COVID-19 diagnostics, oxygen therapeutics, and other essential medical supplies. Any financial returns generated by the Strategic Investment Fund are re-invested in Gates Foundation philanthropic programs. The funding announced Friday builds on the $100 million the foundation has committed to date to support the global response, as well as $5 million in resources to support public health agencies and frontline response organizations in the greater Seattle region. Initial foundation funding has helped to kick-start the search for COVID-19 diagnostics, therapeutics, and vaccines; enhanced virus detection capacity in Africa; and contributed to the response in China. The foundation has also directed its programmatic technical expertise to support multilateral, national, and sub-national responses to the pandemic. "COVID-19 doesn"t obey border laws. Even if most countries succeed in slowing the disease over the next few months, the virus could return if the pandemic remains severe enough elsewhere," said foundation co-chair Bill Gates. "The world community must understand that so long as COVID-19 is somewhere, we need to act as if it were everywhere. Beating this pandemic will require an unprecedented level of international funding and cooperation." While there is not yet global consensus on the total resources required to turn back COVID-19, the figure is more than any one contributor will bear. A coordinated, international effort bringing together all sectors will be required to mobilize the billions in funding needed in the months ahead. Institutions such as the Coalition for Epidemic Preparedness Innovations (CEPI) and Gavi, The Vaccine Alliance are in place to coordinate the development and delivery of COVID-19 vaccines, but they require an influx of new resources to do so. Other organizations such as the World Health Organization (WHO), national governments, and private companies will need to be involved in funding the at-risk manufacturing of vaccine candidates and deciding how to ensure equitable access to essential products for populations worldwide. "This pandemic has unleashed an extraordinary philanthropic response. While significant, it is still only one small part of what must be a coordinated effort to beat this global crisis," said foundation CEO Mark Suzman. "Philanthropy cannot-and should not-supplant the public and private sectors. What philanthropy is good at is testing out ideas that might not otherwise get tried, so governments and businesses can then take on the successful ones. With all sectors working together, we can avoid the worst-case scenarios of human, economic, and social costs." In announcing its new $150 million commitment, the foundation identified four priority areas for investment: Accelerating Virus Detection The foundation will provide partners in sub-Saharan Africa and South Asia with funding to scale their COVID-19 detection, treatment, and isolation efforts. In some countries, this will include leveraging emergency operations centers normally deployed to support polio eradication and malaria elimination efforts toward COVID-19 detection. Protecting the Most Vulnerable Foundation funding will help partners in sub-Saharan Africa and South Asia pilot different approaches to physical distancing and infection suppression in settings where stay-at-home policies and other physical distancing strategies may not be practical. The goal will be to identify infection suppression strategies that can be effectively sustained over time with minimal social and economic disruption. A key focus will be building on lessons learned from two decades of experience in implementing infectious disease prevention programs, specifically the importance of community-designed and community-led engagement efforts. The foundation is also considering gender equality issues in its response, and it will support research into the differential health, economic, and social impacts of the pandemic on women and girls in LMICs. This will help to inform the foundation"s short-, medium-, and long-term policy response to the pandemic and global policy responses. This effort will build on the foundation"s existing work to improve gender data by designing and implementing gender-specific metrics and surveys to capture data that reflects the experiences of women and girls. Minimizing Social and Economic Impact The foundation will provide non-medical funding to help LMICs strengthen social and economic support for people who are living in extreme poverty or who are at risk of falling back into extreme poverty due to the COVID-19 pandemic. Sub-Saharan Africa and South Asia together account for 85 percent of the 629 million people around the world who live on less than $1.90 per day, and past pandemics have had a disproportionate impact on people who cannot afford adequate nutrition, safe sanitation, and quality housing. People living in extreme poverty are also less likely to be able to practice physical distancing because they cannot afford to stop working. The foundation will work with partners to help expand access to social payment systems to communities that are most at risk of serious social and economic disruption due to public health measures undertaken to suppress COVID-19 transmission. Develop Products for a Sustained Response The foundation will continue to invest in efforts to accelerate the development of diagnostics, therapeutics, and vaccines for the COVID-19 response while working with governments, the private sector, and multilateral institutions to ensure scaled manufacturing and the equitable procurement and distribution of these products as they become available. This work will include efforts to develop affordable and accessible point-of-care diagnostics, as well as support for the development of treatments and vaccines whose production can be quickly scaled once clinical trials have demonstrated their safety and efficacy. The foundation has committed to working with governments, CEPI, and the private sector to help provide financing for the at-risk enhancement of vaccine manufacturing capacity. This will allow the production of vaccine candidates so that global vaccine supply can be quickly scaled once clinical trial results are available. The foundation will work with national governments and international organizations such as the WHO; UNICEF; Gavi; and the Global Fund to Fight AIDS, Tuberculosis and Malaria to ensure that LMICs have equitable access to essential commodities and to ensure that supply and distribution chains are well prepared to facilitate their rapid and widespread delivery to Gavi- and Global Fund-eligible countries. — AMA