The major funder of health research stands to gain financially from the pandemic, raising questions about transparency and accountability An increasingly clear feature of the covid-19 pandemic is that the public health response is being driven not only by governments and multilateral institutions, such as the World Health Organisation, but also by a welter of public-private partnerships involving drug companies and private foundations. One leading voice to emerge is the Wellcome Trust, one of the world’s top funders of health research, whose sprawling charitable activities in the pandemic include co-leading a WHO programme to support new covid-19 therapeutics. The Access to Covid-19 Tools (ACT) Accelerator project hopes to raise billions of dollars and deliver hundreds of millions of treatment courses in the year ahead, including dexamethasone and a number of monoclonal antibodies.1 At the same time, The BMJ finds, Wellcome itself holds investments in companies producing these same treatments. Financial disclosures from late 2020 show that Wellcome has a £275m (€318m; $389m) stake in Novartis, which manufactures dexamethasone and is investigating additional therapeutics. And Roche, in which Wellcome holds a £252m stake,2 is helping to manufacture monoclonal antibodies with Regeneron. Both Roche and Novartis report having had conversations with WHO’s ACT Accelerator about their therapeutic drugs.3 Wellcome’s financial interests have been published on the trust’s website and through financial regulatory filings but do not seem to have been disclosed as financial conflicts of interest in the context of Wellcome’s work on covid-19, even as they show that the trust is positioned to potentially gain from the pandemic financially. Revelations of the Wellcome Trust’s financial conflicts of interest follow news reports that another charity, the Gates Foundation, is also positioned to potentially benefit financially from its leading role in the pandemic response. An investigation by the Nation revealed …