Tuesday, May 11, 2021


Canada is virtue signaling while waffling on global access to COVID-19 vaccines

Joel Lexchin, 
Professor Emeritus of Health Policy and Management, York University, Emergency Physician at University Health Network, Associate Professor of Family and Community Medicine, University of Toronto

Based on public statements, it’s easy to come to the conclusion that Canada is working to improve global access to COVID-19 vaccines.
© THE CANADIAN PRESS/Carlos Osorio - POOL Anita Anand, Canada's minister of public services and procurement, opens a box with some of the first 500,000 of the two million AstraZeneca COVID-19 vaccine doses that Canada secured last March through a deal with the Serum Institute of India.

This quote comes from an opinion piece in the Washington Post on July 15, 2020; the lead author, none other than Prime Minister Justin Trudeau:

“…we must urgently ensure that vaccines will be distributed according to a set of transparent, equitable and scientifically sound principles. Where you live should not determine whether you live, and global solidarity is central to saving lives and protecting the economy.”

The person being quoted here in early May of this year is Mary Ng, the International Trade Minister in Trudeau’s cabinet:

“The work we have been doing and the leadership we have been providing is very much about removing all barriers to vaccine access, whether it be production or supply chain or export restrictions…We’re trying to remove all barriers to access to vaccines.”

But despite what Trudeau and Ng said, Canada is not doing all that it can to improve access. Far from it.

Virtue signalling with little action


Canada has signed contracts for enough vaccine doses to inoculate every woman, man and child in Canada four times. Canada is accepting vaccine donations from the United States and also purchasing vaccines from COVAX (COVID-19 Vaccines Global Access — a mechanism mainly designed to ensure that low- and middle-income countries can access vaccines).

Over one-third of Canadians have received at least one dose of vaccine as of May 7, compared to vaccination rates of under two per cent in Africa. Back in January, Canada refused to donate any vaccines and that position has not changed since.

© (AP Photo/ Diomande Ble Blonde) A shipment of COVID-19 vaccines distributed by the COVAX Facility arrives in Abidjan, Ivory Coast, last February.

This pattern of virtue signalling about access to medicines and then doing nothing has a long tradition in Canada.


Back in the late 1990s, the South African government was trying to improve access to drug treatment for the staggering 22 per cent of the population that was HIV positive. At that time, triple therapy — the three-drug cocktail used to treat HIV — cost over US $10,000 per person per year, effectively putting it out of reach of the vast majority of South Africans.

South Africa wanted to encourage the use of low-cost generic drugs. The response from 39 drug companies, backed by the United States, was to take South Africa to court. Canada’s position? We supported access but we also supported the intellectual property rights of the drug companies.

C-TAP, COVAX and the WTO TRIPS waiver

Fast forward to the present and COVID-19. In May 2020, the World Health Organization launched the COVID-19 Technology Access Pool, or C-TAP, an initiative to accelerate and broaden global access to COVID-19 vaccines under development at the time, as well as treatments and diagnostics.

C-TAP has the endorsement of 40 countries. But not Canada. No pharmaceutical company has contributed to C-TAP. Pfizer CEO Albert Bourla said: “At this point in time, I think it’s nonsense, and… it’s also dangerous.”

© (AP Photo/Thoko Chikondi, File) A Malawian policeman guards AstraZeneca COVID-19 vaccines after the shipment arrived in March at the Kamuzu International Airport in Lilongwe, Malawi.

COVAX is designed to give poor countries enough vaccine for 20 per cent of their population, but it is $2 billion short of even achieving that modest objective.

In the face of the failure of C-TAP and in order to supplement what COVAX could do, back in October 2020 India and South Africa asked the World Trade Organization to suspend the protection of intellectual property.

The request included patent rights, technical know-how and undisclosed data for COVID-19 products for the duration of the pandemic. This is known as the TRIPS (Trade-Related Aspects of Intellectual Property Rights) waiver. The objective was to free up unused worldwide capacity to increase the production of vaccines and other products necessary for the prevention and treatment of COVID-19.

As many commentators have pointed out, if the waiver is approved by the WTO (and approval requires consensus among all its 159 members), nothing will change overnight. It will take many months and possibly even longer to ramp up vaccine production.

But that increased capacity is going to be needed. It is increasingly looking like we might require yearly booster shots for COVID-19 as variants multiply. That’s almost six billion doses of vaccine a year for people 15 years and older, almost double the current capacity to produce vaccines.

Moreover, when drug companies think that the pandemic is over, they are going to raise prices dramatically. Pfizer currently charges US$19.50 per dose, but chief financial officer Frank D’Amelio said that Pfizer’s normal price for vaccines is $150 to $175.
Canada’s position on intellectual property

To the amazement of just about everyone, the Biden administration just announced that the U.S. is going to support the waiver for COVID-19 vaccines.

Canada? Just like the South Africa situation, we neither support nor oppose the waiver. The Canadian government will take part in talks at the WTO about the waiver, but won’t say which side it will be taking.
© THE CANADIAN PRESS/Nathan Denette A police escort follows the shipment carrying just under 300,000 doses of the single-shot Johnson & Johnson COVID-19 vaccine, which is developed by the Janssen Pharmaceutical Companies, at Pearson International Airport in Toronto on April 28.

Canada’s position for months has been that it was “merely asking questions about the patent waiver proposal, rather than opposing it.” But in a letter to the U.S. government back in March from the Pharmaceutical Research and Manufacturers of America, Canada was listed as one of the countries standing with the U.S. in opposing the waiver.

Canada is currently negotiating with drug companies over vaccine delivery schedules and is still in a battle with them about changes to how prices for patented drug will be determined.

Innovative Medicines Canada (IMC), the lobby group for the multinational companies, not surprisingly has come out strongly against the waiver. In a statement a few days after the U.S. announced its position, IMC said the “proposed waiver of TRIPS IP protections would be a disappointing step that will create greater uncertainty and unpredictability in the production, quality, and availability of COVID-19 vaccines worldwide.”

How much is fear of further angering the pharmaceutical industry playing into Canada’s position on the waiver?

When it comes to standing up for access to medicines versus standing up for intellectual property rights, for Canada, plus ça change, plus c’est la même chose; the more things change, the more they stay the same.

This article is republished from The Conversation under a Creative Commons license. Read the original article.

In 2017-2020, Joel Lexchin received payments for being on a panel at the American Diabetes Association, for talks at the Toronto Reference Library, for writing a brief in an action for side effects of a drug for Michael F. Smith, Lawyer and a second brief on the role of promotion in generating prescriptions for Goodmans LLP and from the Canadian Institutes of Health Research for presenting at a workshop on conflict-of-interest in clinical practice guidelines. He is currently a member of research groups that are receiving money from the Canadian Institutes of Health Research and the Australian National Health and Medical Research Council. He is a member of the Foundation Board of Health Action International and the Board of Canadian Doctors for Medicare. He receives royalties from University of Toronto Press and James Lorimer & Co. Ltd. for books he has written.

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