The COVID-19 vaccine and its discontents
Canada’s vaccine strategy and approach to global health puts private profit over human need

Jennifer Cole / December 2, 2020  CANADIAN DIMENSION

The global race for a COVID-19 vaccine is nearing an end, with more than 200 treatments either developed or in the works. Despite massive levels of public funding to support the research, Big Pharma stands to make record profits. Photo from Wikimedia Commons.

On November 6, the prime minister, together with Canada’s Chief Public Health Officer, Dr. Theresa Tam, confirmed that pharmaceutical giant Pfizer had developed a COVID-19 vaccine. Ten days later, American biotechnology company Moderna announced its vaccine was 94 percent effective against the virus.

This was followed by the release of encouraging preliminary results by British drug maker AstraZeneca of its experimental COVID shot. All three, if approved by Health Canada, could be available in the early part of next year.

That’s where the good news ends.

Dr. Tam has warned that there will be a limited vaccine supply to begin with. This will increase as production picks up, but she wasn’t pulling any punches.

“While that supply will continue to increase over time,” she said, “it does mean that federal, provincial and territorial governments will have to make important decisions about how to use the initial vaccine supply.”

In an ideal world, Canada would not be dependent upon companies like Pfizer or Moderna to manufacture a vaccine at scale. Indeed, once upon a time, Canada was less beholden to the dictates of private manufacturers taking advantage of a global health emergency to charge monopoly prices.

In the 1950s, Toronto’s Connaught Labs helped develop a vaccine against polio, and played an important role in the global eradication of smallpox. The lab was profitable throughout its history, but was eventually sold off to French giant Sanofi Pasteur during Brian Mulroney’s program of privatization in the 1990s.

In Montreal, the Institut Armand Frappier manufactured a multitude of vaccines including one for tuberculosis. It was later sold to British multinational GlaxoSmithKline.

Both of these facilities were unique because their focus was on human need, not profit.

Imagine if they were still around today. With their robust manufacturing capacity, Canada’s vaccine deployment could rapidly focus on protecting the most vulnerable. Under the current model, we hang our hopes on a pharmaceutical industry that is often unwilling to intervene when the situation is insufficiently profitable.

Instead, the federal government’s National Advisory Committee on Immunization (NACI), founded to research and obtain COVID-19 vaccines, has produced a report with recommendations on who will eventually receive the coveted early doses.

Along with providing its own recommendations, NACI conducted internal surveys among stakeholders including the Public Health Agency of Canada, as well as the general population. Canada’s COVID-19 Snapshot Monitoring Study (COSMO Canada), in collaboration with the Public Opinion Research Team within the Privy Council Office, collected data from 2,000 Canadians asking who they felt should get the first vaccines. Angus Reid polled 1,500 Canadians asking the same question.

There was a consensus.

No Canadian will disagree that elders in long term care be among the first group to receive the vaccine. This is only right considering all they have endured over the past year. After that there’s agreement that health care workers, persons over 65 and those with underlying health issues be inoculated.

NACI recommends vulnerable groups such as the unhoused and Indigenous populations who have limited access to health care or live in remote communities should also be among the early recipients. Subsequently, vaccines would be available for those deemed necessary to the running of the country.

To help determine who is classed as “essential,” Public Safety Canada has compiled a document titled “Guidance on Essential Services and Functions in Canada During the COVID-19 Pandemic.” It lists those considered indispensable to keeping Canada chugging along and includes first responders, postal workers, teachers, grocery store workers, and politicians.

The advisory committee is also tasked with vaccine procurement. To restart economies in haste governments are aiming for herd immunity as the holy grail. When enough people have built up resistance to COVID-19 through inoculation the theory is that this could suppress the pandemic altogether.

Many estimates conclude that between 60 to 70 percent of the population need to achieve herd immunity for it to be effective, but this is contingent upon how much the virus is being transmitted—the “R value,” or reproduction rate.

This all sounds fair enough, but on the international stage, Canada’s coordination with other wealthy jurisdictions including the United States, the European Union, the United Kingdom, and Australia shows that we are moving away from global solidarity towards what has been called “vaccine nationalism.”

Last week, at a meeting of the World Trade Organization (WTO) in Geneva, the world’s wealthiest nations—including Canada—opposed waiving intellectual property rules for COVID-19 vaccines until the end of the pandemic. By refusing to temporarily lift patent protections, WTO members have ensured that pharmaceutical corporations like Pfizer, BioNTech, Moderna, and AstraZeneca will retain “control over key decisions including who gets the vaccines, when they get them, how much they get, and how much they pay.”

Without the ability to dictate what private manufacturers can charge for a new vaccine, we allow the pursuit of profit to triumph over human need. This threatens to exacerbate existing inequalities and disparities between the Global South and Global North.

In a recent interview on the CBC’s Sunday Edition, Matthew Herder, director of the Public Health Law Institute at Dalhousie University, said “We need different incentives, different reward structures to encourage companies and university researchers to develop vaccines to address these kinds of health problems… Patent rights don’t correspond to public health needs. They correspond to things that you can get predictable returns in the marketplace for.”

The confluence of vaccine nationalism and the privileging of private profit over human need calls for a radical change in our approach to public (and global) health.

One way to solve Canada’s domestic production woes is to develop a bold and ambitious industrial strategy that brings the public and private sectors together to build plants and labs to undertake vital research for the public good. This would enable the government to step in under certain circumstances to streamline production, distribution and administration of needed medications and vaccines. Such a model would move us away from simply commercializing the most profitable or expedient scientific discoveries towards an ecosystem that privileges knowledge production to respond to major social, economic and health challenges.

While universities and publicly funded labs across Canada are doing groundbreaking research, they are currently dependent upon pharmaceutical companies to co-ordinate large clinical trials, get regulatory approval in multiple countries and manufacture vaccines. The search for an Ebola cure exemplifies this.

In the early 2000s, government researchers discovered an effective Ebola vaccine at the National Microbiology Laboratory in Winnipeg where it sat and gathered dust without any private sector interest. It was only when the virus became a nightly news story that pharmaceutical giant Merck took interest, saw its profit potential, got approval and started mass producing a treatment.

There has also been publicly funded Canadian research on coronavirus vaccines since the SARS outbreak of 2003, but similarly little interest from the pharmaceutical giants.

Indeed, without domestic vaccine production capabilities Canada will remain behind the proverbial eight ball. What’s more, as long as we pledge our support for a global power hierarchy in which poorer nations are asked to “take the leftovers,” the international community will be less prepared for future pandemics and outbreaks.

In a perfect world, rapid inoculation would be available to all nations, rich or poor, and free at the point of delivery. Yet, nothing about this virus, nor the dictates of global capital, is fair or equitable—even the cure.

Jennifer Cole is a Vancouver based writer with a BA in history from Simon Fraser University.