Canada’s ‘Me First’ COVID-19 Vaccination Strategy Could Impact Global Health

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When the Speech from the Throne was delivered on September 23, Canada had already committed more than $ 1 billion in advance purchase agreements with five drug companies for a minimum of 154 million doses of vaccine, if and when these candidate vaccines have been shown to be effective and safe. Two days later, Canada signed another deal with another company for an additional 20 million doses, covering its bets on which vaccine candidates will be the first to arrive.In doing so, Canada joins the premier league of vaccine nationalists, a handful of wealthy countries that have pre-purchased (so far) more than half of the world’s short-term vaccine supply.

It is understandable that countries want to ensure their ability to protect the health of their citizens. But most of the world’s population live in countries without the same financial resources to participate in the global ‘me first’ vaccine competition. Efforts to elevate national interests at the expense of collective global health result in slower progress and a limited global capacity to pool resources, while placing the interests of rich countries over others, with devastating effects. .

Recent modeling compared two scenarios for allocating the first three billion doses of an 80% effective vaccine. The “uncooperative” scenario – in which two billion doses went straight to high-income countries, and the rest to everyone – would result in 28% more deaths than a “cooperative” scenario, in which the three billion doses are distributed around the world in proportion to the size of the population.

What Can Canada Do?

For starters, our commitment to the World Health Organization COVAX Advanced Market Engagement (AMC). should, at a minimum, be what we invest in purchasing vaccines for use in Canada. The facility manages the world’s largest and most diverse portfolio of vaccine candidates. High-income countries like Canada that join COVAX have the option of purchasing approved vaccines through the facility, even if they have already entered into bilateral purchasing agreements with vaccine manufacturers. On September 25, Canada announced it would do so, pledging $ 220 million to purchase an additional 15 million doses of vaccine from the facility if and as they are approved.

More importantly, the facility’s AMC will provide vaccines to more than 90 eligible poor countries that cannot afford to purchase them on their own. The AMC is to raise $ 2 billion by December to do so, with the short-term goal of vaccinating 3% of the population of all COVAX countries. As of September 21, only $ 700 million had been pledged. On September 25, Canada committed $ 220 million to the AMC, in addition to the $ 25 million already donated. It is welcome and commendable, but it is also insufficient.

The longer-term goal of the AMC is to reach 20% – a goal that will allow health workers and vulnerable populations in poor countries to receive vaccines – but this will depend entirely on the generosity of country donations. high income, philanthropists and pharmaceutical companies. at AMC.

COVAX aims to ensure equitable global access to COVID-19 vaccines.

Much more AMC funding is needed now and in the future. We argue that Canada should commit a dollar per dollar amount to the CMA based on what it spends on its own vaccine purchases. That would mean providing up to $ 1 billion more than its current AMC commitment, with funds going through our country’s Official Development Assistance (ODA) envelope. Canada has global obligations under international declarations to do so.

Canada says it is a voice for equity and human rights, at home and on the world stage. Actions speak louder than words. Canada, in recent years, has not been particularly generous in its aid abroad. We ranked 17th out of 30 in the club of OECD donor countries in 2019, contributing just 0.27% of our gross national income, with no foreseeable increase. An immediate increase of $ 1 billion to the AMC still would not allow us to meet our long-promised 0.7% ODA target.

A billion dollars is a lot of money. But that’s only a fifth of the amount the federal government has borrowed each week since March from the Bank of Canada (which it owns) to fund its pandemic assistance programs. Most of the less endowed countries do not have the same capacity to borrow indefinitely from their own central banks and must instead turn to foreign creditors, with the risk of indebtedness that this implies. Or do without.

Vaccine manufacturing

According to the CEO of the world’s largest vaccine maker, the Serum Institute of India, even with expanded global capacity, it may be until 2024 before there are enough doses for the world’s population. In addition to providing more generous support for the COVAX facility, Canada can also increase its own vaccine manufacturing capacity. It is already on the right track to do so, with the government’s investment of $ 126 million for a new facility in Montreal. The facility’s aim is to produce two million doses of vaccine per month for home use by summer 2021.

Why not double this investment and reserve half of production for AMC to meet urgent global needs? It would signal to all Canadians the importance of a collective response to this pandemic.

Public health is global

As the world eagerly awaits the arrival of an effective vaccine, it is important to remember three things. First, the long-term effectiveness of any vaccine will remain uncertain for some time. Second, even if herd immunity to COVID-19 eventually does develop, there will almost certainly be another new infection in the not-so-distant future. Third, one way to deal with both future pandemic risks and the current COVID-19 vaccine shortage is to embrace the range of non-pharmaceutical interventions that can flatten and even contain infectious curves. This is especially true in countries that are home to the half of humanity that still lacks access to essential health care.

Governor General Julie Payette and Prime Minister Justin Trudeau wait during the Speech from the Throne in the Senate chamber in Ottawa on Wednesday, September 23, 2020. The speech underscored Canada’s commitment to ensuring global access to a COVID-vaccine. 19
THE CANADIAN PRESS / Adrian Wyld

All countries need stronger public health workers: more nurses, testers, contact tracers and community health workers. All countries need universal health coverage, one of the sustainable development goals that the world (including Canada) is committed to achieving by 2030. But it’s the poorest half of the country. humanity who needs it most.

So if Canada and other rich countries, in their vaccine nationalism, inadvertently continue to crowd out poor countries, they should compensate by massively securing the investments those countries need to provide social protection, support. income and food security essential to the health of their citizens. and strengthen their health systems with the public health capacity to suppress outbreaks as they occur.

It is in our own national interest to do so. At the end of the Speech from the Throne on September 23:

“We cannot eliminate this pandemic in Canada if we do not end it everywhere.”

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