McLeod Group guest blog by Adam R. Houston, March 11, 2024
What lessons did the Canadian government learn from the COVID-19 pandemic? On the issue of equitable global access to medicines, the government’s recent actions suggest that it has learned the wrong ones. The gulf between the rhetoric and the reality of the government’s stance on global COVID-19 vaccine access was a particular low point of Canada’s pandemic response. This makes it all the more troubling that Canada has quietly sought to undermine attempts to codify measures to rectify these inequities at the international level, most recently in the Pandemic Treaty currently being negotiating at the World Health Organization (WHO).
Despite the Canadian government’s vocal calls for equitable access – consider the op-ed toplined by Prime Minister Trudeau in the Washington Post – Canada was, in reality, the country that secured the most doses of scarce vaccines per capita by a wide margin, despite not producing any doses domestically. Such an approach in turn undermined the positive steps that Canada did take. The impact of generous cheques to COVAX, the international mechanism set up to promote vaccine equity, was dulled considerably when vaccine hoarding by countries such as Canada left few vaccines on the shelves for COVAX to buy.
More important has been Canada’s reticence to support measures to increase the global supply of vaccines. This reluctance was evident during the ultimately disappointing discussions at the World Trade Organization (WTO) of a proposal known as the “TRIPS waiver”. The TRIPS waiver, supported by a sizeable majority of WTO members, would temporarily suspend certain intellectual property (IP) rights around products needed for the COVID-19 response.
While Canada queried the need for the TRIPS waiver by highlighting its own experience using existing flexibilities under the WTO’s IP Agreement as an alternative, it stonewalled Bolivia’s attempt to take advantage of those very same flexibilities. Yet even after the United States, traditionally a vigilant protector of IP, announced support for a limited waiver restricted to vaccines in May 2021, Canada did not do the same. Instead, it issued a vague communiqué about remaining committed to finding solutions that would not “negatively impact public health” – language echoing the Canadian pharmaceutical lobby’s statement the day before.
At the Pandemic Treaty negotiations, the gulf between Canada’s rhetoric and reality has widened. Canada has pushed for the inclusion of more language around equity, while simultaneously advocating against tools that would actually help ensure equitable access to vaccines and other health products. These contradictions are exemplified by a recent amendment put forward by Canada regarding transparency, which proposes adding sex-disaggregated data while deleting information on revenues, prices and subsidies for health product research and development (R&D).
In an earlier draft, Canada had gone so far as to propose that the description of equity as a guiding principle of the treatyincorporate reference to technology transfer from pharmaceutical companies to third parties to enable wider production of vital products as occurring on voluntary and mutually agreed terms. Despite promoting similar language throughout the Treaty, Canada has never offered any suggestion of what would happen in the all too frequent scenario where such “voluntary and mutually agreed terms” are not reached with pharmaceutical companies, or why a backup plan for just such a scenario is not needed.
In yet another instance where Canada has written cheques for international initiatives that its policy approach simultaneously undermines, Canada has contributed millions of dollars to the WHO’s mRNA Tech Transfer Hub in South Africa, which is intended to disseminate mRNA technology to low- and middle-income countries. However, in order to have any technology to transfer, the Hub had to reverse engineer a vaccine. Some of that underlying technology originates from a public Canadian university, from which it was spun off into a Canadian company that received years of financial support from the Canadian government.
Nevertheless, Canada has been reluctant to redesign its public funding for R&D so that such efforts prioritize public benefits over private profits. Even Parliamentary committees before and after COVID-19 have recommended that such funding come with conditions to make access easier for low- and middle-income countries, but thus far without success.
Despite its counterproductive stances on the Pandemic Treaty, one would not know these were Canada’s negotiating positions if one relied solely on the government’s public communications. Indeed, this would be true even if one participated directly in the government’s rather disappointing public consultations on the Treaty. These consultations have focused on the public drafts of the Treaty without ever revealing Canada’s own positions, let alone discussing or attempting to justify them.
With most of the Pandemic Treaty negotiations being held behind closed doors, it is only thanks to leaked documents, such as those hyperlinked above, that Canada’s actual positions are known. If the government believes that it is taking the right course of action at the WTO and the WHO, it should demonstrate confidence in those positions by publicly setting out its justification.
Indeed, a lack of both transparency and self-reflection continues to plague preparation for the next pandemic. Despite some piecemeal examinations, Canada has yet to undergo a formal inquiry into Canada’s COVID-19 response, despite calls to do so. Furthermore, even in countries that are carrying out an inquiry, national policies with international implications, such as those impacting vaccine equity, have been largely sidelined. That is a reason why calls for a Canadian inquiry have highlighted the need to include global vaccine equity.
At the moment, however, Canada appears content to double down on the status quo, which is what led to the inequities of the pandemic. Throughout COVID-19, a frequent government refrain was that the pandemic isn’t over anywhere until it’s over everywhere. If Canada undercuts the world’s ability to respond effectively to the next pandemic, it will harm its own ability to respond as well. The Canadian approach is both selfish and self-defeating.
Adam R. Houston (JD, MA, LLM, PhD) works in the international humanitarian sector, and is an adjunct professor in Common Law (University of Ottawa) and humanitarian studies (Royal Roads University). His most recent publication on Canada and vaccine equity, “‘Where You Live Shouldn’t Determine Whether You Live’: Canada and the Line between Rhetoric and Reality in Global COVID-19 Vaccine Equity” was published in the edited volume Pandemics, Public Health, and the Regulation of Borders earlier this year. Image: Pixabay.