Canada should focus on vaccine equity — not travel bans — human rights advocate, doctors say

Health and infectious disease specialists are calling for the government of Canada to focus on global vaccine equity, not travel bans, as it takes measures to respond to news of the omicron variant of COVID-19.

The doctors, along with a human rights policy specialist who spoke to CBC this week, said the federal government can and should increase its vaccine shipments to low-income countries sooner than planned, encourage more vaccine production and advocate for rules to make pharmaceutical companies release vaccine recipes.

And doing so is in the best interest of everyone, they said.

"If you don't want to be altruistic ... and if you only want to be self-interested, it's in your interest to have everybody on this planet vaccinated as soon as possible," said Dr. Ross Upshur, a professor in the Dalla Lana School of Public Health and the department of family medicine at the University of Toronto.

After news of omicron emerged, Canada announced it would limit travel from countries in southern Africa, a region that had reported cases of the new variant of concern. Critics immediately questioned the move — as it became clear that the variant was also surfacing in different parts of the world and in Canada.

Vaccine targets not being met

Infectious disease specialists have long said the way to prevent spread and mutation is to make sure countries around the world have enough vaccines for significant portions of their populations. The World Health Organization (WHO) set a goal to have 70 per cent of the globe's population fully vaccinated by mid-2022.

But the world is far from that target with roughly 40 countries — most of them in Africa — that have less than 10 per cent of their populations vaccinated against COVID-19, according to vaccination data from local governments as of Wednesday via Our World in Data.

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"You're right to protect people in your countries, but then I would also caution you and say no one will sleep safely at night, not before Africa has been vaccinated," said Dr. Angelique Coetzee, one of the first doctors to detect the omicron variant in patients in South Africa.

Canada needs to do more — and fast

Throughout the pandemic, Canada has provided vaccines and financial support to other countries through global efforts like the COVAX initiative, which pools funds from wealthier countries to buy vaccines for those countries and to ensure low- and middle-income countries have access.

The initiative had aimed to deliver at least two billion doses worldwide by the end of 2021. But the latest supply forecast in September showed it is expected to only have access to 1.425 billion doses this year. COVAX has struggled to procure vaccines because many factories producing the shots are fulfilling orders placed by rich countries that paid top dollar for their doses.

The emergence of omicron shows Canada needs to do more and sooner, said the policy specialist who spoke to CBC. The first thing on the list should be prioritizing sending as many doses to countries with lower vaccination rates as soon as possible, he said.

"Until COVAX gets access to the doses that they need, we're going to continue to see this huge gap," said Ian Thomson of aid agency Oxfam Canada.

Ottawa has pledged to donate the equivalent of 200 million vaccines (in actual doses and money to purchase doses) through COVAX by the end of 2022.

As of Wednesday, 8.3 million of Canada's donated vaccine doses had been delivered through COVAX, and Canada's financial contributions to the initiative procured about 87 million vaccines doses for low and middle-income countries, according to Global Affairs.

"Vaccine equity involves lots of ingredients. And I think in Canada's case, we've actually stepped up and the Canadian government has offered financial support to COVAX," Thomson said.

"What Canada hasn't done is actually followed through on those commitments."

He pointed to a report published in October by the People's Vaccine Alliance, which includes Oxfam that found of the 40 million doses that Canada had promised early on in the pandemic, only eight percent — or about 3.3 million — of those doses had been delivered.

In an email response to CBC questions Wednesday, Global Affairs Canada spokesperson Geneviève Tremblay said Canada donates doses on "a rolling basis as they are released by the manufacturers."

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Canada has close to six million doses in the national inventory according to the Public Health Agency of Canada, and another million doses that have reportedly gone to waste since the rollout began — and.critics say those should be going to countries in need.

"Building a stockpile of vaccines does nothing other than creating a liability of an expiry date and vaccine spoilage, which is a tragedy considering this global situation," said Dr. Zain Chagla, an infectious diseases physician at St. Joseph's Healthcare Hamilton and associate professor at McMaster University.

"We have to be very cognizant that doses that come onto our soil need to have a demand," Chagla said. "Otherwise, they should not be coming here."

More manufacturers will lead to more vaccines

Thomson said Ottawa could also contribute to vaccine equity by joining advocacy efforts to change to the intellectual property (IP) rights rules that vaccine makers can use to keep their recipes and manufacturing technology confidential.

"We've been pushing for a number of months at the World Trade Organization to have the rules relaxed so that we can have more manufacturers get into the COVID vaccine manufacturing game, particularly in developing countries," Thomson said. "The production can happen there and it can be distributed more quickly to those populations."

Prime Minister Justin Trudeau has said that his government will consider waiving IP rights enjoyed by those vaccine makers to improve access but stopped short of supporting a plan supported by other countries — known as the Trade-Related Aspects of Intellectual Property Right (TRIPS) waiver proposal — to dismantle IP protections for vaccines.

Global Affairs spokesperson Tremblay said Wednesday that the federal government is participating in discussions to waive IP protections.

Canada donated up to $15 million to establish the South Africa Technology Transfer Hub, which could see regional development and production of mRNA vaccines and technologies, Tremblay said.

Syringes and other supplies needed

The WHO warned last month that there could be a shortage of one to two billion syringes needed to administer COVID-19 vaccines next year, and UNICEF Canada president David Morley told CBC such supplies are already in high demand in many countries.

Canada has provided $70 million to COVAX's COVID-19 Support and Delivery envelope "to help countries with efficient and effective in-country roll out, delivery and distribution," Tremblay said.

It has also promised to match the nearly $10 million donated by individual Canadians to the #GiveAVax Fund through UNICEF Canada to cover costs of transporting vaccine and training health care workers.

Directing resources to ensure staff are trained to administer the vaccines and that there are culturally appropriate explanations available to combat misinformation and vaccine hesitancy is an important part of vaccine equity, said Dr. Anna Banerji, an infectious disease specialist at the University of Toronto's faculty of medicine and the Dalla Lana School of Public Health.

"We need to work with countries around the world to help them in what they need to try to get their people vaccinated, so we're not continuously battling new mutations as they occur," Banerji said.

"If you believe that we are our brother's keeper, we really need to help the world for us to move forward with this."