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Jason Nickerson is the humanitarian representative to Canada, and Adam Houston is the medical policy and advocacy officer for Doctors Without Borders/Médecins Sans Frontières.

An outbreak of Ebola in Uganda has killed at least 48 people since it was announced in September, and the number of cases continues to rise. Doctors Without Borders/Médecins Sans Frontières (MSF) teams have been on the ground since the start of the outbreak and are working around the clock to help Ugandan health authorities with their response, but these efforts have been hampered by the fact that no approved vaccine exists for this form of the virus. The current outbreak is of the less common Ebola-Sudan species, and unlike the more widely seen Ebola-Zaire species, there is no approved vaccine.

And yet a viable vaccine candidate – produced more than a decade ago in a Canadian government laboratory – has spent years sitting on a shelf, still undeveloped and unavailable for use because of a medical research and development (R&D) system that is driven by commercial gain rather than by public-health needs. Researchers at Canada’s National Microbiology Laboratory in Winnipeg discovered a suitable vaccine candidate in the 2000s, but instead of being subjected to clinical trials and developed for patient use, it has been collecting dust.

If the story of Canada’s Ebola-Sudan vaccine sounds familiar, it’s because the exact same thing happened with Ebola-Zaire, which caused the world’s largest Ebola outbreak when it first struck West Africa in 2014. Again, Canada’s National Microbiology Laboratory had discovered a promising vaccine in the early 2000s, and again it remained undeveloped for want of a private pharmaceutical company looking to make money on a new product – an unlikely prospect for a vaccine targeting a disease that until then had only affected communities in remote areas of central Africa.

Eventually, after clinical trials largely funded by governments and charities, Canada’s Ebola-Zaire vaccine became the first approved Ebola vaccine (it has since been shown to be more than 97-per-cent effective during outbreaks). It is now a crucial tool that has helped prevent subsequent outbreaks from spreading out of control. But it took the deaths of thousands of people in West Africa’s outbreak to make that happen, almost a decade after the vaccine was first discovered.

Canada’s model of publicly funded medical R&D leaves the final development and production stages of even the most promising discoveries – including those that can address pressing global public-health needs – to the private sector. Diseases like Ebola-Sudan, which primarily affect low-income countries where the potential for profit is limited, do not tend to spark commercial interest, leaving potentially life-saving medical breakthroughs unavailable for people who desperately need them.

This year alone has seen outbreaks of three separate viral hemorrhagic diseases – Ebola, Marburg virus disease and Lassa fever – for which promising Canadian-discovered vaccines have never made it out of the lab to reach patients. Canada’s Lassa vaccine candidate has, at last, picked up some momentum, but only after being licensed to an American not-for-profit vaccine R&D organization that has clinical trials under way.

Ironically, a commercial pharmaceutical company that licensed the Ebola-Sudan vaccine from Canada, only to abandon the project, recently found a stock of up to 100,000 experimental doses in its freezers. These doses will be used in clinical trials in Uganda; if effective, the trials may lead to approval. However, relying on a company that stopped working on the vaccine years ago fortuitously finding some leftover experimental doses behind the coleslaw is hardly a sensible way to approach vaccine development, particularly during an outbreak.

This disjointed approach to medical R&D – in which Canada’s government invests public funds into discovering important new vaccines and medicines but relies on commercial partners for completion – prioritizes private-sector profitability over public-health needs. Unfortunately, Canada shows no sign of wanting to change its approach, despite having been down this road before.

It is time for Canada to act. Since 2020, MSF has been calling on Canada’s government to put lives above profits and place conditions on the medical R&D it funds to ensure that successful innovations are available for global public-health needs. This country also has a world-class vaccine-clinical-trials group, and now a publicly owned manufacturing facility that could be producing vaccines with little commercial value but significant public-health impact. We should be putting all of these resources to use.

Canada often likes to portray itself as a major player in global health, but the story of the Ebola-Sudan vaccine – and the preceding Ebola-Zaire vaccine, and the still unfinished Marburg and Lassa vaccines – show that valuable Canadian innovation is struggling to reach people who can benefit from it during urgent public-health crises.