Canada and other wealthier countries undermining efforts to ensure equitable distribution of COVID-19 vaccine, report warns

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A “shopping spree” by Canada and other high-income countries to secure large quantities of COVID-19 vaccines is undermining global efforts to ensure people in developing countries aren’t pushed to the back of the line, a new report warns.

Researchers with Duke University’s Global Health Innovation Center (GHIC) analyzed the wave of announcements made in recent months by these countries to secure priority access to COVID-19 vaccine candidates in the event that the vaccines are approved for use.

The research found that, to date, these agreements with pharmaceutical companies by high-income countries and a few middle-income countries have secured access to nearly 3.8 billion doses, with options for another five billion.

In a report to be released Monday, the researchers warn that these one-off agreements run contrary to the commitments of Canada and more than 170 other countries that have signed on to support the COVAX Facility. COVAX is co-led by the international vaccine alliance Gavi, the Coalition for Epidemic Preparedness Innovations (CEPI) and the World Health Organization. The aim of COVAX is to ensure equitable access for all countries to a COVID-19 vaccine.

Prime Minister Justin Trudeau announced Canada’s participation in COVAX in September, pledging $220-million to procure up to 15 million vaccine doses for Canada and another $220-million to purchase doses for low-and-middle income countries.

Canada has also signed direct agreements with several pharmaceutical companies that secure access to up to 358 million doses of the various vaccine candidates. Should all of the candidates be approved for use, that would give Canada enough supply to vaccinate its population of 38 million several times over.

The Duke report says current models suggest that there won’t be enough vaccines to cover the world’s population until 2024.

While there have been other warnings regarding “vaccine nationalism,” Duke researchers say the report is the first detailed effort to quantify the number of vaccine doses that have been committed through country-level agreements and the impact this could have on low-income countries.

Andrea Taylor, the Oxford-based assistant director of programs for Duke’s GHIC and the lead researcher for the report, said other governments such as Britain and the European Union have faced sharp criticism for signing large deals with pharmaceutical companies, but Canada’s efforts haven’t received the same level of scrutiny. Ms. Taylor said Ottawa has secured “far and away” more vaccine doses per person than any other country.

“Because manufacturing capacity is limited, every direct deal that’s done by a country like Canada reduces the number of doses that are available for something like COVAX,” she said.

“So I think it’s interesting looking at Canada, because the population is a bit smaller than some of the other countries that have gotten a lot of flak. Their actual number of confirmed doses doesn’t fly off the charts. But when you look at it relative to population, it really does.”

The Duke news release accompanying the report states that the “shopping spree” by high-income countries is undercutting the pledges of COVAX signatories, such as Canada, the EU and Britain. The United States has not signed on to COVAX. The report found that no low-income countries have signed direct agreements with vaccine manufacturers.

The lack of vaccine-manufacturing capacity will be a major cause of delays in vaccinating the global population, the report said. Mr. Trudeau recently announced funding for Quebec biopharmaceutical company Medicago Inc. to create a production facility in Quebec City.

Ms. Taylor said that announcement shows Canada recognizes that this is an issue that needs to be addressed.

“In the last week or two, we have seen a lot more activity and investment going into manufacturing capacity and unlocking additional capacity, which is great news," she said.

In an interview Sunday with The Globe and Mail, International Development Minister Karina Gould said she disagrees with the premise that direct vaccine procurements undermine COVAX. Ms. Gould said Canada is the second largest financial supporter of COVAX and that Ottawa is directly involved in the planning work to ensure COVAX is a success.

“We’ve helped set [COVAX] up right from the beginning and we are very active in helping to shape it. And we really want to see that be a success,” she said. "We understand how important that is to ultimately confront, and hopefully end, the COVID-19 pandemic.”

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