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A health-care worker prepares a dose of the Pfizer-BioNTech COVID-19 vaccine at a UHN COVID-19 vaccine clinic in Toronto on Jan. 7, 2021.Nathan Denette/The Canadian Press

Canada is the only Group of Seven country to draw on a supply of COVID-19 vaccines meant primarily for developing countries, leading to fresh charges of hoarding against a country that is already a world leader in vaccine purchases per capita.

The COVAX program pools funds from wealthier countries to help buy vaccines for themselves and for 92 low- and middle-income countries that can’t afford to buy on their own.

The vast majority of countries receiving the first vaccine shipments from COVAX are low- and middle-income countries, according to information released Wednesday by Gavi, the vaccine alliance that is co-ordinating the program.

But Canada is among just a few rich countries exercising its options now to buy vaccines from the international group. Other wealthy countries on the list receiving the vaccines include New Zealand and Singapore. Canada’s vaccines are expected to arrive by the end of June.

Pending regulator approval, Canada will receive 1.9 million doses of the AstraZeneca vaccine from the COVAX program. It’s listed among countries such as Rwanda, Afghanistan and Sudan, which have yet to receive any vaccines, according to the Our World in Data website.

Prime Minister Justin Trudeau’s government faces intense political pressure for a vaccine rollout that in its first two months has been beset by delays, and repeatedly lowered expectations. Amid a global supply crunch with only a few COVID-19 vaccines approved, countries in the European Union are under similar pressure but held off drawing on the limited doses COVAX has available.

The federal government defended its decision, saying it has always intended to draw from the international program in addition to contributing to the effort.

“Our contribution to the global mechanism had always been intended to access vaccine doses for Canadians as well as to support lower-income countries,” Guillaume Dumas, a spokesperson for International Development Minister Karina Gould, said in a statement. “We’re having a comprehensive approach to fighting the pandemic as we know that the virus won’t be defeated until it is defeated everywhere.”

The COVAX purchase is on top of the seven contracts Canada signed directly with drug makers. Through those seven contracts, and factoring in the two-shot dose regimen for most of the vaccines, the federal government had already bought enough vaccines to inoculate the entire population three times over. The contracts are all contingent on Health Canada approval.

Relying on its contracts with Pfizer and Moderna alone, Canada says it will have enough doses to inoculate everyone in Canada by September.

In September, Mr. Trudeau announced the federal government would give COVAX $440-million. Half of that was to allow Canada to buy up to 15 million vaccine doses, while the rest would go to low- and middle-income countries so they can also buy the critical shots.

At a virtual press conference on Wednesday, Gavi chief executive officer Seth Berkley said the group’s most important role is to “supply vaccines for countries that otherwise wouldn’t get access.”

“Does it help when countries that have a lot of bilateral deals don’t take doses?” he asked. “Of course it helps because that means there are more doses available for others.”

The number of doses that Canada is getting from COVAX is also lower than what Procurement Minister Anita Anand first told The Canadian Press ahead of Wednesday’s announcement. She said Canada would get up to 3.2 million by the end of June. That number was not included in the document released by GAVI on Wednesday.

A letter sent to Canada on Jan. 30 from COVAX, and provided to The Globe, said Canada could expect between 1.9 million and 3.2 million doses. The letter said the lower range was based on “expected distribution due to supply constraints” while the “high end reflects the contracted number of doses.”

Health justice advocates are questioning Canada’s decision to take vaccines from COVAX at a time when high-risk people in poorer countries are still waiting for vaccines.

“It shows that COVAX is not a sustainable solution for low-income and middle-income countries,” said Fatima Hassan, head of the Health Justice Initiative, a South African advocacy group.

“COVAX has a pecking order, and it prioritizes the self-funded countries like Canada,” she said. “It’s not based on global health needs, it’s based on how much money a country is able to put into COVAX.”

Canada’s decision to accept vaccines from COVAX is “the clearest evidence yet of how rich countries are hedging their bets,” Ms. Hassan said.

“We’re seeing richer nations taking a lot of supplies from different mechanisms, while a lot of health care workers in poorer parts of the world are not getting vaccinated. Is that fair and just? No, it isn’t.”

Jason Nickerson, humanitarian affairs adviser at Médecins sans frontières (Doctors Without Borders), said there is a danger that Canada’s use of COVAX could undermine the program’s ability to ship vaccines to countries with higher needs.

“If we’re using COVAX doses – which could otherwise be used to vaccinate high-risk people in low-income countries – to vaccinate low-risk people in Canada, I don’t think that’s a defensible position,” Mr. Nickerson said.

For many poorer countries, COVAX will be the main source of vaccines. Most have not received any vaccines so far. In the entire continent of Africa, for example, about 230,000 vaccines have been administered. Conversely, Canada has received more than 1.1 million doses and vaccinated 2.6 per cent of the population. But the government is being criticized domestically as it falls further behind its peer countries in vaccination rates.

Canada has promised to share any surplus vaccine doses with COVAX. But it has declined to say whether it would wait until the end of its complete vaccination program or do it earlier.

The World Health Organization’s director-general, Tedros Adhanom Ghebreyesus, has urged Canada and other wealthy countries to begin sharing their surplus as soon as their health workers and older people are vaccinated – a relatively early stage in the vaccine rollout.

The COVAX program is aiming to provide 1.3 billion vaccine doses to 92 lower-income countries by the end of this year. But it remains underfunded and is still seeking billions of dollars to meet its goals.

With a report from The Canadian Press

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