‘Are people to be left to die?’ Canada pumps millions into COVID-19 vaccine-sharing effort, but fears persist for poorer nations

This story is part of an ongoing series — The Road to a Vaccine — that looks at Canada’s quest to secure a amid the global pandemic, as well as the hurdles and history it faces to do so.

As the race for a vaccine kicks into high gear, has announced that Canada will chip in $440 million to a global effort to share vaccines and make sure poorer countries aren’t left behind.

Trudeau told reporters Friday said the money for the COVAX Facility will be divided between the global procurement effort — which could mean as many as 15 million additional doses for Canadians — and the sharing program by which vaccines will be sent to countries that wouldn’t otherwise be able to afford them.

“To eliminate the virus anywhere, we need to eliminate the virus everywhere,” Trudeau said. “That’s why Canada is helping ensure vaccines are distributed quickly and fairly around the world.”

There are now more than 100 teams around the world at work on potential vaccines, known as vaccine candidates, a handful of which are moving into the final stages of clinical testing. But it’s a competition some say is at risk of being overshadowed by the nation-versus-nation battle for doses, as a weakened global response has spurred richer countries to seek out vaccine deals of their own.

COVAX is the major global attempt to try to avoid having all the vaccines go to the highest bidders.

Launched this spring by, among others, the World Health Organization and the Bill & Melinda Gates Foundation’s Gavi alliance, it’s since emerged as the only real international effort to get countries to work together on both procuring, manufacturing and distributing vaccines. While Canada had officially signed on as of Monday, details of the financial commitment were unclear until now.

For a country such as Canada, which can afford to buy in, the benefits of the program are arguably twofold: Canada gets the option to share in any successful vaccines the group obtains access to, but is also able to support the sending of vaccines to poorer countries.

For countries that can’t afford vaccines any other way, it could be a lifeline.

The fear that countries with shallower pockets are going to be left out when the time comes was back in the spotlight this week at the UN Virtual Summit.

“Are people to be left to die?” asked Honduran President Juan Orlando Hernandez, a COVID-19 survivor, referring to the problems that may lie ahead.

If all goes to plan, COVAX is aiming to deliver two billion vaccine doses by the end of 2021 to countries around the world, distributing them based on population and need rather than ability to pay.

But that goal is highly dependent on the money they have yet to get from donor countries and philanthropists.

Half of Canada’s financial commitment, or $220 million, will go to COVAX’s financial arm, known as the COVAX Advance Market Commitment, which is in charge of funding vaccines for low and middle-income countries. But it has yet to meet its initial $2-billion goal, raising questions about who will be left out if the needed money isn’t raised.

The program was dealt some early blows, when major players such as the U.S., China and India all declined to sign on, choosing instead to focus on their own vaccine needs.

The United States, for example, has dubbed its own vaccine effort Operation Warp Speed and poured an estimated $10 billion into it while making clear that the fruits of its labour will be for Americans only.

Canada hasn’t escaped accusations of selfishness either.

A public letter signed by more than 100 health and policy experts and released last week accuses the federal government of undercutting efforts such as COVAX by participating in the global jockeying for vaccines.

In fact, before announcing the COVAX funding, Trudeau revealed Canada’s latest advance purchase agreement, this time with a company called AstraZeneca, which has been working with Oxford University on a potential vaccine. Should it pass clinical trials, Canada will be able to acquire as many as 20 million doses.

Canada now has agreements with six different biopharmaceutical companies, in addition to any doses obtained through COVAX. If every vaccine candidate ends up successful (which is admittedly unlikely) and Canada buys the maximum number of doses to which it’s entitled through these contracts, it could end up with almost 300 million vaccine doses.

What happens when COVAX bumps up against all those advance purchase agreements remains murky.

Early on in the pandemic, Canada got stung by a general lack of preparation when it came to acquiring personal protective equipment, notes Colin Furness, an infection-control epidemiologist and assistant professor at the University of Toronto.

Now, he says, the government is moving hard to make sure the same thing doesn’t happen with vaccines: “Aggressively negotiating and throwing around the fact that we’ve got a currency that has purchasing power and throwing out elbows (to) get in line, that’s an understandable thing to do,” he said.

“Though the consequences to those who are then behind us in line, I mean, ethically, that can get a little bit complicated.”

For Jason Nickerson, a humanitarian affairs adviser with Doctors Without Borders, the litmus test for whether it’s possible to have these purchase agreements without jettisoning global responsibilities will be whether or not health-care workers and people who are high risk are able to get vaccinated first and in a timely manner — no matter where they are in the world.

“I think the major concern is that vaccines are going to be delivered to high-income countries to use before they are delivered to low-income countries to vaccinate their high risk populations,” he said.

Karina Gould, Canada’s minister of international development, says that vaccine companies have already committed certain doses to COVAX, so it’s not a matter of Canada’s orders bumping them out of the queue. The exact delivery timelines are still under discussion.

“Canada’s position is that we expect vaccines to be affordable, accessible and equitable around the world,” she said.

And if it looks like funding will be falling short?

“Well, then, we’ll be on the phone, trying to encourage partners around the world to step up and to make a contribution. I know that we’re still waiting on announcements from some of significant players, and I’m confident that they’re going to deliver.”

Last spring, Canada assembled a group of experts on everything from public health to pharmaceuticals and charged them with advising the government on how to lock down a safe and effective vaccine as soon as possible.

But while members of this Vaccine Task Force maintain that their first job is to get a vaccine for Canadians, they believe in the need for global access, and for Canada to strike a balance between protecting its own while doing its part for the global community.

“We recognize that if the disease exists anywhere, it exists everywhere. So it’s also important, and our advice is around that, for Canada to support international global efforts,” says co-chair J. Mark Lievonen, who is also the former president of Sanofi Pasteur Ltd., the Canadian vaccine division of global biopharmaceutical company Sanofi.

How these vaccine deals start playing out is something that Nickerson, of Doctors Without Borders will be watching closely.

“If history is any indication of what can happen during a pandemic, I think that we ought to be concerned,” he said, nodding to the H1N1 pandemic, when a lot of the early vaccines, and only donated to other countries once their own needs were met.

In the same way that COVID has exposed the cracks in our education and health systems, he said that this pandemic risks underscoring how medication and health care are just easier to come by if you’re a richer country: “We need better systems of fair distribution and allocation, and pricing. It’s just not right.”

That said, he says COVAX, and Canada’s commitment, could be a meaningful step in the right direction.

“It’s clear that countries are striking these bilateral deals because they think that it’s the quickest way of gaining access, but there’s also a momentum behind COVAX that I don’t think that we’ve ever seen before,” he said.

“So if it’s properly funded, and if there is a fair, equitable allocation process, then I’m hopeful that this is the start of something good.”

With files from The Associated Press

Alex Boyd is a Calgary-based reporter for the Star. Follow her on Twitter: .n.boyd