Are the actions of world leaders and pharmaceutical companies resulting in rich countries hoarding possible vaccines? Or are rich countries making sure that those who need a vaccine most (front-line workers and medical personnel), get a vaccine first?
These questions are what ONE’s Vaccine Access Test is all about. By asking these questions, we can make sure countries like Canada follow best practices and evidence-based medical research.
Fair global distribution of COVID-19 vaccines will end the pandemic faster for everyone, saving lives and helping economies recover.
Those most at risk of catching and spreading the virus, and those most vulnerable to its effects, must have access first, regardless of nationality or wealth. This is what scientist say will reduce overall transmission the fastest. It is also the right thing to do.
How is Canada scoring on the Vaccine Access Test?
The answer is… there is a lot of room for improvement. Canada gets just 4.4 points out of a potential 15. In fact, most countries and companies are not doing very well right now, and the reason is that despite strong statements in favour of global access, many rich countries—including Canada—have been competing to buy-up as many doses as possible, even before a vaccine is ready. Wealthy nations representing just 13% of the world’s population have already cornered about half of the promised doses of leading COVID-19 vaccine candidates.
On the plus side: Canada does well on multilateral leadership. We have officially joined the COVAX Facility, the global cooperation mechanism to accelerate the development and manufacture of COVID-19 vaccines, and to provide fair and equitable access around the world. Prime Minister Trudeau has also spoken out in favor of global equitable access on numerous occasions, including in a Washington Post op-ed published in July. On the domestic side, Canada has released a preliminary guidance on priority distribution of vaccines.
On the ‘good but need to do more’ side: Canada has committed around 40% of its fair share to the ACT-Accelerator, the only mechanism positioned to deliver a coordinated global response on vaccines (via COVAX) but also tests and treatments.
On the minus side: Canada does not have requirements on transparency and equitable access when they award R&D contracts and has not endorsed the WHO Solidarity Call to Action which calls for the pooling of knowledge, intellectual property and data on Covid-19 medical research. National guidance on priority distribution of vaccines in Canada has not yet been published, while in other countries like the UK, the Government has shared its plan to first focus on essential workers and older people.
Canada also needs to do better on communicating how its bilateral deals with pharmaceutical companies can align with the Prime Minister’s commitments to global equitable access.
Right now, the average score of all seven deals Canada has secured is 0.4, which drags down Canada’s overall standing on the Vaccine Access Test. This is because there is no public information on cost or staggered delivery, which could allow for a more equitable distribution of the initial doses available. This is in contrast with the United States where there is a website outlining basic information on bilateral deals, like the total value or each contract and whether all doses are expected at once, or staggered through time.
Now let’s be clear. It is impressive that Canada has struck all these bilateral deals. Canadians would be right to feel re-assured that our Government has worked hard to make sure that, when a Covid-19 vaccine arrives, we will have access to it.
But for the first few months at least, the reality will be that the supply of doses will be constrained. Even with increased manufacturing capacity, experts predict that the world will be able to produce between 1 and 4 billion doses by the end of 2021. If the vaccine requires two doses, this means that only a relatively small proportion of the world’s population will be vaccinated within the next year or so—even if we get the good news of successful trials before the end of this year.
Altogether, these deals could provide almost 10 doses per Canadian! This is while most countries in the world have struck zero deals, because they don’t have the ability to pay—so have little negotiating power with pharmaceutical companies. Thankfully, the COVAX Facility is there to provide broader access in lower-income countries. That more than 180 countries (including Canada) have chosen to participate is a truly amazing achievement.
But there remains a fundamental question: when the first doses come in, who will get them as a priority?
Science tells us that to save the most lives and end the pandemic sooner, it would be more efficient to first vaccinate the most at-risk (ex. essential workers, the elderly) in all countries, rather than 100% in a few rich countries. Expert modelling suggests that if vaccines are distributed more equitably in all countries, it could save almost twice as many lives as if only rich countries have access to the first doses.
The bottom line is that right now, we do not know who will get the vaccine in priority in Canada, and whether the ordered doses will be delivered over time, which could allow a fairer distribution across countries of the first batches. Without this information, it is difficult to know how firm Canada’s commitment to global equitable access really is.
How can Canada improve on its score on the Vaccine Access Test?
The Vaccine Access Test is intended to start conversations and even debates around how to end this pandemic, and lead to concrete actions that move us collectively in the right direction. Canada’s rather low score is not set in stone—in fact, we are confident it can improve over the next weeks and months.
Here is what Canada can do to improve its score:
- Invest its fair share in the ACT-Accelerator, or an additional CAD$600 million (+ 2 points)
- Commit not to hoard doses before other countries have also vaccinate their most vulnerable populations. (+1-3 points)
- Publish basic information on the deals it makes with pharmaceutical companies, including the schedule of delivery and cost (+1-3 points)
- Support the WHO Solidarity Call to Action (+1 point)
So, let’s keep talking, and let’s keep improving. Because none of us are safe until all of us are safe.