Canada should focus on vaccine equity not travel bans human rights advocate, doctors say

Health and infectious disease specialists arecalling for the government of Canada to focus on global vaccine equity, not travel bans, as it takes measures to respond to news of the omicron variant of COVID-19.

The doctors, along with a human rights policy specialist who spoke to CBC this week, saidthe federal government can and should increase its vaccine shipments to low-income countries sooner than planned, encouragemore vaccine production and advocatefor rules to make pharmaceutical companies release vaccine recipes.

And doing so isin thebest interest of everyone, they said.

"If you don't want to be altruistic ... and if you only want to be self-interested, it's in your interest to have everybody on this planet vaccinated as soon as possible," said Dr. Ross Upshur, a professor in the Dalla Lana School of Public Health and the department of family medicine at the University of Toronto.

After news of omicron emerged, Canada announced it would limit travel from countries in southern Africa, a region that hadreported cases of the new variant of concern. Critics immediately questioned the move as it became clear that the variant wasalso surfacingin different parts of the world and in Canada.

Vaccine targets not being met

Infectious disease specialists have long said the way to prevent spread and mutation is to make sure countries around the world have enough vaccines for significant portions of their populations. The World Health Organization (WHO) set a goal to have 70 per cent of the globe'spopulation fully vaccinated by mid-2022.

But the world is far from that targetwithroughly 40 countries most of them in Africa that have less than 10 per cent of their populations vaccinated against COVID-19, according tovaccinationdata from local governments as of Wednesday via Our World in Data.

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Most patients who are testing positive for the new coronavirus variant are young and can be treated at home, says Dr. Angelique Coetzee, chair of the South African Medical Association and a member of South Africa's vaccine advisory committee.

"You're right to protect people in your countries, but then I would also caution you and say no one will sleep safely at night, not before Africa has been vaccinated," said Dr. Angelique Coetzee, one of the first doctors to detect the omicron variant in patients in South Africa.

Canada needs to do more and fast

Throughout the pandemic, Canada has providedvaccines and financial support to other countries through global efforts liketheCOVAXinitiative,which poolsfunds from wealthier countriesto buy vaccines for those countries andto ensure low- and middle-income countries have access.

The initiative had aimed to deliver at least two billion doses worldwide by the end of 2021. But the latest supply forecast in September showed it is expected to only have access to 1.425 billion doses this year. COVAX has struggled to procure vaccines because many factories producing the shots are fulfilling orders placed by rich countries that paid top dollar for their doses.

The emergence of omicron shows Canada needs to do more and sooner, said the policy specialistwho spoke to CBC.The first thing on the list should be prioritizing sending as many doses to countries with lower vaccination rates as soon as possible, he said.

"Until COVAX gets access to the doses that they need, we're going to continue to see this huge gap," said Ian Thomson ofaid agency Oxfam Canada.

Ottawa has pledged to donate the equivalent of 200 million vaccines (in actual doses and money to purchase doses) through COVAX by the end of 2022.

As of Wednesday, 8.3 million of Canada's donated vaccine doses hadbeen delivered through COVAX,and Canada'sfinancial contributions to the initiativeprocured about 87 million vaccines doses for low and middle-income countries, according toGlobal Affairs.

"Vaccine equity involves lots of ingredients. And I think in Canada's case, we've actually stepped up and the Canadian government has offered financial support to COVAX," Thomson said.

"What Canada hasn't done is actually followed through on those commitments."

He pointed to a report published in October by the People's Vaccine Alliance, which includes Oxfamthat found of the 40 million doses that Canada hadpromised early on in the pandemic, only eight percent or about 3.3 million of those doses had been delivered.

In an email response to CBC questionsWednesday, Global Affairs Canadaspokesperson Genevive Tremblay said Canada donates doses on "a rolling basis as they are released by the manufacturers."

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Dr. Isaac Bogoch says it's important to understand the new coronavirus variant, and equally important to get people around the world vaccinated. (Credit: AP Photo/Tsvangirayi Mukwazhi)

Canada has close to six million dosesin the national inventory according to the Public Health Agency of Canada,and anothermillion dosesthat havereportedly gone to waste since the rollout began and critics say those should be going to countries in need.

"Building a stockpile of vaccines does nothing other than creating a liability of an expiry date and vaccine spoilage, which is a tragedy considering this global situation," said Dr. Zain Chagla, an infectious diseases physician at St. Joseph's Healthcare Hamilton and associate professor at McMaster University.

"We have to be very cognizant that doses that come onto our soil need to have a demand," Chagla said. "Otherwise, they should not be coming here."

More manufacturers will lead to more vaccines

Thomson said Ottawa could also contribute to vaccine equity by joining advocacy effortsto changetothe intellectual property (IP) rights rules that vaccine makers can use to keep their recipes and manufacturing technology confidential.

"We've been pushing for a number of months at the World Trade Organization to have the rules relaxed so that we can have more manufacturers get into the COVID vaccine manufacturing game, particularly in developing countries," Thomson said. "The production can happen there and it can be distributed more quickly to those populations."

Prime Minister Justin Trudeau has said that his government will consider waiving IP rights enjoyed by those vaccine makers to improve access but stopped short of supporting a plan supported by other countries known as the Trade-Related Aspects of Intellectual Property Right (TRIPS) waiver proposal to dismantle IP protections for vaccines.

Global Affairs spokesperson Tremblay said Wednesday that the federal government is participating in discussions to waive IP protections.

Canada donated up to $15 million toestablish the South Africa Technology Transfer Hub, which could see regional development and production of mRNA vaccines and technologies, Tremblay said.

Syringes and other supplies needed

The WHO warned last month that there could be a shortage of one to two billion syringes needed to administer COVID-19 vaccines next year, and UNICEF Canada president David Morley told CBCsuch supplies are already in high demand in many countries.

Canada has provided $70 million to COVAX's COVID-19 Support and Delivery envelope "to help countries with efficient and effective in-country roll out, delivery and distribution," Tremblay said.

It has also promised to matchthenearly $10 milliondonated by individual Canadians to the #GiveAVax Fund through UNICEF Canada to cover costs oftransporting vaccine and training health care workers.

Directing resources to ensurestaff are trained to administer the vaccines and that there are culturally appropriate explanations available to combat misinformation and vaccine hesitancyis an important part of vaccine equity, said Dr. Anna Banerji, an infectious disease specialist at the University of Toronto's faculty of medicine and the Dalla Lana School of Public Health.

"We need to work with countries around the world to help them in what they need to try to get their people vaccinated, so we're not continuously battling new mutations as they occur," Banerji said.

"If you believe that we are our brother's keeper, we really need to help the world for us to move forward with this."