Foreign Affairs Committee on March 21st, 2022

[Joshua Tabah]

It is a monumental undertaking to have designed a new multilateral mechanism for the procurement and delivery of vaccines. I would point to a few specific milestones that give us comfort and confidence in how effective the mechanism has been.

First, the COVAX mechanism was able to deliver its first doses to Ghana in February 2021, mere weeks after those doses received initial regulatory approval from the WHO. It represents the first time that a novel product in the vaccine space like this was made available so early in an equitable way around the world.

Another significant milestone earlier this year was achieving a billion doses delivered. For many of us, it was a key moment to recognize the enormity of not just the effort but also the result in progress that COVAX has made.

At this stage, with over 1.3 billion doses shipped and many more planned deliveries in the coming weeks and months, we feel that COVAX is the key platform positioned to provide support to countries that require it. It offers end-to-end integrated support, including technical assistance, planning support, cold chain assistance, and local administration and rollout support. When we set out to build this new mechanism with a number of other allies, it was important not just to position COVAX for effective procurement, but also to be able to procure safe and effective vaccines that would respond to what countries require and then to complement that with comprehensive support to strengthen immunization systems in countries.

I mentioned in my opening remarks that there were delays last spring and summer that the world faced. Production was not able to keep pace with the demand that spiked around the world. By about October or November, though, COVAX was well positioned to meet those needs of countries and it achieved a milestone of over 350 million doses delivered in December alone.

[Ali Ehsassi, Liberal, Willowdale, ON]

The latest data suggests that approximately 63% of the population of the world has received one dose. I noted during your presentation that you were talking about the milestone of 70% immunization by the end of the year. How likely is it that the WHO will hit that target by the end of this year? It would appear to me that we may very well surpass that target.

[Joshua Tabah]

There's a great deal of analysis and multiple opinions on this question. It's one the committee is likely to return to. Personally, I do think that the world is on track for an average immunization level of around 70% or even exceeding it by the end of 2022. I will note, however, that the WHO's goal is that every country achieve immunization levels of 70%, ideally by this summer. That is a much more ambitious goal. I think that there are multiple countries, in particular, fragile and conflict-affected states, that will struggle to achieve that level of immunization on that timeline.

[Ali Ehsassi, Liberal, Willowdale, ON]

Thank you. Now I'll turn to Ambassador de Boer.

Hello, Ambassador. It's great to see you before this committee. I want to ask you about the meetings and the discussions that were taking place at the WTO earlier this month. Of course, various initiatives are on the table. There is one that is led by India and South Africa and another one that is led by the European Union.

Could you tell us what Canada's perspective and views are on the merits of the two initiatives that are currently under discussion?

[Stephen de Boer]

I think what you're referring to are two processes. There is a proposal that was put forward by a number of countries led by India and South Africa. It was presented to the TRIPS council quite a while ago—I believe it was in October 2020—and it has been an ongoing discussion.

The other process that you're referring to is one that is led by the director general of the WTO. It's the so-called quadrilateral process that includes the U.S., the European Union, South Africa and India. That process was launched in December and is ongoing.

[Ali Ehsassi, Liberal, Willowdale, ON]

These two processes would not be either-or, but would essentially complement each other, is that correct?

[Stephen de Boer]

It's not clear. There are stories that there is a compromise that has now been reached, but that compromise has not been approved by the quadrilateral. My assumption is that if a compromise were reached, that would go to the TRIPS council for discussion, rather than the earlier proposal, and that members would engage on that particular text.

[Ali Ehsassi, Liberal, Willowdale, ON]

Thank you.

[The Chair, Liberal, Sven Spengemann]

Thank you, Mr. Ehsassi.

Good morning, Mr. Bergeron. You have six minutes. Go ahead.

[Stéphane Bergeron, Bloc, Montarville, QC]

Thank you, Mr. Chair.

Thank you to the witnesses.

Good morning to my fellow members. It's nice to see everyone again after two weeks off, which may have felt long to some and short to others.

Mr. Tabah said something in his opening statement that took me by surprise. He said that the vaccine landscape in 2021 was supply constrained, but that the situation had evolved in 2022 to become demand constrained.

I was taken aback when he said that, given the situation in a number of countries, including Haiti, where only 1% of the population is vaccinated. I'll come back to Haiti in a moment. In the Democratic Republic of the Congo and Chad, less than 1% of the population is fully vaccinated. In Papua New Guinea, just 2.8% of the population is vaccinated, and in Yemen, the number is 1.4%.

While we may be about to enter a phase where the landscape is demand constrained, the situation is very different in some African countries and in Haiti, for instance.

What, then, accounts for your rather optimistic view of the situation in 2022, Mr. Tabah?

[Joshua Tabah]

Thank you for that excellent question.

Low demand is not necessarily an optimistic sign. It's a complex challenge. The doses are available. If Haiti wants to access doses through COVAX, they could be there in a few weeks.

Low vaccination rates are not the result of a shortage of doses; rather, they are the result of a lack of demand and the limited health care capacity in those countries. I repeat, the doses are available. Nearly five billion doses have been made available through the COVAX facility this year. It is now necessary and urgent to work with those countries to ensure, not only that the political demand exists and logistical capacity is in place, but also that the population wants to be vaccinated against COVID‑19. The misinformation and lack of demand in many communities is significant.

That is why we are working with partners such as the WHO and PAHO. We want to make sure that governments in the region, including those in Haiti and the Dominican Republic, have access to comprehensive supports so they can work with their populations. That way, when more requests for vaccine access start coming in, the necessary capacity will be in place. The doses are available now.

[Stéphane Bergeron, Bloc, Montarville, QC]

I gather from Mr. Tabah's remarks that the next challenge for the international community will revolve around on-the-ground distribution and administration to populations, not so much the production and allocation of doses. I would think Canada has some work to do in that regard.

Now I want to talk about what Canada has done. Canada has donated x number of doses to other countries on a bilateral basis through a mechanism that is still unclear. The criteria used to determine which countries would or would not receive doses from Canada are still somewhat murky.

For example, Canada provided doses to Jamaica on four occasions, either directly or through COVAX, but did not provide any doses directly to countries like Haiti. Clearly, Haiti, one of the poorest countries in the world, is in the grip of not only a major political crisis, but also a major humanitarian crisis because of the earthquake that hit the northern part of the country. What's more, Canada and Quebec are home to a large Haitian diaspora.

What accounts for the disparity in Canada's provision of doses to countries on a bilateral basis?

[Joshua Tabah]

Thank you for your question.

Our offer of vaccines to the government and people of Haiti is quite clear, and our ambassador is keeping a very close eye on the situation. We are ready to work with the Haitians as soon as they tell us they need doses to administer.

We are here for our neighbours in the Americas and the Caribbean, of course. We want to make sure that Haiti has all the support it needs to strengthen its commitment to the vaccination campaign.

We have established criteria. When countries in need of doses with the capacity to administer them cannot receive doses from Canada through COVAX, we can deal bilaterally with those countries. That's what we did last year with Jamaica.

[The Chair, Liberal, Sven Spengemann]

Thank you, Mr. Bergeron.

[Stéphane Bergeron, Bloc, Montarville, QC]

Thank you, Mr. Chair.

[The Chair, Liberal, Sven Spengemann]

We will now pass the floor to Ms. McPherson.

Please go ahead for six minutes.

[Heather McPherson, NDP, Edmonton Strathcona, AB]

Thank you, Chair.

I'd like to thank our guests for joining us today.

Welcome back to all of my colleagues from the weeks in our constituencies.

This is obviously an issue that's very important to me. I brought forward the motion for us to study this in this committee, so I'm looking forward to asking some questions today.

The first question I want to ask is regarding the TRIPS waiver. It recently emerged that a compromise agreement was negotiated. We heard about that earlier. This would soon be presented to the WTO. In the view of most CSOs, the document is only a small step forward as it applies only to small geographical areas and addresses the export of vaccines made under compulsory licence.

Will Canada support the TRIPS waiver at the WTO? Why has Canada been dragging its feet on the original waiver? Is any action ready to be taken on this reintroduced waiver?

One big concern that I should flag is the idea that this is so urgent. We have heard time and time again that the government is thinking about it, questioning it and looking at it, but we haven't seen the urgency.

Mr. Tabah talks about the idea that we had a very big problem in terms of supply at the beginning of the pandemic.

My questions are, will we be supporting that going forward and why didn't we support this in a more expedited way?

[Stephen de Boer]

I want to be very clear. There is no TRIPS waiver at this point. There was a proposal, as I mentioned to Mr. Ehsassi. There is now a process by which—

[Heather McPherson, NDP, Edmonton Strathcona, AB]

I'm sorry to interrupt. Does Canada intend to support the quad that is coming forward?

I do apologize for interrupting you. It's just that I have such little time.

[Stephen de Boer]

That's fair enough.

That is not an official waiver text either. We don't have that text.

As we understand it, a compromise was reached among the four and they have gone back to capitals to consult. The text has not been shared by the quadrilateral members with Canada or any WTO members, nor has it been shared by the DG.

I understand the plan would be that, if they agree, it would be presented to the TRIPS council as soon as possible. However, we do not have access to this particular text, so as it stands right now there is no waiver text.

With respect to your other question, Canada has never said that we would oppose a TRIPS waiver. It's been problematic in that there has not been a TRIPS waiver text. Canada has said that we are ready to engage with members on the basis of a compromised text. In this case it will have to be when that text is available and when the quadrilateral group has confirmed that this is the compromise.

I should also say—

[Heather McPherson, NDP, Edmonton Strathcona, AB]

You do know the intention of the text, though. Would Canada be finally willing to support the intention of a TRIPS waiver?

[Stephen de Boer]

I'm not sure why I would know the intention when this text has not been confirmed by the four quadrilateral members.

[Heather McPherson, NDP, Edmonton Strathcona, AB]

I'm going to ask another question to keep it moving.

[Stephen de Boer]

Sure.

[Heather McPherson, NDP, Edmonton Strathcona, AB]

Another question I have is around CAMR, which is Canada's access to medicines regime. We know there was a proposal put forward from a manufacturer in Bolivia. We heard a number of concerns about the process to access the CAMR.

How is the government addressing this? As it stands, of course, CAMR isn't working. We'd like to see it work better.

Is this a priority for the government?