Foreign Affairs Committee on April 4th, 2022

[Hedy Fry, Liberal, Vancouver Centre, BC]

I just wanted to go back to one of the pieces I asked you about in my question, which is that we know that many countries.... You take a country like Hong Kong. It obviously isn't a low-income country, but Hong Kong is finding itself now with a huge number of deaths as a result of the pandemic, when it was doing very well at the very beginning of the pandemic in term of its public health protocols.

What we're hearing, though—and I have been checking this out in a lot of medical journals—is that a lot of people in Hong Kong do not want to take vaccines because of cultural issues. They don't trust vaccines; they don't understand them. There are all kinds of reasons why many countries don't want to take vaccines or the uptake is low.

What do you think one can do about that? What's a good strategy to deal with cultural issues? You cannot make people do something if they don't want to, but is there a creative way to get people to take up vaccines? What are the ways to do that?

[Brittany Lambert]

Certainly campaigns to combat misinformation are key and vaccine hesitancy is an issue everywhere. That being said, I would say two things. I would say low supply to many places has bred hesitancy. Here, it's very mainstream. Everybody gets the vaccine, everybody talks about it. The government can credibly campaign to increase uptake, because it actually has vaccines to offer people. I think that may explain—not necessarily in Hong Kong; I don't know that situation—some of the hesitancy that we've seen in places like Africa.

Then there are other complex social factors that drive hesitancy for some communities—a history of colonial, medical, vaccine research abuse, etc.

[Hedy Fry, Liberal, Vancouver Centre, BC]

You have no creative answers to help us to overcome some of those problems? Here in Canada, we see vaccine hesitancy. In a country like Canada and in a country like Hong Kong, which is a well enough educated country, we still see this sort of cultural barrier, but I want to move on again.

As you know, the Ottawa Group has been covering the trade and health issues. What role do you think this group can play and has it played in leading the discussion at the WTO for the 32 other members of the group? As you said, only vaccines are covered in TRIPS. How about introducing issues like treatment and testing, etc.? What role do you think the Ottawa Group can play and should play?

That's for anyone.

[Brittany Lambert]

I don't know the ins and outs of the Ottawa Group and everything they're doing, but I hope they can play a constructive role. I just think it's important that it not be construed as an alternative to the TRIPS waiver, because the IP barriers that developing countries have been raising are clearly important to them, and the Ottawa Group doesn't include anything to that effect.

[Hedy Fry, Liberal, Vancouver Centre, BC]

No, and I think the thing about the TRIPS waiver is that Canada doesn't have any skin in this game, necessarily, because Canada is not a pharmaceutical country. It doesn't deliver huge pharmaceuticals. We have to get ours from other people. Europe is a big vaccine producer and the United States produces some vaccines, but my question still comes down to this: How do we get uptake? It's one thing to take a horse to water, but you have to make it drink.

The question for me is, how do we get uptake in low-income and middle–income countries that are hesitant? I know that religious reasons play a huge role in people taking vaccines and/or accepting vaccines. In other countries, cultural issues play a big role. I want to go back to this, because for me that is a big stumbling block. The TRIPS waiver notwithstanding and Canada playing a role in that, I think I agree with you on that one. The issue for me is that you could do whatever you would, but if people aren't going to take vaccines, how do we find a way around this?

Education is a long-term thing, as you know. You just don't tell people, “Oh no, no, no. Please trust us, because we think this is important for you.” What sort of way can we use to get around this? I know that some people have talked about paying people to take vaccines. I have heard that discussed in many countries. Do you think that's a valid way to get people to take up vaccines when, for various cultural and other reasons, they don't want to?

[The Chair, Liberal, Sven Spengemann]

Dr. Fry, unfortunately, that's past your time. We'll have to wait for the answer in the next round.

[Hedy Fry, Liberal, Vancouver Centre, BC]

I'm sorry, Chair.

[The Chair, Liberal, Sven Spengemann]

Ms. Normandin, welcome to the committee.

You have six minutes.

[Christine Normandin, Bloc, Saint-Jean, QC]

Thank you, Mr. Chair.

I thank all the witnesses for their testimony.

My questions will be mainly for Ms. Langlois.

Ms. Langlois, I would like to talk about the letter that you sent to several parliamentarians on March 23, sharing your concerns about an amendment to the TRIPS agreement.

The second point you mentioned is that, according to the current draft, only countries producing less than 10% of global vaccines would be eligible. Would it not be more appropriate, for example, to also allow countries that produce more than 10% of global vaccine to participate, on condition that they produce vaccines for lower-income countries?

Could you talk about that, please?

[France-Isabelle Langlois]

I would first like to say that my area of expertise, and that of Amnesty International, is limited to human rights. We have concerns about the fact that the changes or restrictions requested are not consistent with the spirit of human rights or the treaties and conventions signed by Canada.

With regard to the patent waiver and intellectual property, we must bear in mind that there must be as few restrictions as possible. The process must be democratized as much as possible so that as many people as possible around the world have access to treatments and not just vaccines.

For all sorts of reasons, there is hesitancy, as Ms. Fry rightly pointed out, not only about vaccines, but also about treatments. The longer we delay, the more hesitancy there will be. When we appropriate technologies or vaccines, restrict access to them and delay sharing them with all of humanity, it sends a terrible message. For example, by sending the surplus of AstraZeneca vaccines, which we do not want, to the poorest countries, we are sending the terrible message that these vaccines are not good for us, but they are good for them.

We have to bear that in mind. We must not restrict the production of vaccines to certain countries, no matter how the restrictions come about. We must make the opportunity available to others. We must support all countries that want and are able to produce vaccines.

Canada's role is not limited to purchasing vaccines and sending them to the poorest countries. All the logistics must be established in those countries so they can administer treatments, including vaccines. The situation is complicated in the case of vaccines. Current vaccines require specific handling, especially when it comes to the cold chain. In many regions of the world, it is difficult to implement without the appropriate technology and logistics. Not only must we provide the technology and the remedies, among other things, but we must also raise people's awareness of the importance of these medications and treatments.

[Christine Normandin, Bloc, Saint-Jean, QC]

Thank you very much. You answered some of the questions I was going to ask you, which is why I let you have more time.

I just wanted to follow up on Dr. Fry's questions and touch on the issue of hesitancy.

The proposed changes to TRIPS only cover prevention—vaccines—and don't allow for any latitude when it comes to treatment. Doesn't that make people even more hesitant? As we know, people may be vaccine-hesitant, but when they get sick, they are much less hesitant to receive treatment.

Does the fact that treatments are not included contribute to people's tendency to be hesitant?

[France-Isabelle Langlois]

I'm not exactly sure why treatments were not included, but what you are suggesting makes sense to me. I think we need to keep in mind that pharmaceutical companies want to control the profits. All along, economic interests have taken precedence over the health and the lives of entire populations.

[Christine Normandin, Bloc, Saint-Jean, QC]

In your January 10 letter, you urged parliamentarians to ensure that human rights are included as guiding principles in the World Health Assembly's debates on a future international treaty on pandemics.

I'd like to hear your thoughts on human rights and the right to health. Is there specific wording stating that that means the right to vaccines, or does that have to be interpreted, such as by a legal opinion?

[France-Isabelle Langlois]

The right to health means the right to access all available treatments, regardless of what they are, and to have fair and equal access to health care, no matter what it is. We can infer that vaccines are part of health care for many diseases, including COVID‑19.

[Christine Normandin, Bloc, Saint-Jean, QC]

Would it make sense to specify in advance what's included and what's not? That way, debates about whether or not it includes certain elements, such as treatment, could be avoided down the road.

[France-Isabelle Langlois]

Exactly. I believe Canada should support the ongoing work to establish a treaty on pandemics specifically. We can expect more pandemics, so the idea is that, when the next one comes along, we can avoid spending months or even years debating these issues as we are doing now. A treaty would give us the mechanisms to ensure greater equity in terms of treatment and prevention.

[Christine Normandin, Bloc, Saint-Jean, QC]

Thank you.

[The Chair, Liberal, Sven Spengemann]

Thank you very much, Ms. Langlois and Ms. Normandin.

Ms. McPherson, you have six minutes, please.

[Heather McPherson, NDP, Edmonton Strathcona, AB]

Thank you, Mr. Chair.

Thank you to our witnesses for being here today. This is so important. The work you've been doing on this is vital.

Over the weekend and last week, we heard about the new development of the omicron XE variant, which is, of course, extremely worrying. It means that what we're doing here today is that much more important.

I have to start by saying that I'm extremely frustrated that we are in this position, that we are still debating and still discussing some of the issues that we're discussing today. The first time I raised this issue within the foreign affairs committee was actually on November 17, 2020, when I asked to ensure that we had an equitable way to make sure that countries around the world could access vaccines, and that they would not all be procured and snatched up by wealthy countries at the expense of global health. Obviously, when we look at the history of how vaccines have been rolled out during the COVID pandemic, that has not been the case.

I guess that's where I'll start today. Some of my colleagues have already brought up the idea that the pharmaceutical companies have been given the power to determine who gets a vaccine and who doesn't. Of course, when you leave a corporation, whose reason for being is profit, in charge of rolling out life-saving vaccines, you are not going to have an equitable rollout. We know that the profits that Pfizer, BioNTech and Moderna have made are around $34 billion in 2021, despite the fact that they received $8 billion in public funding.

Perhaps I'll ask our colleagues from Oxfam to comment first. Could you give us a little more insight on what it means when we give corporations the power to determine who is able to be vaccinated and who is able to access vaccines, rather than treating this as a public health thing that is determined in a more equitable way?

[Brittany Lambert]

You're right, Heather, about the pharmaceutical monopolies. The big four, if you will, have basically had exclusive patents on these vaccines that the entire world wants. That has basically enabled them to play God and decide what price they're going to sell the vaccines at and who they're going to sell them to. They have obviously prioritized contracts with the wealthiest governments, who were willing to pay more.

They've insisted that they can supply the world. They've consistently exaggerated their production capabilities. This control that they retained enabled them to artificially constrain supply at the cost of millions of lives in developing countries. The profits they're making are quite outrageous. Moderna and BioNTech have 69% profit margins. If you look at how much Pfizer, BioNTech and Moderna are making together, it adds up to profits of about $65,000 per minute.

[Heather McPherson, NDP, Edmonton Strathcona, AB]

That's per minute.

[Brittany Lambert]

Yes. It's quite shocking.

I think lives should be prioritized over corporate profits, when they clearly have more than enough already.

[Heather McPherson, NDP, Edmonton Strathcona, AB]

Thank you so much.

[Diana Sarosi]

If I could add to that, the thing is that we knew that would happen, because this is how it has happened in the past and this is just how the world works, right? That's why COVAX was set up. That's the thing about it: COVAX, in its conception, was a brilliant idea to try to avoid that kind of situation, but by then, countries had started to make side deals with these pharmaceuticals, and COVAX got completely undermined. Otherwise, it would have been COVAX purchasing for the world. These pharmaceuticals wouldn't have been able to pit countries against each other for the highest prices.

[Heather McPherson, NDP, Edmonton Strathcona, AB]

Exactly. One of the other things is that this is not new. We have had problems with access to essential medicines in the past. I worked with MSF on campaigns decades ago on this.

One of the other concerns I have and that I want to flag for you is that we have heard that Canada will be using vaccine doses to contribute to the calculation of official development assistance. Now, considering the impacts that COVID has had on women and girls, the food shortages we're seeing around the world right now, and the impacts on our ability to deliver on the feminist international assistance policy, what are the impacts of our using those vaccines as part of our ODA? How will that impact Canada's ability to play a meaningful role in the world with regard to humanitarian and development assistance?