Foreign Affairs Committee on April 25th, 2022

[Ziad Aboultaif, Conservative, Edmonton Manning, AB]

Thank you.

[The Chair, Liberal, Sven Spengemann]

Thank you so much.

Thank you, Mr. Aboultaif. We'll have to leave it there in the interest of time.

Ms. Vandenbeld, please go ahead. You have four minutes.

[Anita Vandenbeld, Liberal, Ottawa West—Nepean, ON]

Thank you very much.

Thank you to the witnesses for their expert testimony today.

I'd like to follow up on a previous question asked by Ms. McPherson and touched on by Mr. Aboultaif. It's about how donations are provided, as cash versus actual vaccines.

When there are supplementary doses a country doesn't need, or options to purchase, there's a mechanism to provide that bilaterally from country to country. My understanding is that cash donations directly to COVAX and the ACT-Accelerator are far preferable. Rather than having to find existing doses and sending those vaccines somewhere, providing cash can be done much more flexibly. It can also add to things like health systems. When Canada provides cash donations equivalent to vaccines, we're also including things like syringes and everything else, and we're one of the few countries doing that.

I'm looking at numbers. My understanding is that if you include the cash transfers in lieu of vaccines, we're well over 100 million already and well on our way to the 200 million vaccine doses that we pledged. That's not even including the extra billion dollars in budget 2022.

Can you talk about whether or not the cash donations equivalent is most needed right now?

[Dr. Seth Berkley]

Thank you for that question. You are absolutely right: Cash is better now.

There was a moment in the middle of last year when we were unable to access doses because of export bans from multiple countries, because of vaccine hoarding, etc. At that point, donations were a godsend. They were really helpful because they allowed doses to flow, but we now have the unlocking of doses from manufacturers. By the way, that's another delay that Lily did not mention. It is not a UNICEF delay, but we also have to wait for the companies to be ready to ship doses, having cleared them, even though they have been produced. Sometimes the delay we talk about in delivery is that. Cash is better.

That said, we don't want to see wastage anywhere. Lily talked about COVAX internally, but we would prefer to see all doses go to a good home. We have tried to continue to respond to countries that have come to us and said, “We have doses that are available” as long as we can match them up to what countries want and they have adequate shelf life. Of course, we will not try to push those doses out anymore if the countries don't need them or already have an excess of those doses. That's really the challenge. Cash gives us flexibility, and thank you, Canada, for providing the ancillary syringes, etc., for doses. You're right that some other countries haven't done that, and that has meant that we've had to use financing to purchase them.

[Anita Vandenbeld, Liberal, Ottawa West—Nepean, ON]

I'd also like to follow up on what you both have said about capacity and building up health systems. I've noted that in addition to the $732 million extra for the ACT-Accelerator in the 2022 budget, we are also providing $296 million to build up health systems around the world.

I'll start with Ms. Caprani.

Can you tell us why this is so important, particularly when you're talking about children and talking about future pandemics? Why is it so important that we're funding not just vaccines but health systems?

[The Chair, Liberal, Sven Spengemann]

Make it a brief answer, please, in the interest of time.

[Lily Caprani]

Thank you.

It is absolutely essential. Thank you to Canada for leading the way and demonstrating a willingness to invest in health systems. Often the Cinderella service doesn't get the investment. It's often not as attractive to donors and it's harder to measure, but it is absolutely critical.

To give an example to illustrate it right off the bat, we receive reports all the time from countries that they are having to divert resources from their current health systems in order to respond to the pandemic in a way that comes at the cost of other essential services. That's why we need to invest in these systems.

It's no surprise that the biggest indicator of a country's likelihood of having tackled the pandemic and achieved good vaccine coverage is the prior existence of a strong, well-funded, well-coordinated health care system. It's the number one way that we will end this pandemic and prevent the next one. I am concerned that in our pandemic preparedness and response debates and discussions around the world this year, investment in primary health care and in system strengthening still falls to the bottom of the political priority list. I hope that Canada will help make sure it doesn't.

[The Chair, Liberal, Sven Spengemann]

Thank you so much.

Thank you, Ms. Vandenbeld.

Mr. Bergeron, you have six minutes. Go ahead.

[Stéphane Bergeron, Bloc, Montarville, QC]

Thank you, Mr. Chair.

A panel of experts at the World Health Organization earlier this month found that a single dose of a human papillomavirus vaccine would be sufficient to provide effective immunity against COVID‑19. Obviously, if this news proves to be true, it is extremely promising for the future, particularly with regard to vaccinations around the world and the fight against this pandemic, and even against a possible endemic.

What do you think about that?

[Dr. Seth Berkley]

The announcement from the WHO was looking, through their SAGE, which is their advisory mechanism, at HPV as a single-dose versus a two-dose and, in the past, even a three-dose vaccine for human papilloma virus and cervical cancer. It has nothing to do with COVID-19 in terms of where they are. They have suggested that data suggests, although it is not complete, that one dose of vaccine will give you protection for a period of time. They are unable to say at this time whether it will be a lifetime or not, but they feel that will be a more cost-effective way of working and, of course, people would be able to go back and revaccinate at a later time if necessary.

We will be following that WHO recommendation and therefore hopefully be able to accelerate the access to HPV vaccines.

[Stéphane Bergeron, Bloc, Montarville, QC]

Would you like to add anything, Ms. Caprani?

[Lily Caprani]

To be clear on COVID-19 vaccines, as Dr. Berkley has said, the SAGE group of experts constantly monitors the scientific evidence available and updates its guidance. On COVID-19, we now know that protection with boosters is essential for the most vulnerable populations. We would encourage all policy-makers to follow the guidelines of the SAGE experts, which are regularly updated to reflect the latest understanding of the evolution of the virus.

[The Chair, Liberal, Sven Spengemann]

Thank you very much.

Thank you, Mr. Bergeron.

We have Ms. McPherson, please, for two minutes.

[Heather McPherson, NDP, Edmonton Strathcona, AB]

Thank you very much.

My first question will be for Ms. Caprani. I'm concerned about the vaccination rates internally for countries in areas where there is conflict, humanitarian crises ongoing, internally displaced people, refugee camps and whatnot. How can Canada assist in making sure the vaccines can get to those communities and vulnerable populations?

[Lily Caprani]

I think you heard earlier that the fairly newly convened vaccine delivery partnership is doing country-by-country assessment of the national priorities and the need for very flexible and tailored plans of support for every single country. Of those 18 that remain under 10% coverage, 15 are emergency countries experiencing either conflict or other humanitarian emergencies.

We know, from our experience as humanitarian agencies responding around the world for the last 75 years, that what we require are very flexible forms of funding so that we can respond in emergencies. We need flexible and tailored planning and we need to work closely with those governments to adapt to their own local needs.

Some of the best examples we've seen of successful and quite rapid increase in coverage rates have been countries where they've been able to bundle and integrate the COVID response into other humanitarian response actions and health system actions, rather than having to treat it as yet another vertical response that stands alone.

This is not necessarily in the context of humanitarian emergency, but I know that Ethiopia has managed to increase by five times its coverage rate since mid-February by being able to be much more flexible in its planning. Other countries in emergency situations need to be able to do the same.

I would encourage Canada and all donor governments to make sure that funding is delivered in a flexible way to allow the humanitarian agencies to work closely on tailoring the kind of deployment needed so that it works for the local context.

[Heather McPherson, NDP, Edmonton Strathcona, AB]

It's interesting what you were—

[The Chair, Liberal, Sven Spengemann]

Thank you very much, Ms. McPherson.

I apologize, but it's in the interests of time. We have two more intervenors.

Mr. Genuis, you have four minutes.

[Garnett Genuis, Conservative, Sherwood Park—Fort Saskatchewan, AB]

Thank you, Mr. Chair.

On a point of clarification, do we have an hour with the next witnesses as well?

[The Chair, Liberal, Sven Spengemann]

We have slightly less. We need to compress that a bit, but I'll propose an equitable distribution.

[Garnett Genuis, Conservative, Sherwood Park—Fort Saskatchewan, AB]

All right. I thought we were going to proceed to them so we don't run out of time for them, because I think having time with them is important.

I do have additional questions, if possible.

Following up on my previous questions, Dr. Berkley, could you clarify that the funding for the no-fault compensation mechanism comes from donors to COVAX and not from industry? Is that correct?

[Dr. Seth Berkley]

That is correct.

[Garnett Genuis, Conservative, Sherwood Park—Fort Saskatchewan, AB]

Okay. There's no mechanism by which industry would be contributing to that.

[Dr. Seth Berkley]

There currently is no mechanism. Of course, normally industry does pay its own insurance costs or self-insures against AEFIs, but in the case of novel vaccines and during a pandemic, they weren't willing to do that. That's why we created this external no-fault compensation scheme.

[Garnett Genuis, Conservative, Sherwood Park—Fort Saskatchewan, AB]

Is that something they had asked for?

[Dr. Seth Berkley]

It is correct that they had requested, as part of their indemnification and liability, some type of no-fault compensation scheme. Not every manufacturer had asked for that, but that was a desired outcome by a number of manufacturers who also said they wouldn't supply vaccines to developing countries unless there was some type of no-fault compensation scheme.