Foreign Affairs Committee on May 9th, 2022

[Stéphane Bergeron, Bloc, Montarville, QC]

Excuse me for interrupting, Mr. Gagnon, but we missed part of what you were saying. After "patents", we missed about 30 seconds of what you said.

I'm sorry to have to ask you to repeat it, but for the benefit of the committee members, it would be a good idea to go back a bit.

[Dr. Marc-André Gagnon]

Okay.

I had finished talking about AstraZeneca and was talking about the Canadian firm Genevant, which owns many of the patents for messenger RNA vaccines. Providence Therapeutics, an Alberta company which wanted to work on messenger RNA technology transfers for vaccines, was interfered with systematically. It was impossible to go forward.

Biolyse Pharma wasn't the only company that could produce vaccines. PnuVax, next door to the National research Council of Canada in Montreal, could produce some. Canada's Providence Therapeutics could handle the technology transfer, but was institutionally prevented from doing so.

[Stéphane Bergeron, Bloc, Montarville, QC]

If you are willing, Mr. Chair, I'd like to continue this discussion.

In a few moments, we will be meeting the Vice Minister, Foreign Trade and Integration, from the Bolivian Ministry of Foreign Affairs. He spoke to us about the problems encountered by Biolyse Pharma in connection with the Canadian Access to Medicines Regime, and to technology transfer that would have made it possible to produce vaccines in Bolivia. The Canadian Access to Medicines Regime never really proved to be particularly effective, because after it was established, only one country, Rwanda in 2007, submitted an application, because the procedure was so complicated.

Why do you feel the system isn't working and why, as you have just explained, are we witnessing the same Canadian institutions organizing things in a way that makes sure they won't work?

[Dr. Marc-André Gagnon]

I believe it's a clear case of regulatory capture. It's a regime that was designed in partnership with pharmaceutical firms, which ensured they would be able to set up all kinds of administrative impediments to make things extremely complex.

Don't forget that in 2011, Canada passed an act to reform the Canadian Access to Medicines Regime. A parliamentary majority voted to eliminate some of the administrative impediments, but then elections were triggered and the Senate had not yet adopted the bill, which meant it was was now dead on the Order Paper.

Everyone in Canada working in the field of intellectual property is well aware of the fact that the Canadian Access to Medicines Regime doesn't work. On top of everything else, right in the middle of the COVID‑19 pandemic, Canada refused to amend schedule 1 of the Patent Act to allow technologies used to combat COVID‑19 to be included among those that could be made available if a country were to have a go at getting around all the administrative roadblocks to try and obtain them.

That, in the end, is what Bolivia did, but Canada refused to help that country by amending the basket of treatments, medicines and vaccines available during pandemics and health emergencies.

[The Chair, Liberal, Sven Spengemann]

Thank you very much, Mr. Bergeron and Professor Gagnon.

Ms. McPherson, please, you have six minutes.

[Heather McPherson, NDP, Edmonton Strathcona, AB]

Thank you, Mr. Chair.

Thank you very much to our witnesses for being here today. This is such important testimony.

It is my 50th birthday today, so this is a perfect birthday present for me actually. Thank you so much.

I'm going to start with Dr. Pai. I read an article you wrote last week, Dr. Pai. I will submit it to the analysts so they can have a look at it as well.

You talked about how ensuring that global vaccine equity happens is the most selfish thing we can do, that in fact it is the thing that will protect us the most. It protects us health-wise from future pandemics. If we can't do it because it saves lives, can we not do it simply because it's good for our own health and also good for our economy?

Could you speak to that a little bit more? I would like to give you some opportunity to do that

One other quick thing before I stop is that I know you didn't have a chance to respond to some of the previous questions, so please take some time to respond to them too.

[Dr. Madhukar Pai]

Thank you, ma'am, and happy birthday.

Yes, I did a whole segment for CTV News, along with Dr. Joanne Liu and Dr. Richard Gold, which was telecast last week, where I said that the most selfish thing that we could do is to help vaccinate the world.

The rationale is very simple. We are already in the third year of this pandemic because this virus is running unchecked. Reducing the overall transmission of the virus is the surest way to reduce the number of new patients and bad variants.

First, bad variants are absolutely coming our way, which is what I wanted to mention to Dr. Fry as well. It is never too late to vaccinate, because we don't know what bad variant is coming our way. Already we are seeing that the subvariants are even more transmissible—every single subvariant—and all it takes is another new patient perhaps to make it as deadly as the delta variant, and we would be in an all-out crisis all over again. I don't think we can deal with that.

Second, we're not just talking about transmission. The consequences of long COVID are terrible, disastrous, for the whole world, so it's a very good reason to vaccinate even to prevent long COVID and its complications.

In terms of the selfishness, I cannot do better than Joseph Stiglitz, the Nobel Prize economist. He just published an article last week in the journal that I edit. The title is “Vaccinating the world...is a no-brainer” as an economic investment.

The Economist magazine called it the “deal of the century”, with an economic return in the order of several thousand souls. In other words, there is no better investment anybody can come up with than vaccinating the world, which is why the G7, including us, should have done this more than a year ago. We could have put down $50 billion, or whatever is required to vaccinate the world, and by now we could have saved multiple trillions of dollars. That's the difference between paying billions now and being done with it, or continuing this pandemic into year four and dealing with all of the consequences—deaths of 15-plus million, long COVID and economic damage. The Economist magazine and the IMF have already estimated that trillions of dollars in economic losses have happened.

It is foolish to hold onto anything that will prevent this virus from multiplying. Stockpiling vaccines, not supporting domestic manufacturing, is absolutely foolish because we will be paying for it in the coming years.

I would rather that we pay now and pay less rather than holding back vaccines, not doing the right thing and suffering with trillions of dollars in economic losses.

Moreover, our borders are open. No matter how hard you try, new variants are going to keep coming in. We saw it. Every single variant came from somewhere else and devastated our health system. Can we afford a single variant more? Are we ready to go into another lockdown? We are not. That's why I'm saying that the most selfish thing we could ever imagine is to help vaccinate the world and share the therapeutics.

Ma'am, you're right: Antivirals are absolutely critical as well. There was a beautiful article in The New York Times saying that Paxlovid is pretty much not going to be available for low- and middle-income countries. Why do the richest nations gobble up all of the supplies? It will be the same thing if there's a new vaccine available for new variants, an omicron vaccine. Again, the high-income countries will take everything. Low-income countries will be at the bottom of the pile. That is why their self-sufficiency gives them a chance to modify their vaccine as and when they need to.

[Heather McPherson, NDP, Edmonton Strathcona, AB]

Thank you, Dr. Pai.

I'm going to ask this one question of both of you because I think it's something we really need to get on the record.

Do you feel now that with the response we have seen globally, particularly from the Canadian government, there is any likelihood that if there were a new pandemic, a new variant, an expansion, a different result would happen, a different result from when you look at CAMR, when you look at COVAX, when you look at our vaccine response?

Dr. Pai, I will start with you, but if you wouldn't mind saving some time for Dr. Gagnon as well, I would appreciate it.

[Dr. Madhukar Pai]

The answer is a resounding no. Given the selfishness, greed and myopia of the world's richest countries that we have seen, the naked display of that in the last two years, I'm one hundred per cent convinced that in the next crisis we will behave the exact same way. We will go nationalist. We will go isolationist. We will only look inward. We will not even look beyond our boundaries, and we'll be back in the same crisis all over again.

Things like the climate crisis and pandemics cannot be solved with this nationalistic way of thinking.

[Heather McPherson, NDP, Edmonton Strathcona, AB]

Thank you.

Dr. Gagnon.

[Dr. Marc-André Gagnon]

I say a resounding no as well, but the difference is that, the next time, we will have no excuse for not making these choices.

[The Chair, Liberal, Sven Spengemann]

Ms. McPherson, thank you very much.

Colleagues, we have about 15 minutes left until 12:40, at which point we're scheduled to go briefly in camera to talk about drafting instructions.

With your concurrence, I would suggest that we have three-minute and one-and-a-half-minute rounds. That should complete a second round, but with pithy shorter questions. If that's amenable, then we will go ahead with Mr. Aboultaif for three minutes.

Mr. Aboultaif, please go ahead.

[Ziad Aboultaif, Conservative, Edmonton Manning, AB]

Thank you, Chair.

Dr. Pai, the Canadian government invested $173 million in Medicago to produce the Covifenz vaccine in order to donate 200 million doses of vaccine to the world—to countries who most need it—yet WHO denied an emergency permit to do so because Philip Morris is the largest tobacco manufacturer in the world and has a big stake in the Medicago. How do you explain that?

Where is the fairness in distribution and in getting vaccines to the most needy when WHO stands in the way? Couldn't they provide some solutions to that, given the need for vaccination?

[Dr. Madhukar Pai]

Thank you, sir.

Unfortunately, I'm not an expert on this particular issue of how tobacco company involvement is seen or not. Like I said, I do not think the WHO would do this only to one company. This is their policy and they're probably applying it to all companies regardless of who is involved or not. I'm afraid I'm not able to tell you what WHO should be doing or not.

[Ziad Aboultaif, Conservative, Edmonton Manning, AB]

However, people like you and others are also asking for a patent to be given away to facilitate making vaccines available. This is another way to do so. Why do we have a double standard? Why can't you call for that too? Why is this an exception while other calls are not an exception?

[Dr. Madhukar Pai]

I'm guessing that the WHO and UN agencies have to walk a tight line here, because tobacco company involvement has been proven to be challenging for them across the disease areas. For them, I think it's not just a COVID issue but probably a system-wide policy to not engage with tobacco companies, and to change that would require a whole another country-level discussion at the World Health Organization.

[Ziad Aboultaif, Conservative, Edmonton Manning, AB]

However, that's again another way of standing in the way of providing vaccines to where they are most needed. We are facing a once-in-a-century challenge with this pandemic that we're going through. Once in a lifetime—in a century—could the WHO make an exception on this or not?

[Dr. Marc-André Gagnon]

Since I think Dr. Pai's connection is frozen, I'll jump in.

We need not underestimate what tobacco means in terms of the global health crisis as well. Robert Proctor has discussed this in his book the Golden Holocaust, for example, which looks at the history of this. A move like the one by WHO to be proactive on this was very important. Basically the agreement was that they would not be doing business with arms companies and tobacco companies. That is the policy.

Now we can disagree with that policy in times of sanitary emergency, but at the same time WHO would have been criticized even more if it had refused to enforce its policy at that time. This is very sad and we can blame Canada for basically funding this. At the same time, we need to understand that it is not the role of Philip Morris to be doing this type of research. It could have been very easy—

[The Chair, Liberal, Sven Spengemann]

Professor Gagnon, I apologize, but just in the interests of time, we'll have to leave it there.

Colleagues, we have lost the connection to Dr. Pai and we're working to get him back.

In the meantime, we will have Ms. Vandenbeld, please, for three minutes.

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

Thank you very much.

Thank you to both of you for being here. I do hope we get Dr. Pai back because some of my questions were specifically for him.

I'll start with Professor Gagnon, although some of my questions were specifically for Dr. Pai. Just going back through some of the testimony, I know that Dr. Pai had mentioned that Canada has only contributed 15 million vaccines, but in fact, there's an additional 87 million doses that have already gone to the global south and are in people's arms because of the cash equivalence. That also includes the syringes, which we heard of in previous testimony.

That's not my specific question. It's more about all of the other things. This is about so much more than doses. For instance, when you look at manufacturing capacity, Canada is partnering with South Africa on the COVAX manufacturing task force to look at that as a pilot project. I'd be interested in your views on that. There's the fact that a lot of countries need assistance with regulatory processes, with procurement processes and with their communication with their public. One of the examples is $50 million that Canada has provided to the Pan American Health Organization. With regard to what Dr. Fry mentioned about testing, treating and health systems, Canada is either first or second to the ACT accelerator in each of those areas.

My specific question is really on this idea that somehow we haven't learned from this process and that if there's a future pandemic, we wouldn't do any better. The fact is that there's almost $300 million in budget 2022, additional money on top of the $2.7 billion we've already provided, that's specifically for health systems. We heard previous testimony that health systems are the biggest indicator of the countries that either failed or succeeded.

Can you comment on the support that Canada has given in all of these other areas—more than other countries—and also the support we are now committing to for improving health systems in future pandemics?

[Dr. Marc-André Gagnon]

I see that Dr. Pai has come back, and in fact, I would like him to answer this question because I have not followed the help that we've been providing to the health systems.

I want to say one thing in terms of COVAX and donations. For me, COVAX emerged in response to C-TAP, the COVID-19 technology access pool, which wanted to develop the technology in collaboration, sharing information, etc. COVAX was organized, first and foremost, as a way to maintain the patent technology in place and respect the patent system. You pay the manufacturer, and then you deliver the drug. It's not about creating self-sufficiency in different countries.

On the health care systems, I will let Dr. Pai answer that.

[The Chair, Liberal, Sven Spengemann]

Thank you very much.

Ms. Vandenbeld, unfortunately, that's your allotment. These are very short rounds now, a compressed second round, but maybe there's a chance in the final round for the Liberal party to have a follow-up.

Mr. Bergeron, I'm sorry to have to assign you such a short amount of speaking time, but you do have the floor for a minute and a half.

[Stéphane Bergeron, Bloc, Montarville, QC]

Thank you, Mr. Chair.

I'm going to try and counterbalance the rather rosy picture that the Parliamentary Secretary to the Minister of International Development, Ms. Vandenbeld, has just painted.

Mr. Gagnon, I'd like to allow you to return briefly to the reply you gave us with respect to Canada's actions to short-circuit the possibility of giving developing countries access to the Canadian Access to Medicines Regime, the CAMR.

[Dr. Marc-André Gagnon]

The basic short-circuit that prevents things from moving forward is the fact that, even if Bolivia and Biolyse Pharma had succeeded in going through all the required hoops, Canada refused to include it in schedule 1, leaving no other recourse.

What was absolutely deplorable in my view, was when Canada, in December 2020, took a position at the World Trade Organization, the WTO, by simply saying that if no one had called upon the CAMR, that simply showed that there was no need to work toward an exemption from certain provisions of the TRIPS Agreement, or from some aspects of intellectual property rights pertaining to trade.

This declaration was quite simply dishonest, to put it mildly. I don't know who, in the group working on international trade patents, decided to take that position, but it was simply nonsense.

[The Chair, Liberal, Sven Spengemann]

Thank you, Mr. Gagnon.

Thank you, Mr. Bergeron.

Ms. McPherson, please go ahead for one and a half minutes.