Public Accounts Committee on Feb. 6th, 2023

[The Chair, Conservative, John Williamson]

I call the meeting to order.

Welcome to meeting No. 48 of the House of Commons Standing Committee on Public Accounts.

Pursuant to Standing Order 108(3)g), the committee is meeting today as part of its study, called “Report 9, COVID‑19 Vaccines, of the 2022 Reports 9 and 10 of the Auditor General of Canada“.

I would like to welcome our witnesses. We have a long list, so please bear with me.

From the Office of the Auditor General, we have Karen Hogan, Auditor General of Canada; Susan Gomez, principal, and Nadine Cormier, director. Welcome.

From the Public Health Agency of Canada, we have Luc Gagnon, assistant deputy minister and chief digital transformation officer, digital transformation branch, by video conference; Dr. Harpreet Kochhar, president; and Stephen Bent, vice-president, COVID-19 vaccine rollout task force.

From the Department of Health, we have Stephen Lucas, deputy minister; Celia Lourenco, acting associate assistant deputy minister, health products and food branch; and Supriya Sharma, chief medical adviser and senior medical adviser, health products and food branch.

Finally, from the Department of Public Works and Government Services, we have Arianne Reza, associate deputy minister; and Michael Mills, assistant deputy minister, procurement branch.

Welcome, everyone.

All four departments will have five minutes each.

I'm going to begin with Ms. Hogan. You have the floor for five minutes, please.

[Karen Hogan, Auditor General, Office of the Auditor General]

Mr. Chair, thank you for this opportunity to discuss our report on COVID‑19 vaccines, which was tabled in the House of Commons on December 6, 2022.

I would like to acknowledge that this hearing is taking place on the traditional unceded territory of the Algonquin Anishinaabe people.

Joining me today are Susan Gomez, the principal who was responsible for the audit, and Nadine Cormier, the director who led the audit team.

This audit examined how the federal government procured, authorized, and distributed vaccines to the provinces and territories to immunize Canadians against COVID‑19.

Overall, we found that the Public Health Agency of Canada, Health Canada, and Public Services and Procurement Canada worked together to respond to the urgent nature of the pandemic and secured enough COVID‑19 vaccine doses to vaccinate everyone living in Canada.

Health Canada helped get vaccines to Canadians by adjusting its usual authorization process. The department did this by reviewing information from the vaccine companies as it became available, rather than waiting to receive a complete application package before starting its review. We found that Health Canada followed a systematic process to authorize the COVID‑19 vaccines.

In 2020, Public Services and Procurement Canada established advance purchase agreements with seven companies that showed the potential to develop viable vaccines. Between December 2020 and May 2022, the federal government paid for 169 million vaccine doses. Over 84 million were administered to eligible people across the country. On average, the Public Health Agency of Canada delivered vaccines within two days of receiving a province’s or a territory’s request. This is successful, considering the logistics of transporting temperature-sensitive materials to sometimes remote locations.

We found that the Public Health Agency of Canada and Health Canada collaborated and analyzed COVID-19 vaccine surveillance data to monitor the safety, coverage and effectiveness of the vaccines. However, a lack of finalized data-sharing agreements with the provinces and territories meant that the agency struggled to effectively share detailed case-level safety surveillance data with Health Canada, the World Health Organization and vaccine companies.

We raised concerns about the sharing of health data between federal and provincial or territorial health authorities in 1999, 2002, 2008 and again in 2021. These long-standing issues, including implementing a pan-Canadian framework for sharing information, must be urgently addressed, because the sharing of health data is a cornerstone of effective surveillance to keep Canadians safe.

We also found that problems with information sharing affected the Public Health Agency of Canada's ability to gather wastage and expiry information. Delays in implementing important functionalities of VaccineConnect also reduced the agency's ability to track wastage.

By the end of May 2022, Canada had 32.5 million doses of COVID-19 vaccines, estimated to be worth about $1 billion, in federal, provincial and territorial inventories. Another 50.6 million doses were deemed surplus and offered for donation.

Between December 2020 and May 31, 2022, which marked the end of the period covered by our audit, 15.1 million doses were wasted. The Public Health Agency of Canada told us that from June to December 2022, another 11 million doses expired before they could be used or donated.

Wastage can happen for many reasons, and given the evolving nature of the pandemic, some wastage was to be expected.

Mr. Chair, this concludes my opening remarks. We'd be pleased to answer any questions the committee may have. Thank you.

[The Chair, Conservative, John Williamson]

Thank you very much, Ms. Hogan.

I'll turn now to Dr. Kochhar from the Public Health Agency of Canada.

You have the floor for five minutes, please.

[Dr. Harpreet S. Kochhar, President, Public Health Agency of Canada]

Good morning, and thank you, Chair.

Thank you for the opportunity to appear before this—

[The Chair, Conservative, John Williamson]

Could I ask you to remove your mask while you're speaking, please? It helps with translation and enables all the members to hear clearly.

Thank you very much.

[Dr. Harpreet S. Kochhar]

Again, good morning. Thank you for the opportunity to appear before this committee to talk about the Public Health Agency of Canada's role in access to COVID-19 vaccines.

Joining me today are Stephen Bent, vice-president of the vaccine rollout task force, and Luc Gagnon, the chief digital transformation officer for Health Canada and the Public Health Agency of Canada.

I'd like to start by acknowledging the findings and recommendations from the OAG audit on COVID-19 vaccination.

You'll recall that this period of time covered by the audit, January 1, 2020 to May 31, 2022, was a time of unprecedented mobilization to procure, allocate, distribute and track the administration of COVID-19 vaccines.

Since May 31, 2022, another 13 million doses of vaccine have been administered in Canada. Additionally, 13.5 million more doses were donated, and 11.4 million doses, both mRNA and non-mRNA, had their shelf life extended.

Early in the pandemic, the government needed to make decisions on COVID‑19 vaccine procurement. This was at a time when global demand was high and there was uncertainty about which, if any, vaccine candidates would be approved for use.

To help the government make the necessary evidence‑based decisions in this uncertain environment, the COVID‑19 Vaccine Task Force was established in April 2020.

Guided by the advice of this task force, Canada adopted a diversified vaccine strategy and built its vaccine portfolio with seven suppliers through advance purchase agreements. Our strategy was successful, and Canada was among the first in the world to secure early supply and administer COVID-19 vaccine doses in December 2020.

The Public Health Agency of Canada is proud of its role and the success of the largest vaccination campaign in our country's history, a campaign that was central to the COVID-19 response and recovery.

We are also pleased that the OAG audit on COVID-19 vaccines noted that the Public Health Agency of Canada allocated and distributed COVID-19 vaccines to provinces and territories equitably and in a timely manner.

The Government of Canada will continue to ensure the sufficient supply of COVID-19 vaccines for anticipated demand and population protection. This includes recommended booster doses and new bivalent formulations for people in Canada.

At the same time, we're taking steps to manage our COVID-19 vaccine surplus. This includes making surplus doses available for donation to other countries to help address global vaccine inequity. However, this has become increasingly difficult due to global oversupply and diminishing demand.

The Agency is also working closely with Public Services and Procurement Canada and vaccine manufacturers to adjust contractual commitments and delivery schedules, where possible.

Furthermore, we continue to work with provinces, territories, and Indigenous and federal partners on demand planning and forecasting to determine supply requirements for COVID‑19 vaccination programs.

Concerning the safety of COVID-19 vaccines, PHAC is committed to continued transparency. This includes improving information sharing among partners, including Health Canada, WHO and vaccine companies.

We understand that this information sharing is an important part of our public health and regulatory system, and Canada's vaccine safety surveillance system continues to effectively monitor, detect, share and act on vaccine safety signals. The agency will continue to lead the consultations with provinces and territories to address information-sharing issues identified by the audit. The Public Health Agency of Canada will continue to share data from this system in aggregate form on a regular schedule with the World Health Organization and on an as-needed basis with vaccine manufacturers.

The agency is actively working to fully implement VaccineConnect, an IT system to manage a nationwide vaccination program. As of November 2022, the system has a newer module for tracking orders and inventory at the central level to support supply chain management.

The agency will continue to work closely with provinces and territories to identify data quality gaps, and will continue engaging with jurisdictional partners to identify service gaps.

In conclusion, the Public Health Agency of Canada will review lessons learned and collaborate with implicated departments and stakeholders to optimize COVID-19 vaccine supply management and reduce COVID-19 vaccine surpluses.

Thank you. I would be happy to respond to any questions.

[The Chair, Conservative, John Williamson]

Thank you very much, Dr. Kochhar. I appreciate it.

We'll hear for five minutes from Dr. Lucas from the Department of Health.

It's over to you, please.

[Dr. Stephen Lucas, Deputy Minister, Department of Health]

Thank you, Mr. Chair.

I would like to thank the committee members for the opportunity to appear before you today. Joining me is Health Canada's chief medical advisor, Dr. Supriya Sharma, and the acting associate assistant deputy minister of the health products and food branch, Dr. Celia Lourenco.

Health Canada is responsible for regulating health products in Canada, including vaccines. The department evaluates data in support of the safety, quality and efficacy of health products before authorizing them for sale in Canada. We also monitor the safety of health products while they are on the market and take prompt action should safety concerns emerge.

Health Canada acknowledges the extensive effort of the Office of the Auditor General, in collaboration with relevant partners across government, in developing the COVID‑19 vaccines report assessing the procurement, authorization, allocation, distribution and surveillance of COVID‑19 vaccines.

In fulfilling its mandate, Health Canada relies on information sharing with the Canada Public Health Agency in collaboration with the provinces and territories to continuously monitor vaccine safety.

I will focus on the areas of the audit relating to Health Canada’s responsibilities. Specifically, the authorization of COVID‑19 vaccines, surveillance, and data sharing.

The COVID-19 pandemic presented a global threat and public health emergency that required the federal government to act quickly regarding vaccine approval, procurement, distribution and surveillance.

One of Health Canada's top priorities in light of the pandemic was to exercise regulatory agility to support access to vaccines while maintaining rigorous evidence standards that were aligned with those of international regulatory partners.

Health Canada welcomes the results of the audit that found that Health Canada expedited the regulatory review and authorization of the vaccines used to combat COVID-19 while upholding the rigorous standards required for our approval. The expedited authorization process was developed and implemented for COVID-19 vaccines through an interim order and modified the department's usual process in a few key ways.

First, the department created dedicated teams that focused on the review of COVID‑19 vaccines by mobilizing existing internal resources with expertise in vaccines.

Second, Health Canada authorized vaccine manufacturers to submit data on a rolling basis, which allowed us to review data from early in the development of the vaccine while later-stage clinical trials were taking place. The vaccines were only authorized once all the necessary data were reviewed and considered acceptable.

Third, we applied terms and conditions on each vaccine authorization to more closely monitor vaccine safety, quality and effectiveness as they are administered in Canada and globally.

Finally, Health Canada cooperated extensively with our international partners to share information during the review process and reduce duplication.

The audit concluded that the Public Health Agency and Health Canada efficiently provided access to COVID‑19 vaccines, with Health Canada’s expedited authorization process playing a critical role in ensuring that vaccine doses were available to Canadians in a timely manner.

The audit also found that the Public Health Agency and Health Canada shared relevant surveillance data, such as cases of adverse events following immunization, to effectively monitor the safety and effectiveness of COVID-19 vaccines. This allowed both organizations to take immediate action in response to vaccine safety signals resulting from reported adverse events and subsequently communicate them to the Canadian public and to the vaccine manufacturers. In doing so, Health Canada was able to act appropriately and in a timely manner to respond to confirmed vaccine safety signals based on reported adverse events.

However, the audit also highlighted long-standing issues related to data sharing, which affected the Public Health Agency's ability to share detailed case-level safety surveillance data with Health Canada. For example, the audit recommended that more should be done to facilitate the sharing of surveillance data with Health Canada by allowing the department access to the Canadian adverse events following immunization surveillance system, CAEFISS, and by expediting the implementation of the pan-Canadian health data strategy.

Health Canada agrees with the audit's findings. Its recommendations validate the department's efforts to advance a more robust and consistent method of sharing health data.

Health Canada will continue to collaborate with the Public Health Agency and provinces and territories on the pan-Canadian health data strategy, and we support ongoing work with provinces and territories to provide greater access to CAEFISS.

In closing, Health Canada welcomes the Auditor General’s recommendations and is committed to continuous improvement in the timely access to accurate health data to achieve better health outcomes for Canadians.

Thank you again to the committee for inviting me. I will be pleased to answer any questions you may have.

[The Chair, Conservative, John Williamson]

Thank you, Dr. Lucas.

Ms. Reza, you have the floor for five minutes, please.

[Arianne Reza, Associate Deputy Minister, Department of Public Works and Government Services]

Thank you, Mr. Chair. Good morning.

I am pleased to appear before the committee to discuss the Auditor General's report on securing vaccines during the COVID-19 pandemic. Here with me today is Michael Mills, assistant deputy minister of procurement.

The Government of Canada worked diligently to secure access to safe and effective COVID-19 vaccines.

On behalf of the Public Health Agency of Canada, and based on advice from the COVID‑19 Vaccine Task Force, Public Services and Procurement Canada led negotiations and finalized agreements with vaccine suppliers.

The report by the Auditor General focused on whether Public Services and Procurement Canada provided adequate procurement support to secure COVID‑19 vaccines. It concluded that the department provided efficient procurement support to the Public Health Agency of Canada as part of a whole-of-government response to a rapidly evolving coronavirus pandemic.

Working with the Public health agency of Canada, Health Canada and Innovation, Science and Economic Development Canada, and guided by the Task Force, we successfully secured enough COVID‑19 vaccine doses to vaccinate everyone living in Canada.

At the end of May 2022, the Public Health Agency reported that about 82% of eligible people at that time had received at least two doses.

This was the largest mass vaccination program in Canadian history, carried out under the most extraordinary of circumstances.

In the midst of the COVID-19 pandemic and in a hyper-competitive global market, Public Services and Procurement Canada was tasked with procuring the vaccines to reduce Canadians' risk of serious illness, hospitalization and death. At the time, there was great uncertainty about which vaccines would be developed and authorized, and when the vaccines would be available for distribution. Canada also had very limited domestic capacity to produce vaccines and relied on international products.

In those early days, procuring the required vaccine doses was an around-the-clock effort that was undertaken by PSPC immediately after the vaccine task force made its recommendations regarding potential vaccines.

As the department worked to secure a sufficient supply of vaccine doses, we were always mindful of the urgency, as well as the need for due diligence. As the Auditor General noted, Public Services and Procurement Canada modified its procurement processes early in the pandemic to allow use of its emergency contracting authority, enabling the department to procure vaccines using a non-competitive approach.

Based on expert advice, Canada adopted a sweeping strategy to supply everyone in Canada with the most promising COVID‑19 vaccines. It was a strategy to cover all bases, securing agreements with several companies in case Health Canada authorized only one or a few vaccines.

By January 2021, Public Services and Procurement Canada had signed seven advance purchase agreements for up to 414 million potential doses. These agreements included advance payments required to support vaccine development, testing, and at-risk manufacturing.

The Auditor General found that the department exercised due diligence on the seven companies by conducting assessments to examine their financial capability to meet requirements and by conducting integrity checks to mitigate the risk of unethical business practices.

Ultimately, our approach was successful. In July 2021, the government announced that Canada had received more than 66 million doses of COVID‑19 vaccines, enough to fully vaccinate every eligible person in Canada and meeting the government’s target to provide vaccines to those who wanted them by fall 2021.

In closing, Public Services and Procurement Canada employed a procurement strategy that covered all the bases to secure vaccines to protect Canadians, and it has proven effective.

Of course, we continue to evolve our vaccine procurement strategy based on the best scientific advice available, including securing new formulations for variants, boosters and pediatrics as they become available and approved by Health Canada.

Thank you. I'm happy to take your questions.

[The Chair, Conservative, John Williamson]

Thank you all very much.

We'll now turn to our members. In the first round, each member will have six minutes.

Dr. Ellis, you have the floor for six minutes, please.

[Stephen Ellis, Conservative, Cumberland—Colchester, NS]

Thank you very much, Chair, and thank you to the witnesses for being here.

Certainly, having been a physician in charge of a regional COVID unit, this has very personal meaning for me with respect to now looking at lessons learned.

I take umbrage at the AG report in terms of its saying that a billion dollars' worth of wasted vaccines is acceptable, expected, reasonable or perhaps successful—that's the word that was used. On behalf of Canadians, I think that's a bit appalling.

That is, of course, directly related to VaccineConnect, with a total cost of $59.1 million, of which $37.4 million was paid. We know that this was a failing system. That people were using spreadsheets in this day and age is absolutely shocking.

As a simple question, did we pay the remaining $21.7 million, and why did we?

[The Chair, Conservative, John Williamson]

Maybe indicate who the question is for, Dr. Ellis.

[Stephen Ellis, Conservative, Cumberland—Colchester, NS]

Sure, I'll ask Dr. Lucas.

[Dr. Stephen Lucas]

I'll defer to Dr. Kochhar on that question.

[Dr. Harpreet S. Kochhar]

The contract was with a contracting firm that was providing those services to us. The rest of the money was actually spent on making sure we had the infrastructure available for it to work.

Luc Gagnon is online, in case you need a bit more on that.

[Stephen Ellis, Conservative, Cumberland—Colchester, NS]

No, that's fine. Thank you.

Much like “ArriveSCAM”, we continue to pay for an app that didn't work. It's not surprising.

Again, it's hard, with so many of you there, to know who to direct this to. That being said, we've lost probably a billion dollars' worth of vaccines. How many contracts are there now outstanding, and how much more vaccine are we going to lose?

[Dr. Harpreet S. Kochhar]

Mr. Chair, many contracts we have currently are based on the advance purchase agreement. They are with different vaccine manufacturers. The details are with our colleagues in PSPC, but just as a reminder, these are evolving scenarios, with bivalent vaccines coming on board too. We continue to move to obtain those specific vaccines, which are current and which we can use on the Canadian population.

[Stephen Ellis, Conservative, Cumberland—Colchester, NS]

That's fine. Thank you for that response. The question, though, is this: How many more vaccines are we on the hook for? What are we going to do with them? Are we going to lose them because we can't track expiry dates, and will it cost us multiple more billions of dollars?

Perhaps Ms. Reza could answer that.

[Arianne Reza]

As Harpreet alluded to, we have seven APAs. I think six of them have received regulatory approval. We had an opportunity to purchase up to 412 million doses. Some of those are firm, and some of those are options that are triggered at the request of Canada. We continue to work with all of the suppliers to adjust the supply based on demand.

[Stephen Ellis, Conservative, Cumberland—Colchester, NS]

How many of those are firm contracts? I guess that's my question. How much money are we on the hook for?

[Arianne Reza]

Each of the APAs has a firm portion to it, usually reflective of the type of—

[Stephen Ellis, Conservative, Cumberland—Colchester, NS]

I get that part. How much is it?

[Arianne Reza]

We do not have the number of firm contracts or firm doses on hand. We'll have to come back to you with details.

If I could add a footnote on this, it is a constantly evolving field. For example, there are usually a minimum of 20 million firm doses per APA. There are additional doses related to boosters and various elements, and when there's a decision based on a public health need to trigger options of certain types of platform.

[The Chair, Conservative, John Williamson]

Doctor, just let me interrupt.

You can request that the documents be sent to the committee. I think the offer was made, but if you would like to make that request, we will follow up on that. You can do that, please.