Give Justin Trudeau credit for one thing: The man knows how to deflect. As news broke in recent weeks of the first vaccines against the coronavirus to pass phase 3 clinical trials, from Pfizer, Moderna and AstraZeneca, and as it emerged the vaccines would begin distribution in some countries as early as next month, the Prime Minister could see the question coming: When will they be available in Canada?
The answer, we now know, is later: much later. Possibly months later. But as that might reflect poorly on the Prime Minister and the government he leads, he changed the subject.
“One of the things to remember is Canada no longer has any domestic production capacity for vaccines,” Mr. Trudeau admonished members of the media at his Tuesday news conference. “We used to have it decades ago, but we no longer have it. Countries like the United States, Germany and the U.K. do have domestic pharmaceutical facilities, which is why they’re obviously going to prioritize helping their citizens first.”
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In an instant, the story changed: from Government Bungles Vaccine Procurement to that old standby, Why Can’t Canada Make Cool Things? The Conservatives gamely took the bait, demanding to know why the government hadn’t done more to increase domestic vaccine production capacity. Which simply opened the door to a discussion of why capacity was lacking in the first place, and what responsibility the previous government might bear for that.
More to the point, it reinforced the Prime Minister’s premise: that the only way Canada could have had timely access to these vaccines is if we had made them ourselves (and its corollary: that since we can’t make them ourselves, the government is not to blame if they’re late). But this is nonsense.
It isn’t enough, first, just to have “domestic production capacity for vaccines” in some vague, undifferentiated way. In fact, Canada has plenty of capacity – just not for these particular kinds of vaccines. That’s not surprising, since the technology for these – especially the “mRNA” approach taken by Pfizer and Moderna, which uses bits of the virus’s genetic code to stimulate the body’s defences into action, rather than the virus itself – did not exist until about five minutes ago.
The premise, then, is not just that governments should have maintained the capacity to make tens of millions of vaccines in Canada, for decades at a time, on the off-chance that a once-a-century pandemic would come along. It is that this spare capacity should have been put in place all those years ago in anticipation of technologies that hadn’t been invented yet. Otherwise all you are buying is the “capacity,” effectively, to start from scratch, retooling existing facilities to entirely different purposes.
Perhaps it is to be imagined that, had we spent all that money on a domestic vaccine capacity, the technologies would have been invented here, and not in the United States, Germany, or the U.K. But that’s quite a bet.
And it’s an unnecessarily expensive one. The alternative to domestic manufacturing, in vaccines or anything else, is not simply going without: it is to buy from other countries. Negotiating local production agreements with the big drug companies, as many countries have done, is one way to ensure an adequate supply of vaccines, but it’s not the only one. The other way is to pay them to deliver them.
Which is, in fact, what we have done. The government has contracts to purchase up to 20 million doses each of the Pfizer, Moderna and AstraZeneca vaccines, with tens of millions more possibly to come from four other companies if and when their vaccines are approved. The vaccines are coming. The only question is why they are coming later to Canada than elsewhere. It isn’t only the United States, Germany and the U.K. we’re behind, after all. We’re behind just about everybody: Belgium, Spain, Italy, France, Russia, India, Argentina, Brazil, Australia, Japan, even Indonesia and Mexico.
One reason that we seem to be later to take delivery: we were later to place our orders. Canada didn’t make its first purchase for the Pfizer and Moderna vaccines until Aug. 5; AstraZeneca’s, in late September; in either case, weeks after other countries. Why? Writing in Maclean’s in August, University of Ottawa epidemiologist and law professor Amir Attaran offered one explanation: “Because the Trudeau government dithered. When our closest allies put their money down and placed orders for over a billion vaccine doses, our government failed to keep up.”
Perhaps that is why the government eventually purchased so many doses, among the largest, per capita, in the world – to make up in volume what it lost in timeliness. According to the Toronto Star, the way was open for it to pay a premium “to be near the front of the line,” and in some cases, the government took it. Could it have tried harder, acted sooner, bid higher? Or was the government, as Prof. Attaran suggests, blinded by “incompetent nationalism,” consumed with supporting long-shot local initiatives that failed to pan out, only to find it was too late to get first crack at the good stuff?
At any rate, hold on – it can only get worse. Even assuming Health Canada parts with the habits of a lifetime and approves the first vaccine more or less simultaneously with its U.S. and European counterparts, and even assuming the vaccines can be shipped to Canada in advance of approval, and stored (in super-cold conditions) until then, that still leaves the ultimate logistical nightmare: getting them into the arms of millions of Canadians, safely and speedily.
The track records of governments in this country, federal and provincial, do not fill one with optimism on this score. Even now, they are wrangling over how the vaccines should be allocated among provinces: whether it should be based on the number of people in each, or the number of cases, or the number of the elderly, or some other basis.
Quite what the people who, in eight months of trying, still can’t test more than about 50,000 people a day for the disease, will make of the challenge of vaccinating the entire population, one shudders to think. But if they’re even halfway done this time next year, it will be a pleasant surprise.
Canadian authorities are assessing COVID-19 vaccine candidates while trials are underway, speeding up any eventual approval for wide use. But science reporter Ivan Semeniuk says it’s likely high-risk people will be prioritized for receiving any vaccine first, with some possibly getting it as early as the first part of 2021.
The Globe and Mail
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Andrew Coyne