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Canada’s Vaccine Mess

“I think we have nothing to be proud of on this, that’s for sure,” André Picard, a health expert in Canada and a longtime columnist for The Globe and Mail, told me.

To some degree, this is the natural result of living in a small country during an unprecedented global health crisis that has scrambled supply chains all over the world. Without much domestic manufacturing capacity to speak of, Canada had to sign advance-purchase deals with international vaccine companies. The country hedged its bet by mostly going with companies funded by Operation Warp Speed, and so far its strategy has been to overbuy doses in the hopes of securing enough to vaccinate all of its citizens. A mounting critique, however, is that perhaps Canada should have been more specific than “first quarter of 2021” in terms of arranging vaccine-delivery timing. Picard said that Canada, by not giving manufacturers a specific week, or even day, allowed them to push delivery until the outer limit of the quarter.

“The time between the vaccines being approved and the vaccines getting into people’s arms is one where you can’t do it fast enough,” says Tim Evans, the head of McGill University’s School of Population and Global Health as well as Canada’s COVID-19 Immunity Task Force. “A large majority of people see vaccines as our ticket out of this pandemic. So I think that’s part of the issue—every day seems like an eternity.”

But Canada’s problems run deeper: Through a combination of bureaucracy and legislation, the country has slowly lost its drug manufacturers that were doing original R&D, its capacity to respond to potential pandemics early, and its federal clout in organizing national strategies for pandemic response and emergency vaccine rollout.

“I think it’s a frustration for Canadians, especially to see this massive rollout in the U.S. next door, and to see some countries around the world have much more vaccination per capita,” Picard said. “But I think a lot of it is historic, unfortunately.”

To Robert Van Exan, a lifer in the Canadian pharmaceutical industry, the reasons for the country’s vaccine shortages are as plain as day.

“Canada has watched its pharmaceutical industry slowly move out of here over decades, because they created an environment that was not conducive to investment in this country,” charges Van Exan, a semiretired vaccine-industry consultant who spent nearly 35 years at Sanofi Pasteur working on policy, immunization campaigns, sales, and product development.

He cites long-standing Canadian policies in three areas as being particularly antagonistic to vaccine makers, especially multinationals: patents, prices, and procurement.

Most countries give pharmaceutical companies drug patents guaranteeing them a term of market exclusivity as a sort of reward for the 10 to 15 years the companies spend, on average, in research and development. Van Exan notes that Canada’s patent protection can be years shorter and much more complex than in other countries, such as the United States, which makes developing drugs in Canada less inviting. The Canadian government also has the ability to regulate drug and vaccine pricing—another turnoff. “And in fact, we’re in the process right now of adding even more teeth and more rigor to the price regulator than we had before,” Van Exan explains. (In Canada, provinces run partially subsidized drug plans, which is why control pricing is so popular.)

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