Why Canada needs a national vaccine strategy

As a country, Canada is doing an admirable job to slow the spread of the new coronavirus based on our existing health care system and available resources at home and abroad.

Our frontline healthcare workers are risking their lives daily to help the sick, while policymakers are making tough but necessary calls to close parts of the economy to keep Canadians healthy and safe.

We’re doing our best with what we have, but when it comes time to review our response to COVID-19, Canada will need to find better ways to manage the next pandemic that will inevitably hit.

A key takeaway should be making Canada more independent when it comes to supporting our citizens, not just with supplies of personal protective equipment but also vaccines required to fight off the virus and save lives.

Many Canadians probably don’t realize it, but we have no sizeable domestic vaccine manufacturers in this country, leaving our population particularly vulnerable to pandemics like COVID-19. Most vaccines distributed for use in Canada are acquired by government tender from the big international vaccine companies such as GlaxoSmithKline (British), Sanofi (French), Merck & Co. and Pfizer (American). Once the vaccine drug substance is shipped to Canada, it’s mixed with formulas in a secondary manufacturing process to make the drug product that’s filled into vials or syringes labelled for the local market.

The system is flawed because most of the vaccine manufacturing expertise and value are tied-up in primary manufacturing. Large pharmaceutical companies have little incentive to transfer primary production away from their current secure locations. What’s more, these big pharma companies will only manufacture profitable vaccines, so there’s little appetite for producing vaccines for uncommon diseases such as Ebola or zika, which have devastated global populations in the past.

Government-owned vaccine manufacturing facilities

Canada needs its own large vaccine manufacturer to serve Canadians instead of relying on treatments to come from other countries. And if we want to be more self-sufficient when the next pandemic hits, we as a country need to start planning now. The sooner, the better, since developing and manufacturing a human vaccine can take five, even 10 years, with a price tag of $1-billion or more.

A new national vaccine strategy wouldn’t have prevented COVID-19 in Canada, but as we all know from history, pandemics have a habit of recurring. COVID-19 is the third coronavirus in recent memory that causes severe respiratory disease and human death after SARS (severe acute respiratory syndrome) and MERS (Middle East respiratory syndrome). There is still no vaccine against SARS or MERS, but if we had started working on a SARS vaccine immediately following the SARS outbreak in 2003, we might have a SARS vaccine by now.

What would a national vaccine strategy look like in Canada? The current government tender system works well for large volume, low-margin vaccines with competition between the pharma companies ensuring the Canadian taxpayer gets good value for their money. However, when it comes to the manufacture of small-volume, high-value-added niche vaccines for tropical diseases and pandemic vaccines, the government will need to step in.

A primary manufacturing facility for pandemic vaccines should be federally owned and operated.

And while health care is a provincial responsibility, a primary manufacturing facility for pandemic vaccines should be federally owned and operated. Ideally, provinces would invest in the facility and provide the talent and research to ensure continuous innovation, research and development.

The manufacturing facility could be staffed by vaccine industry veterans from Canada and other countries who are keen to make a difference by transferring their expertise to the next generation of scientists and engineers. It would also work closely with Health Canada to establish specifications for new niche and potentially pandemic vaccines. The scientific equipment supply industry would be invited to place their products for use in the facility for publicity.

What’s more, to work effectively and efficiently, the facility would need an independent board of directors including representatives from government, industry and academia that would determine the vaccine development portfolio, operating budget, timelines and staffing levels.

Complementing, not competing with, the private sector

For this system to be successful, the Canadian vaccine manufacturing facility wouldn’t compete with the international pharma industry. The government facility would only manufacture vaccines that big pharma shows no interest in, due to its small scale. The focus would be on a portfolio of niche vaccines to establish technological excellence in areas such as virus manipulation, purification and inactivation methods.

If the technology did become of interest to the majors down the road, it could be transferred for a fee, alongside some assurances that the public interest would be a top priority.

If Canada did go this route, it wouldn’t be alone. France’s Vaccine Research Institute, set up to accelerate the development of effective vaccines against HIV/AIDS, HCV (hepatitis C) and emerging infectious diseases, is now looking to pandemic vaccines. In the UK, the Vaccines Manufacturing and Innovation Centre is now planning to produce a COVID-19 vaccine.

Canada has a world-class health care system with renowned scientists and researchers that have the know-how and expertise to develop pandemic vaccines. All we need now is a national strategy to make it happen and to prepare our country for the next pandemic.

The time to start developing this national vaccine strategy is now.

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