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The Vaccine Challenge: ‘Not Putting All Our Eggs in One Basket’

2020-09-11 21:01:01

Unless the military is buying a large quantity of something that flies and is very expensive, Canadians don’t pay a lot of attention to the minister of public services and procurement. But the current holder of the job, Anita Anand, is firmly in the national spotlight now, as the leader of the government’s efforts to secure a supply of coronavirus vaccine for Canadians.

She faces a trying task. At this point, there is still no vaccine that has been proven both effective and safe. Then there is a whole other set of questions surrounding the production capacity of the world’s vaccine makers.

I spoke this week with Ms. Anand about the challenges she has been facing and also with a scientist and health policy expert about the government’s efforts to make sure that Canada will have enough vaccine.

One big strategic thought, Ms. Anand told me, has guided the government’s approach to negotiations with virus makers.

“Because we do not know which vaccine or vaccine is going to be successful, ultimately we must bet on multiple vaccines at the same time,” she said. “We are not putting all our eggs in one basket.”

That in turn has influenced the government’s decision to, in effect, place orders and take out options for doses that far surpass Canada’s population of 38 million. After striking deals with four companies, she said the government now had guarantees for a minimum of 80 million doses and options for another 102 million. And negotiations with other companies are still underway.

But once vaccines are approved and in production, she said, it may be apparent that some of them are less effective with certain groups of people. Other vaccines might require multiple inoculations.

“The numbers may seem a little lower if you look at them in that context,” she said.

Aside from the question of quantity, there’s figuring out a price. Some drug makers, notably AstraZeneca, have said they don’t plan to profit from any coronavirus vaccine, but they are the exceptions. While the public most likely ranks safety and effectiveness over getting vaccine as cheaply as possible, Ms. Anand is also aware that she can’t allow drug makers to unfairly exploit the pandemic.

“It’s neither a buyers’ nor sellers’ market,” she said, adding that it is different from buying laptops and chairs. The negotiations are “not simply a matter of distributing a standard-form contract and having vaccine suppliers agree to our preferred terms, including price,” she said.

Instead, and because the development, testing and production of the vaccines remain works in progress, Ms. Anand said that the government had agreed to advance some of the purchase price to contribute to those costs. But she said that the contracts with each of the four companies included bailout clauses should things go wrong.

Amir Attaran, a scientist and lawyer who teaches in both the law and medical schools at the University of Ottawa, has been very critical of Canada’s approach to buying vaccines. And one of his criticisms has involved putting Ms. Anand’s department in charge of it.

“They have no brains whatsoever when it comes to public health and medicine,” Professor Attaran said. “Putting them in charge is a cardinal error.”

Professor Attaran said he believed that Health Canada should be doing the nation’s vaccine shopping.

Ms. Anand, however, noted that her department had developed considerable expertise by buying millions of doses of flu vaccine each year.

“This isn’t a completely new endeavor for public services and procurement,” she said.

Two of the vaccines Canada has agreed to buy from Moderna and Pfizer are in large-scale, make-or-break Phase 3 trials. The proposed vaccines the government will acquire from Novavax and Johnson & Johnson are not as far along in their testing.

Regardless, Ms. Anand is predicting that the first shipments of vaccine will start early next year.

When she was sworn into the cabinet last November, the virus wasn’t even on the horizon and there was no inkling of what was to come in her new job. But she said that she was enjoying her high-pressure role.

“I come from a background of corporate law and teaching corporate and securities law where a complex contracting is the meat and potatoes of the courses I taught,” she said. “So I’m able now to bring much of the theoretical knowledge into practical play.”


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