Question Period Note: GLOBAL EFFORTS

Since the beginning of the COVID-19 pandemic, Canada has engaged with international partners bilaterally and multilaterally, through the G7, the G20, the World Health Organization (WHO), and the Pan American Health Organization to help inform our domestic response and to contribute to global efforts on fighting COVID-19.

Key Messages
• Canada has contributed $2.5 billion to the global fight against the virus. This includes a total of $1.3 billion to support the Access to COVID-19 Tools Accelerator.
• During the G7 Leaders’ Summit on June 11-13, 2021, G7 leaders announced a collective commitment of more than 2 billion vaccine doses to be shared with the world. Canada’s portion of that is 100 million doses.
• The Prime Minister announced that Canada will donate the equivalent of at least 200 million doses to the COVAX Facility by the end of 2022. This includes an immediate commitment to contribute up to 10 million Moderna vaccine doses.
• Canada is also working with international partners to address barriers to equitable access of vaccines by improving global capacity to manufacture them.
• The Prime Minister announced an investment of up to $15 million to COVAX Manufacturing Task Force partners in support of establishing the South Africa Technology Transfer Hub. This initiative will help build capacity to enable the development and production of mRNA vaccines and technologies in the region.
• Canada supports the development of a new international instrument to improve multilateral cooperation on pandemic prevention, preparedness and response. We also need to improve the tools we already have by strengthening the World Health Organization and its existing core international legal instrument for health emergencies, the International Health Regulations.
If Pressed – Mixed Doses

• The Government of Canada has successfully pursued a strategy to engage and encourage other countries and international partners to recognize people in Canada who have received mixed vaccine schedules as being ‘fully vaccinated.’
• International recognition of mixed vaccine schedules can support accelerated global access to vaccines and slow the pandemic by expanding options for vaccination where supply is unstable, and by using vaccine doses for public health objectives, rather than for travel documentation.
If Pressed – Development of a new International Instrument on Pandemic Prevention, Preparedness and Response
• Canada is pleased to see the important consensus reached at the recent Special Session of the World Health Assembly to negotiate a new international instrument to improve multilateral cooperation on pandemic prevention, preparedness and response. This sends a critical message to the global community on our collective will to take bold action to ensure we are better prepared for the next pandemic.
• Our work should provide a foundation for action across all levels and sectors and integrate a One Health approach so that we can effectively and collectively prevent, detect, prepare and respond to future infectious disease threats.
• We also need to improve the tools we already have by strengthening the WHO and its existing core international legal instrument for health emergencies, the International Health Regulations.
• Canada is ready to collaborate with other countries to design this new instrument, should it be legally binding or otherwise, so that it will have a real impact on the health and safety of people around the world. We look forward to discussions in the Intergovernmental Negotiating Body.
If Pressed – Findings from the International Pandemic Preparedness and Response Panel
• The Government of Canada welcomes the frank assessment and bold recommendations from the Independent Panel for Pandemic Preparedness and Response.
• We thank the Panel members for their efforts to understand how a localized outbreak became a global pandemic, and to assess how the international system responded.
• One of the Panel’s important conclusions is that the world was not prepared for the pandemic on a number of fronts. We know there are many lessons from this pandemic, which we are learning from to adjust our approach.
• Canada is working with our international partners to improve global cooperation so that we remain well-positioned and prepared to respond to future global health events.

Canada has participated in various G7 and G20 discussions on ways to strengthen our collective capacities to prevent, prepare and respond to future health emergencies. This has also contributed to enhancing bilateral relationships with key partners such as the U.S. and the EU. On June 3-4, the former Minister of Health participated in the G7 Health Ministers meeting to discuss COVID-19 measures, global health security, clinical trials, digital health and antimicrobial resistance. G7 Health Ministers endorsed a Declaration on these topics, in addition to the G7 Therapeutics and Vaccines Clinical Trials Charter. Most recently, G7 Health Ministers met on November November 29th to discuss the Omicron variant.

In June, following the G7 Leaders Summit, the Prime Minister met with his EU counterparts and announced a Canada-EU dialogue on health to enhance collaboration in the post-pandemic environment.

Recently, G20 Health Ministers Meeting met on September 5-6 with discussions focussed on healthy and sustainable recovery, building One Health resilience, coordinated and collaborative response, and equitable access to vaccines, therapeutics and diagnostics, and the impact of mental health and wellbeing. The joint G20 Finance and Health Ministers Meeting was also held on October 29, focusing on the financing of global pandemic prevention, preparedness and response through the commitment to establish a Finance and Health Task Force to explore options to strengthen existing and develop new financing mechanisms.

Given the magnitude of this pandemic’s impact across sectors, the Prime Minister and other Ministers are engaging regularly with their international counterparts, including Finance, Foreign Affairs, Agriculture and Employment. The G20 Leaders Summit was held October 30-31, and included commitments to support the achievement of a 70% vaccination rate in all countries by mid-2022, support for the Access to COVID Tools Accelerator (ACT-A), as well as the continuity of health services, including for sexual and reproductive health and mental health.

On November 18, 2021, the Prime Minister attended the North American Leaders Summit in Washington D.C. along with U.S. President Joseph Biden and Mexican President Andrés Manuel López Obrador. The three leaders agreed to several commitments, including re-envisioning and updating the North American Plan for Animal and Pandemic Influenza; shoring-up critical medical supply chains; supporting the Global Health Security Agenda; and continuing trilateral engagement under the North American Drug Dialogue to address the ongoing opioid overdose crisis. The Prime Minister also held his first in-person bilateral meeting with President Biden, and reaffirmed the commitments in the February 2021 Roadmap for a Renewed U.S.-Canada Partnership. The Prime Minister and President agreed to launch a Canada-U.S. Working Group on Supply Chains, tasked with producing a progress report in the next 120 days; and to develop a renewed vision for joint management of the border, applying lessons learned from the pandemic.

In addition, senior and technical staff of the Health Portfolio have engaged with their counterparts in a variety of fora, both bilaterally and multilaterally (e.g., World Health Organization (WHO), U.S. Centers for Disease Control and Prevention, Global Health Security Initiative, the Global Outbreak Alert and Response Network), to exchange information and best practices that have informed and enhanced Canada’s response to COVID-19.

The Public Health Agency of Canada (PHAC) has successfully pursued a strategy to engage and encourage other countries and international partners to recognize people in Canada who have received mixed vaccine schedules and/or extended dose intervals as being ‘fully vaccinated.’ The first priority for engagement has focused on national health and scientific decision-making authorities with significant impact and influence and with whom we have close, trusted relationships, including the U.S. and the U.S. CDC, United Kingdom, the European Union and the European Centres for Disease Control. The U.S. announced on October 15 that people vaccinated with any combination of two doses of a COVID-19 vaccine authorized by either the U.S. Food and Drug Administration or the World Health Organization are considered fully vaccinated as part of their new border reopening measures, which came into effect on November 8, 2021. The United Kingdom (UK) also announced that as of October 4, 2021, Canada will be included in the UK government’s international travel pilot project, which recognizes individuals vaccinated in pilot project countries with mixed doses as fully vaccinated.  The Government of Canada has also engaged with the World Health Organization, given its global influence, and has successfully added supportive language highlighting the importance of recognizing mixed dose and extended interval COVID-19 vaccine recipients in recent G7 and G20 Health Declarations.

Review and Lessons Learned from COVID-19
On May 12, 2021, the Independent Panel for Pandemic Preparedness and Response (IPPPR) published their final report and recommendations. The report concludes that the pandemic was a result of “failures and gaps in international and national responses” at every juncture of preparedness for, and response to, COVID-19. As a result, “February 2020 was a lost month when steps could have been taken to curtail the epidemic and forestall the pandemic.”
The IPPPR suggests that the failure of countries to respond was a combination of two things: “they did not sufficiently appreciate the threat and know how to respond”; and, “in the absence of certainty about how serious the consequences of this new pathogen would be, “wait and see” seemed less costly and consequential than concerted public health action.”

The IPPPR also notes that stronger leadership and better coordination at national, regional and international levels were needed to more effectively respond and recommend a more focused and independent WHO, a pandemic treaty and a Senior Global Health Threats Council that would be led at the Head of State and Government level. Among its recommendations, the Panel also recommends greater investment in preparedness and stronger accountability mechanisms to spur action. They call for improved surveillance and for the WHO to have authority to rapidly publish information and to dispatch expert missions.

Canada has consistently supported a comprehensive evaluation and review process of the global response to COVID-19. Efforts to strengthen WHO and Member States preparedness and response capacities are also being discussed in several international fora including the WHO, G7, G20, Global Health Security Initiative, Global Health Security Agenda and North American Plan for Animal and Pandemic Influenza. Canada recognizes the importance of continued bilateral and multilateral discussions on how to enhance health security and to effectively address risks.

Development of a new International Instrument on Pandemic Prevention, Preparedness and Response
On November 29 to December 1, 2021, the World Health Assembly convened for a Special Session for only the second time in the organization’s history. Protracted Member State negotiations eventually led to the Assembly adopting a milestone decision, “The World Together: Establishment of an intergovernmental negotiating body to strengthen pandemic prevention, preparedness and response”, which was co-sponsored by upwards of 120 Member States, including Canada. The decision establishes an intergovernmental negotiating body (INB), open to all Member States, to draft and negotiate a new WHO convention, agreement or other instrument, with the expectation that this work will proceed with the intention of creating a binding instrument, while at the same time keeping the door open to other forms of non-binding agreements should the INB decide.

In discussing a new instrument, Member States reiterated several themes:
• equity, particularly the importance of timely and equitable access to medical countermeasures;
• the value of universal health coverage and primary health care in strengthening health care systems to support both prevention and response;
• the importance of a whole of government/whole of society approach; and
• the need for a One Health approach, which was underlined by both MS and successive statements by the Food and Agriculture Organization, the World Organisation for Animal Health, the UN Environmental Program, and the World Bank, all of whom committed to participate both in the process for a new instrument as well as in broader capacity-building efforts.

Canada intervened to highlight the importance of incorporating a gender equity lens to any future work on pandemic preparedness and response, and called on the WHO for a robust approach to the prevention of sexual exploitation and abuse and sexual harassment. Canada also spoke to the need to improve existing tools by strengthening the WHO and the International Health Regulations (2005) as the existing core international legal instrument for health emergencies, as actions that could bear fruit over the short term while negotiations on a new instrument continue.

In terms of next steps, Member States will convene the first meeting of the INB by March 1, 2022, to elect Member State co-chairs and vice-chairs for the process, agree on working methods, and begin the development of the substantive elements and a working draft of the new instrument. A second meeting will be held by August 1, 2022, to review the progress achieved and agree whether the new instrument should be legally binding.

Key Facts
• Since February 2020, Canada has participated in regular G7 Health Ministerial calls to discuss COVID-19, which has contributed to enhancing bilateral relationships with key countries such as the U.S.
• On June 3-4, the former Minister of Health participated in the G7 Health Ministers meeting to discuss COVID-19 measures, global health security, clinical trials, digital health and antimicrobial resistance with her counterparts.
• G7 Health Ministers endorsed a Declaration on these topics, in addition to the G7 Therapeutics and Vaccines Clinical Trials Charter and most recently met on November 29 to discuss the Omicron variant.
• Canada also participated in the G20 Health Ministers Meeting and the G20 Finance and Health Ministers Meeting, endorsing the establishment of a G20 Finance and Health Task Force that will present options for the sustainable financing of global pandemic prevention, preparedness, and response.
• On December 1, Canada and other WHO Member States agreed to launch a process to develop a new convention, agreement, or other international instrument to enhance global pandemic prevention, preparedness and response.