COVID-19 Vaccine Task Force and Conflicts of Interest

Addressing conflicts of interest regarding the vaccine in infectious disease outbreaks based on good governance for health approach: a policy brief

BACKGROUND

Infectious disease outbreaks pose a significant threat to public health, and achieving herd immunity highlights the importance of addressing conflicts of interest (COI) in vaccine development and policy-making. This policy brief aims to present policy options that address COI regarding vaccines in infectious disease outbreaks, based on good governance for health approach.

METHODS

Our study used a scoping review methodology. We conducted a systematic search, which led to identifying 43 eligible articles. A qualitative approach (i.e., content analysis) was employed for data analysis, using "ATLAS.ti 9" software. The primary results underwent a process of cleaning, categorisation, and subsequent discussion in three sessions with the research team.

RESULTS

Relationships between theindustry and "government/policymakers" as well as "academic institutions/researchers" are prominent origins of COI regarding the vaccine in infectious disease outbreaks. To address this issue, we present nine policy options that target both the root cause of the problem and the adoption of good governance for health approach.

CONCLUSIONS

The key principles of good governance for health, including, "Transparency", "The Rule of Law", "Effectiveness", "Efficiency", "Participation", "Consensus Orientation", "Equality", "Responsibility", "Responsiveness" and "Accountability" must be taken into account when formulating policy options to address COI regarding the vaccine in infectious disease outbreaks. The effectiveness of the policy options outlined in this policy brief should be assessed in practical contexts, as this evaluation may uncover the need for revisions.

Biopharmaceutical Financialization and Public Funding of Medical Countermeasures (MCMs) in Canada During the COVID-19 Pandemic

BACKGROUND

Analysing the Canadian government's efforts to support the development of COVID-19 "medical countermeasures" (MCMs), this article seeks insights into political economy as a driver of pandemic response. We explore whether Canadian public funding policy during the pandemic involved departures from established practices of financialisation in biopharmaceutical research and development (R&D), including the dominance of private sector involvement in an intellectual property (IP) intensive approach to innovation underscoring profit, and governance opacity.

METHODS

We interrogate public funding for MCMs by analyzing how much the Government of Canada (GoC) spent, how those funds were allocated, on what terms, and to whom. We identify the funding institutions, and the funds awarded between February 10, 2020, and March 31, 2021, to support the research, development, and manufacturing of MCMs, including diagnostics, vaccines, therapeutics, and information about clinical management and virus transmission. To collect these data, we conducted searches on the Internet, public data repositories, and filed several requests under the Access to Information Act (1985). Subsequently, we carried out a document-based analysis of electronically accessible research contracts, proposals, grant calls, and policy announcements.

RESULTS

The GoC announced CAD$ 1.4 billion for research, development and manufacturing of COVID-19 MCMs. Fully 68% (CAD$ 959 million) of the announced public funding was channelled to investment in private sector firms. Canadian public funding showed a consistent focus on early and late stage development of COVID-19 MCMs and the expansion of biopharmaceutical manufacturing capacity. Assessing whether Canada's investments into developing COVID-19 MCMs safeguard affordable and transparent access to the products of publicly funded research, we found that access policies on IP management, sharing of clinical data, affordability and availability were not systematic, consistent, or transparent, and few, if any, mechanisms ensured long-term sustainability.

CONCLUSION

Beyond incremental change in policy goals, such as public investment in domestic biomanufacturing, the features of Canadian public policies endorsing financialization in the biopharmaceutical sector remained largely unchanged during the pandemic.

Mobilization of science advice by the Canadian federal government to support the COVID-19 pandemic response

The procurement and provision of expert-driven, evidence-informed, and independent science advice is integral to timely decision-making during public health emergencies. The 2019 coronavirus disease (COVID-19) pandemic has underscored the need for sound evidence in public health policy and exposed the challenges facing government science advisory mechanisms. This paper is a jurisdictional case study describing (i) the federal science advice bodies and mechanisms for public health in Canada (i.e., the federal science advice "ecosystem"); and (ii) how these bodies and mechanisms have mobilized and evolved to procure expertise and evidence to inform decisions during the first two years of the COVID-19 pandemic. We reviewed publicly accessible Government of Canada documents, technical reports, and peer-reviewed articles available up to December 2021. Canada's federal landscape of science advisory bodies for public health within the Health Portfolio was largely shaped by Canada's experiences with the 2003 severe acute respiratory syndrome and 2009 H1N1 outbreaks. In parallel, Canada has a designated science advisory apparatus that has seen frequent reforms since the early 2000s, with the current Office of the Chief Science Advisor created within the Science Portfolio in 2018. The COVID-19 pandemic has further complicated Canada's science advice ecosystem, with involvement from departments, expert advisory groups, and partnerships within both the federal Health and Science Portfolios. Although the engagement of federal departments outside the health sector is promising, the COVID-19 experience in Canada supports the need to institutionalize science advisory bodies for public health to improve pandemic preparedness and ensure rapid mobilization of well-coordinated and independent advice in future emergencies. This review also identified pressing areas for further inquiry to strengthen science advice for public health in Canada, including to assess the independence of science advisory actors and the interaction between federal and subnational authorities.

Health Services and Policy Research in Canada: An Editor's Reflections

Healthcare Policy is a vibrant and growing canada-focused health services and policy journal. As I mark my two-year anniversary as volunteer editor-in-chief of Healthcare Policy, I can say that I have had the privilege to see the scope and breadth of researchers' progress on important health system problems. From this vantage point, a number of trends are worth summarizing for the journal's readers.