Health
Potential COVID-19 vaccine still not in Canada, three months after approval for trials – Global News
Shipments of a Chinese and Canadian-developed COVID-19 candidate vaccine remain delayed from getting to Canada, more than three months after Health Canada approved them for Phase 1 trials here.
The Ad5-nCoV potential vaccine is being produced at CanSino Biologics in Tianjin, China, and uses cell lines developed at the National Research Council of Canada (NRC).
Researchers at Dalhousie University’s Canadian Center for Vaccinology were set to test the CanSino product in Phase 1 trials in Halifax as early as late May.
Ad5-nCoV has already completed relatively promising Phase 2 trials within China. In June, it was approved for use in the People’s Liberation Army – China’s armed forces.
A Chinese patent was granted for Ad5-nCoV this month, and Phase 3, large-scale trials — which include people who have been exposed to COVID-19 — are set to begin soon in Russia, Saudi Arabia, Brazil and Mexico.
Yet Canada — the home of the cells used to develop the candidate vaccine — is still waiting to even see the product.
In an email to Global News, the NRC said the “vaccine candidate for Phase 1 clinical trials has not yet been approved by Chinese customs for shipment to Canada. Once the Canadian Center for Vaccinology receives the vaccine candidate it will start the clinical trial for CanSino, under the regulatory supervision of Health Canada.”
When asked specifically how much the Government of Canada has invested specifically in the CanSino Ad5-nCoV vaccine project, including the planned clinical trials in our country, the communications advisor for the NRC cited confidentiality reasons for not revealing details. “For reasons of commercial confidentiality the terms of the agreement between the NRC and CanSino cannot be shared. The overall aim of the NRC’s collaboration with CanSino is to enable production of the candidate vaccine in Montreal, for the purposes of later stage clinical trials, as well as for emergency pandemic use should the vaccine be approved by Health Canada,” said Nic Defalco via email.
CanSino did not respond to a Global News request for information about the delay.
The NRC and CanSino previously teamed-up to develop a successful Ebola vaccine approved for use in 2017.
The ongoing delay comes at a time of high diplomatic tension between Ottawa and Beijing: over the detention of Canadians Michael Kovrig and Michael Spavor in China, and the U.S. extradition hearing of Huawei executive Meng Wanzhou in Canada.
“Of all the vaccine candidates that are out there … which one did Canada choose to partner with? One that is owned by a company closely allied to China’s military, at a moment when Canada’s relationship with China is the worst it’s ever been,” said Amir Attaran, professor of law and medicine at the University of Ottawa.
“And as a result, the Chinese are blocking us receiving vaccines, to do clinical trials in this country. It’s farcical.”
Other vaccines
Medical syringe is seen with AstraZeneca company logo displayed on a screen in the background in this illustration photo taken in Poland on June 16, 2020. (Photo Illustration by Jakub Porzycki/NurPhoto via Getty Images).
Attaran says Canada should have looked to its allies when making vaccine deals, and not just for political reasons.
“It’s certainly not the best vaccine of its kind in development,” said Attaran.
“It shares technological features of the vaccine that is being developed at Oxford University and manufactured by AstraZeneca. And that one, the latter one, is clearly superior in its Phase 2 outcomes to the CanSino version.”
Phase 2 trial results in July showed the Oxford-AstraZeneca vaccine to be safe — with only minor side effects — and it appeared to produce both types of immune responses, as hoped for by researchers.
AstraZeneca has inked deals with the U.K., the U.S., Australia, Europe’s Inclusive Vaccines Alliance, the Coalition for Epidemic Preparedness Innovations and Gavi the Vaccine Alliance for more than one billion doses.
The CanSino Phase 2 trial showed similar results, but with more adverse side-effects when the vaccine was delivered at the levels required to induce an immune response, and it showed a reduced immune response for older people.
Earlier this month, the Canadian government signed new deals with pharmaceutical firms Pfizer and Moderna to secure millions of doses in 2021 of the coronavirus vaccine candidates each company is currently developing.
Pfizer is currently working on four experimental coronavirus vaccines and Moderna is also working on what’s been described as among the leading candidates for a vaccine.
Procurement Minister Anita Anand did not specify how many doses have been secured as part of the deals, only that it would be “millions of doses.”
The federal government has invested $600 million to support COVID-19–related vaccine and therapy clinical trials, but for reasons of “commercial confidentiality,” it will not reveal the terms of the CanSino deal.
However, we do know more about the two other vaccine projects involving the NRC.
One is a $56 million investment to support VBI Vaccines, a company based in Massachusetts, with operations in Ottawa.
The other is $23 million of funding for The University of Saskatchewan’s Vaccine and Infectious Disease Organization-International Vaccine Centre.
When asked by Global News if the Canadian government is in negotiations with AstraZeneca, a spokesperson for minister Anand said “given the steep global competition, and in order to protect Canada’s negotiating position, it would be imprudent to provide details regarding specific suppliers with whom we are currently negotiating … We owe it to Canadians to explore every option for vaccines, and that is exactly what we will continue to do.”
Professor Matthew Herder, Director of the Health Law Institute at Dalhousie University said the Canadian government should be more open about the deals it is making.
“I think one of the things the government should be doing is making public the deals that they’re entering into. So we can have that hard conversation about whether our interests and the interests of other populations are potentially going to benefit from these vaccines,” said Herder.
“We really don’t know how good of a deal it is; the terms of the deal between Canada and CanSino, the terms of the newer deals between the federal government and Moderna, as well as Pfizer for their vaccines. We don’t know the terms of those deals either.”
In response to questions raised by Conservative MP Scott Reid, parliamentary documents signed by Innovation, Science and Industry Minister Navdeep Bains, say “The NRC retains the intellectual property related to the cell line, while CanSino, in turn, owns all intellectual property rights for the vaccines it develops.”
It also says the agreements between the NRC and CanSino “permit the NRC to manufacture a set limit of the vaccine for emergency pandemic use in Canada for ten years. The agreements do not address large-scale manufacturing of the vaccine in Canada or distribution to other countries — these will be the subject of a subsequent agreement with the Government of Canada as required.”
Temporary patent amendment
Prime Minister Scott Morrison addresses the media during a visit to AstraZeneca on Aug. 19, 2020 in Sydney, Australia. The Australian government has announced an agreement with the British pharmaceutical giant AstraZeneca to secure at least 25 million doses of a COVID-19 vaccine if it passes clinical trials. (Photo by Lisa Maree Williams/Getty Images).
The issuing of a Chinese patent for the CanSino vaccine candidate this month will not affect how it can be used in Canada.
The Canadian Intellectual Property Office patent database does not currently show whether CanSino has a patent pending in Canada for Ad5-nCoV, as patent applications are generally only made public 18 months after an application. It would be standard practice for CanSino to have applied in Canada and elsewhere already.
Even if a patent were granted already, the Canadian government would currently be able to bypass it, because of an amendment to the Patent Act under Bill-13 measures, passed in March, in response to COVID-19.
It allows the government “to make, construct, use and sell a patented invention to the extent necessary to respond to the public health emergency.”
Herder thinks that could be a small factor in why the candidate vaccines have been prevented from getting to Canada.
However, the legal amendment is time-limited, preventing the Patent Commissioner from making any such authorization after Sept. 30, 2020.
“I cannot understand why that deadline was added to this measure,” said Herder.
“Forecasts at the time this legislation was passed would have put the vaccine being ready in early 2021, I think, at the earliest, and so that deadline needs to be changed. And I think that’s one of the concrete steps the federal government can and should take to extend it into the foreseeable future.”
Vaccine Nationalism
World Health Organization (WHO) Director-General Tedros Adhanom Ghebreyesus attend a news conference organized by Geneva Association of United Nations Correspondents (ACANU) amid the COVID-19 outbreak, caused by the novel coronavirus, at the WHO headquarters in Geneva Switzerland July 3, 2020. Fabrice Coffrini/Pool via REUTERS.
This week, the World Health Organization (WHO) called for international cooperation when it comes to developing and distributing vaccines.
“Nationalism exacerbated the pandemic and contributed to the total failure of the global supply chain. For a period of time, some countries were without key supplies, such as key items for health workers who were dealing with surging cases of COVID-19,” said WHO chief Tedros Adhanom Ghebreyesus, insisting that if the virus isn’t eliminated everywhere, it will inevitably come back.
“It’s critical that countries don’t repeat the same mistakes. We need to prevent vaccine nationalism.”
Even Pope Francis asked for richer nations to think of others when racing to procure vaccines.
“It would be sad if the rich are given priority for the COVID-19 vaccine. It would be sad if this vaccine became the property of this or that nation, if it is not universal and for everyone,” said the pontiff.
As of August 2020, 39 countries form part of a Solidarity Call to Action on COVID-19, an initiative of the WHO and Costa Rica, to pool global resources.
Canada is not a member, and neither is China.
Most of the members are poorer developing countries. Only six are also part of the Organisation for Economic Co-operation and Development (OECD), i.e. fully-developed countries, but none would be regarded as world powers.
“In the absence of that kind of commitment to collaborate and share, what we’re seeing is exactly what you’d expect. It’s a bit of ‘every nation first and for itself first’,” said Herder.
“The richer nations are, of course, better positioned to take care of people within their borders.”
So even if Canada is falling behind in the vaccine race, it’s still far ahead of most nations.
Health
Toronto reports 2 more measles cases. Use our tool to check the spread in Canada – Toronto Star
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Canada has seen a concerning rise in measles cases in the first months of 2024.
By the third week of March, the country had already recorded more than three times the number of cases as all of last year. Canada had just 12 cases of measles in 2023, up from three in 2022.
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Cancer Awareness Month
Posted on: Apr 18, 2024
April is Cancer Awareness Month
As we recognize Cancer Awareness Month, we stand together to raise awareness, support those affected, advocate for prevention, early detection, and continued research towards a cure. Cancer is the leading cause of death for Métis women and the second leading cause of death for Métis men. The Otipemisiwak Métis Government of the Métis Nation Within Alberta is working hard to ensure that available supports for Métis Citizens battling cancer are culturally appropriate, comprehensive, and accessible by Métis Albertans at all stages of their cancer journey.
Receiving a cancer diagnosis, whether for yourself or a loved one, can feel overwhelming, leaving you unsure of where to turn for support. In June, our government will be launching the Cancer Supports and Navigation Program which will further support Métis Albertans and their families experiencing cancer by connecting them to OMG-specific cancer resources, external resources, and providing navigation support through the health care system. This program will also include Métis-specific peer support groups for those affected by cancer.
With funding from the Canadian Partnership Against Cancer (CPAC) we have also developed the Métis Cancer Care Course to ensure that Métis Albertans have access to culturally safe and appropriate cancer services. This course is available to cancer care professionals across the country and provides an overview of who Métis people are, our culture, our approaches to health and wellbeing, our experiences with cancer care, and our cancer journey.
Together, we can make a difference in the fight against cancer and ensure equitable access to culturally safe and appropriate care for all Métis Albertans. Please click on the links below to learn more about the supports available for Métis Albertans, including our Compassionate Care: Cancer Transportation program.
I wish you all good health and happiness!
Bobbi Paul-Alook
Secretary of Health & Seniors
Health
Type 2 diabetes is not one-size-fits-all: Subtypes affect complications and treatment options – The Conversation
You may have heard of Ozempic, the “miracle drug” for weight loss, but did you know that it was actually designed as a new treatment to manage diabetes? In Canada, diabetes affects approximately 10 per cent of the general population. Of those cases, 90 per cent have Type 2 diabetes.
This metabolic disorder is characterized by persistent high blood sugar levels, which can be accompanied by secondary health challenges, including a higher risk of stroke and kidney disease.
Locks and keys
In Type 2 diabetes, the body struggles to maintain blood sugar levels in an acceptable range. Every cell in the body needs sugar as an energy source, but too much sugar can be toxic to cells. This equilibrium needs to be tightly controlled and is regulated by a lock and key system.
In the body’s attempt to manage blood sugar levels and ensure that cells receive the right amount of energy, the pancreatic hormone, insulin, functions like a key. Cells cover themselves with locks that respond perfectly to insulin keys to facilitate the entry of sugar into cells.
Unfortunately, this lock and key system doesn’t always perform as expected. The body can encounter difficulties producing an adequate number of insulin keys, and/or the locks can become stubborn and unresponsive to insulin.
All forms of diabetes share the challenge of high blood sugar levels; however, diabetes is not a singular condition; it exists as a spectrum. Although diabetes is broadly categorized into two main types, Type 1 and Type 2, each presents a diversity of subtypes, especially Type 2 diabetes.
These subtypes carry their own characteristics and risks, and do not respond uniformly to the same treatments.
To better serve people living with Type 2 diabetes, and to move away from a “one size fits all” approach, it is beneficial to understand which subtype of Type 2 diabetes a person lives with. When someone needs a blood transfusion, the medical team needs to know the patient’s blood type. It should be the same for diabetes so a tailored and effective game plan can be implemented.
This article explores four unique subtypes of Type 2 diabetes, shedding light on their causes, complications and some of their specific treatment avenues.
Severe insulin-deficient diabetes: We’re missing keys!
(Lili Grieco-St-Pierre, Jennifer Bruin/Created with BioRender.com)
Insulin is produced by beta cells, which are found in the pancreas. In the severe insulin-deficient diabetes (SIDD) subtype, the key factories — the beta cells — are on strike. Ultimately, there are fewer keys in the body to unlock the cells and allow entry of sugar from the blood.
SIDD primarily affects younger, leaner individuals, and unfortunately, increases the risk of eye disease and blindness, among other complications. Why the beta cells go on strike remains largely unknown, but since there is an insulin deficiency, treatment often involves insulin injections.
Severe insulin-resistant diabetes: But it’s always locked!
(Lili Grieco-St-Pierre, Jennifer Bruin/Created with BioRender.com)
In the severe insulin-resistant diabetes (SIRD) subtype, the locks are overstimulated and start ignoring the keys. As a result, the beta cells produce even more keys to compensate. This can be measured as high levels of insulin in the blood, also known as hyperinsulinemia.
This resistance to insulin is particularly prominent in individuals with higher body weight. Patients with SIRD have an increased risk of complications such as fatty liver disease. There are many treatment avenues for these patients but no consensus about the optimal approach; patients often require high doses of insulin.
Mild obesity-related diabetes: The locks are sticky!
(Lili Grieco-St-Pierre, Jennifer Bruin/Created with BioRender.com)
Mild obesity-related (MOD) diabetes represents a nuanced aspect of Type 2 diabetes, often observed in individuals with higher body weight. Unlike more severe subtypes, MOD is characterized by a more measured response to insulin. The locks are “sticky,” so it is challenging for the key to click in place and open the lock. While MOD is connected to body weight, the comparatively less severe nature of MOD distinguishes it from other diabetes subtypes.
To minimize complications, treatment should include maintaining a healthy diet, managing body weight, and incorporating as much aerobic exercise as possible. This is where drugs like Ozempic can be prescribed to control the evolution of the disease, in part by managing body weight.
Mild age-related diabetes: I’m tired of controlling blood sugar!
(Lili Grieco-St-Pierre, Jennifer Bruin/Created with BioRender.com)
Mild age-related diabetes (MARD) happens more often in older people and typically starts later in life. With time, the key factory is not as productive, and the locks become stubborn. People with MARD find it tricky to manage their blood sugar, but it usually doesn’t lead to severe complications.
Among the different subtypes of diabetes, MARD is the most common.
Unique locks, varied keys
While efforts have been made to classify diabetes subtypes, new subtypes are still being identified, making proper clinical assessment and treatment plans challenging.
In Canada, unique cases of Type 2 diabetes were identified in Indigenous children from Northern Manitoba and Northwestern Ontario by Dr. Heather Dean and colleagues in the 1980s and 90s. Despite initial skepticism from the scientific community, which typically associated Type 2 diabetes with adults rather than children, clinical teams persisted in identifying this as a distinct subtype of Type 2 diabetes, called childhood-onset Type 2 diabetes.
Read more:
Indigenous community research partnerships can help address health inequities
Childhood-onset Type 2 diabetes is on the rise across Canada, but disproportionately affects Indigenous youth. It is undoubtedly linked to the intergenerational trauma associated with colonization in these communities. While many factors are likely involved, recent studies have discovered that exposure of a fetus to Type 2 diabetes during pregnancy increases the risk that the baby will develop diabetes later in life.
Acknowledging this distinct subtype of Type 2 diabetes in First Nations communities has led to the implementation of a community-based health action plan aimed at addressing the unique challenges faced by Indigenous Peoples. It is hoped that partnered research between communities and researchers will continue to help us understand childhood-onset Type 2 diabetes and how to effectively prevent and treat it.
A mosaic of conditions
(Lili Grieco-St-Pierre, Jennifer Bruin/Created with BioRender.com)
Type 2 diabetes is not uniform; it’s a mosaic of conditions, each with its own characteristics. Since diabetes presents so uniquely in every patient, even categorizing into subtypes does not guarantee how the disease will evolve. However, understanding these subtypes is a good starting point to help doctors create personalized plans for people living with the condition.
While Indigenous communities, lower-income households and individuals living with obesity already face a higher risk of developing Type 2 diabetes than the general population, tailored solutions may offer hope for better management. This emphasizes the urgent need for more precise assessments of diabetes subtypes to help customize therapeutic strategies and management strategies. This will improve care for all patients, including those from vulnerable and understudied populations.
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