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Canada should have known the World Health Organization likely wouldn’t accept Medicago’s COVID-19 vaccine over its close ties with tobacco giant Philip Morris — before deciding to invest millions of dollars of taxpayer money in the company.
The WHO told CBC News on March 25 the biopharmaceutical firm’s request for emergency use authorization of its Covifenz vaccine had “not been accepted” due to the company’s “linkage with the tobacco industry” and was now “on hold.”
Marlboro cigarette manufacturer Philip Morris International owns 21 per cent of Medicago shares and the WHO reiterated it has long had a “strict policy” on “not engaging with companies that promote tobacco” and that Medicago had been informed of the decision.
That leaves Medicago’s vaccine in limbo, after the federal government gave the company $173 million in 2020 to develop the vaccine, build a new production facility and purchase 20 million doses with an option for 56 million more.
Canada has approved the vaccine and is expected to distribute it next month, but it’s the only country so far and use of the shot worldwide would be severely hampered without WHO approval.
“Medicago now has to face the consequences of their choice,” said Dr. Gaston De Serres, a medical epidemiologist at the Quebec National Institute of Public Health (INSPQ).
“It’s not something they overlooked. It’s a decision they took understanding its implications, understanding this would come with big problems when dealing with WHO.”
Medicago knew working with WHO would be ‘difficult’
De Serres said the problems Medicago would have had in getting a COVID-19 vaccine with close ties to the tobacco industry approved by the WHO were “quite obvious,” and that the federal government “should have known” this issue would arise before investing in it.
“They wouldn’t have to work hard to know that Philip Morris was also an important shareholder,” he said.
“And WHO I think is fully entitled to say tobacco is the largest preventable cause of premature death and we don’t want to have anything to do with the tobacco industry.”
Since the beginning of the pandemic, there have been over six million confirmed deaths from COVID-19 worldwide. The WHO estimates tobacco kills more than eight million people each year.
Medicago produces its vaccine with the plant species Nicotiana benthamiana, a close relative of the tobacco plant that is used for pharmaceutical development — largely because of the high number of viruses that can successfully infect it.
But the WHO’s policy on Big Tobacco is no secret, and Canada signed the legally binding WHO Framework Convention on Tobacco Control in 2005 committing to “protect” public health policies “from the commercial and other vested interests of the tobacco industry.”
Medicago produces its vaccine with a plant species that is a close relative of the tobacco plant and is used for pharmaceutical development. (Turgut Yeter/CBC)
A spokesperson for the Public Health Agency of Canada (PHAC) told CBC News the federal government “studied the matter of its investment in Medicago carefully” and believes it is still “compliant with its treaty obligations related to tobacco control” with the WHO.
But Medicago told Global News last year that it even had trouble getting a “formal invitation” to attend WHO meetings and was never able to get in “through the big door.”
“WHO, although they love the product and the technology, they have to deal with the fact that we’re supported by tobacco,” Nathalie Landry, executive vice president of scientific and medical affairs at Medicago, said in the January 2021 interview.
“It’s difficult for Medicago to be associated with WHO.”
Can tobacco companies ‘redeem themselves’?
This also isn’t the first time a Canadian health product has faced challenges getting WHO approval over controversial tobacco industry ties.
The experimental Ebola drug ZMapp, which was partially developed in PHAC’s National Microbiology Lab, faced similar hurdles getting WHO authorization for emergency use during the devastating West Africa Ebola outbreak in 2014 before finally getting approved.
“We’ve seen this problem before with the WHO and it may be that they are going to need to look at this policy that they have around involvement with tobacco,” said Alison Thompson, an associate professor of bioethics at the University of Toronto.
“It’s not as simple anymore as saying we’re not going to get into bed with tobacco or nobody in tobacco should be profiting from this, because it’s one possible way for tobacco companies to redeem themselves.”
But Dr. Gary Kobinger, a Canadian immunologist and virologist at the Galveston National Laboratory at the University of Texas who helped develop Zmapp, said investors were similarly hesitant to fund the drug over its ties to the Reynolds American tobacco company.
The solution is to get Philip Morris out of Medicago, and if WHO still will not approve the vaccine … then it’s going to be an expensive lesson.– Cyntia Callard, Physicians for a Smoke-Free Canada
“I do understand the policy [the WHO] has in place. We all do. The question is, what is the solution?” he said.
“Can entities that were found guilty of causing so many human deaths be redeemed ? Can they produce live-saving solutions and contribute, with or without profit, to now save lives?”
Kobinger said he does not believe the tobacco industry is “essential to vaccine development,” but that if they do get involved in developing new shots they should at least ensure that they can get WHO approval before bringing them to market.
Tedros Adhanom Ghebreyesus, director-general of the WHO, speaks during a press conference in Geneva on Dec. 20, 2021. WHO officials now say they have yet to make a final decision on whether or not to continue reviewing the Medicago vaccine. (Salvatore Di Nolfi/The Associated Press)
WHO debating tobacco industry investment ‘trend’
WHO officials now say they have yet to make a final decision on whether or not to continue reviewing the Medicago vaccine, and are holding ongoing talks about how to better address the “general trend” of tobacco companies investing in the health industry.
When asked by CBC News during a virtual press conference Wednesday when a final decision on the shot could be made, Mariangela Simao, WHO’s assistant director-general for drug access, vaccines and pharmaceuticals, said it could be coming soon.
“We’re seeing an increasing trend globally of the tobacco industry diversifying their portfolio by engaging with the pharma industry,” she said.
“So this process is still on hold but we should have a decision on the continuation or not of the process in the next few weeks.”
WATCH | What the WHO’s decision on Medicago vaccine means for Canada:
Quebec’s Medicago COVID-19 vaccine faces WHO rejection over company’s tobacco ties
16 days ago
Duration 5:08
Canada Tonight medical contributor Dr. Samir Gupta speaks with Ginella Massa about Quebec’s Medicago COVID-19 vaccine facing rejection from the WHO and what it means for Canadians. 5:08
‘Throw away’ technology due to tobacco ties?
Alyson Kelvin, a virologist at the Vaccine and Infectious Disease Organization (VIDO) at the University of Saskatchewan, said that tobacco plants have been used for scientific discovery for years and could lead to a promising vaccine technology going forward.
“We understand that tobacco is probably the most dangerous plant in the world, causing the most deaths — but do we throw away all that technology because of that?” she said.
“Medicago’s technology is robust. It’s led to a fantastic vaccine with a good safety profile and good effectiveness. I feel that there’s a path forward that needs to be explored and it’s unfortunate that there are ties to tobacco companies.”
The efficacy of the vaccine against all variants studied prior to the emergence of Omicron was 71 per cent, and even slightly higher for the Delta variant at 75 per cent against infections of any severity, according to data released by Medicago in December.
International Development Minister Harjit Sajjan urged the WHO to approve the Medicago shot so that 20 million doses could be donated to the global vaccine-sharing initiative COVAX and used in countries with lower vaccination rates.
Medicago’s vaccine was 71 per cent effective against all variants prior to Omicron, and even slightly higher for the Delta variant at 75 per cent against COVID-19 infections of any severity, according to data released by the company in December. (Turgut Yeter/CBC)
But WHO officials said Wednesday that COVID-19 vaccine supply in lower income countries has actually “stabilized” this year due to donations from COVAX, despite the fact that one-third of the world still hasn’t had a first dose — including 83 per cent of Africa.
Thompson, the bioethicist, said if the WHO were to ultimately approve the Medicago shot, it would be one way for Canada to address the global inequities it has contributed to by vaccine hoarding.
“There are competing harms here — there’s the harm of allowing Philip Morris to potentially profit from this, but there’s also the harm of withdrawing the opportunity for millions of people to receive a vaccine,” she said.
“And I think I know which side I would come down on — I think the moral importance of saving a life is greater.”
Canada working on ‘solutions’ with Medicago
Innovation Minister François-Philippe Champagne said last week that the federal government is working with Medicago to find a solution “because we want that vaccine to be available for the world.
Conservative MPs called on Champagne and Health Minister Jean-Yves Duclos this week to answer to the health committee on the WHO decision and explain what the federal government’s plan is moving forward.
“There needs to be transparency when the government invests $173 million,” Conservative MP and health critic Michael Barrett said in a statement.
Innovation Minister François-Philippe Champagne said last week that the federal government is working with Medicago to find a solution ‘because we want that vaccine to be available for the world.’ (Adrian Wyld/The Canadian Press)
Champagne said the company is aware that its involvement with the tobacco industry presents a problem, and implied it was talking to Phillip Morris about divesting. Philip Morris International did not respond to a request for comment.
“With respect to shareholding, there’ll be solutions,” he said. “The company is aware and they’re working on that.”
Cynthia Callard, executive director for Physicians for a Smoke-Free Canada, said the government should try to resolve the situation with the WHO by ensuring Philip Morris is no longer an investor in the company — and hope for the best with the pending approval.
“Medicago is not a one off,” she said. “The solution is to get Philip Morris out of Medicago, and if WHO still will not approve the vaccine … then it’s going to be an expensive lesson.”
PHOENIX (AP) — Arizona voters have approved a constitutional amendment guaranteeing abortion access up to fetal viability, typically after 21 weeks — a major win for advocates of the measure in the presidential battleground state who have been seeking to expand access beyond the current 15-week limit.
Arizona was one of nine states with abortion on the ballot. Democrats have centered abortion rights in their campaigns since the U.S. Supreme Court overturned Roe v. Wade in 2022. Abortion-rights supporters prevailed in all seven abortion ballot questions in 2022 and 2023, including in conservative-leaning states.
Arizona for Abortion Access, the coalition leading the state campaign, gathered well over the 383,923 signatures required to put it on the ballot, and the secretary of state’s office verified that enough were valid. The coalition far outpaced the opposition campaign, It Goes Too Far, in fundraising. The opposing campaign argued the measure was too far-reaching and cited its own polling in saying a majority of Arizonans support the 15-week limit. The measure allows post-viability abortions if they are necessary to protect the life or physical or mental health of the mother.
Access to abortion has been a cloudy issue in Arizona. In April, the state Supreme Court cleared the way for the enforcement of a long-dormant 1864 law banning nearly all abortions. The state Legislature swiftly repealed it.
Voters in Arizona are divided on abortion. Maddy Pennell, a junior at Arizona State University, said the possibility of a near-total abortion ban made her “depressed” and strengthened her desire to vote for the abortion ballot measure.
“I feel very strongly about having access to abortion,” she said.
Kyle Lee, an independent Arizona voter, does not support the abortion ballot measure.
“All abortion is pretty much, in my opinion, murder from beginning to end,” Lee said.
The Civil War-era ban also shaped the contours of tight legislative races. State Sen. Shawnna Bolick and state Rep. Matt Gress are among the handful of vulnerable Republican incumbents in competitive districts who crossed party lines to give the repeal vote the final push — a vote that will be tested as both parties vie for control of the narrowly GOP-held state Legislature.
Both of the Phoenix-area lawmakers were rebuked by some of their Republican colleagues for siding with Democrats. Gress made a motion on the House floor to initiate the repeal of the 1864 law. Bolick, explaining her repeal vote to her Senate colleagues, gave a 20-minute floor speech describing her three difficult pregnancies.
While Gress was first elected to his seat in 2022, Bolick is facing voters for the first time. She was appointed by the Maricopa County Board of Supervisors to fill a seat vacancy in 2023. She has not emphasized her role in the repeal vote as she has campaigned, instead playing up traditional conservative issues — one of her signs reads “Bolick Backs the Blue.”
Voters rejected a measure to eliminate retention elections for state Superior Court judges and Supreme Court justices.
The measure was put on the ballot by Republican legislators hoping to protect two conservative justices up for a routine retention vote who favored allowing the Civil War-era ban to be enforced — Shawnna Bolick’s husband, Supreme Court Justice Clint Bolick, and Justice Kathryn Hackett King. Since the measure did not pass, both are still vulnerable to voter ouster, though those races hadn’t been decided by early Wednesday morning.
Under the existing system, voters decide every four to six years whether judges and justices should remain on the bench. The proposed measure would have allowed the judges and justices to stay on the bench without a popular vote unless one is triggered by felony convictions, crimes involving fraud and dishonesty, personal bankruptcy or mortgage foreclosure.
OMAHA, Neb. (AP) — Nebraska voters supported a measure Tuesday that enshrines the state’s current ban on abortions after the 12th week of pregnancy in the state constitution, and they rejected a competing measure that sought to expand abortion rights. Nebraska was the first state to have competing abortion amendments on the same ballot since the U.S. Supreme Court overturned Roe v. Wade in 2022, ending the nationwide right to abortion and allowing states to decide for themselves. The dueling measures were among a record number of petition-initiated measures on Nebraska’s ballot Tuesday.
What were the competing abortion measures?
A majority of voters supported a measure enshrining the state’s current ban on abortion after the first 12 weeks of pregnancy in the state constitution. The measure will also allow for further restrictions. Last year, the Legislature passed the 12-week ban, which includes exceptions for cases of rape and incest and to protect the life of the pregnant woman.
Voters rejected the other abortion measure. If they had passed it by a larger number of “for” votes than the 12-week measure, it would have amended the constitution to guarantee the right to have an abortion until viability — the standard under Roe that is the point at which a fetus might survive outside the womb. Some babies can survive with medical help after 21 weeks of gestation.
Abortion was on the ballot in several other states, as well. Coming into the election, voters in all seven states that had decided on abortion-related ballot measures since the reversal of Roe had favored abortion rights, including in some conservative states.
Who is behind the Nebraska abortion measures?
The 12-week ban measure was bankrolled by some of Nebraska’s wealthiest people, including Republican Sen. Pete Ricketts, who previously served as governor and donated more than $1.1 million. His mother, Marlene Ricketts, gave $4 million to the cause. Members of the Peed family, which owns publishing company Sandhills Global, also gave $1 million.
The effort was organized under the name Protect Women and Children and was heavily backed by religious organizations, including the Nebraska Catholic Conference, a lobbying group that has organized rallies, phone banks and community townhalls to drum up support for the measure.
The effort to enshrine viability as the standard was called Protect Our Rights Nebraska and had the backing of several medical, advocacy and social justice groups. Planned Parenthood donated nearly $1 million to the cause, with the American Civil Liberties Union, I Be Black Girl, Nebraska Appleseed and the Women’s Fund of Omaha also contributing significantly to the roughly $3.7 million raised by Protect Our Rights.
What other initiatives were on Nebraska’s ballot?
Nebraska voters approved two measures Tuesday that will create a system for the use and manufacture of medical marijuana, if the measures survive an ongoing legal challenge.
The measures legalize the possession and use of medical marijuana, and allow for the manufacture, distribution and delivery of the drug. One would let patients and caregivers possess up to 5 ounces (142 grams) of marijuana if recommended by a doctor. The other would create the Nebraska Medical Cannabis Commission, which would oversee the private groups that would manufacture and dispense the drug.
Those initiatives were challenged over allegations that the petition campaign that put them on the ballot broke election rules. Nebraska’s attorney general said supporters of the measures may have submitted several thousand invalid signatures, and one man has been charged in connection with 164 allegedly fraudulent signatures. That means a judge could still invalidate the measures.
Voters also opted Tuesday to repeal a new conservative-backed law that allocates millions of dollars in taxpayer money to fund private school tuition.
Finally, they approved a measure that will require all Nebraska employers to provide at least 40 hours of paid sick leave to their employees.
WASHINGTON (AP) — Voters in Missouri cleared the way to undo one of the nation’s most restrictive abortion bans in one of seven victories for abortion rights advocates, while Florida, Nebraska and South Dakota defeated similar constitutional amendments, leaving bans in place.
Abortion rights amendments also passed in Arizona, Colorado, Maryland and Montana. Nevada voters also approved an amendment, but they’ll need to pass it again it 2026 for it to take effect. Another that bans discrimination on the basis of “pregnancy outcomes” prevailed in New York.
The results include firsts for the abortion landscape, which underwent a seismic shift in 2022 when the U.S. Supreme Court overturned Roe v. Wade, a ruling that ended a nationwide right to abortion and cleared the way for bans to take effect in most Republican-controlled states.
They also came in the same election that Republican Donald Trump won the presidency. Among his inconsistent positions on abortion has been an insistence that it’s an issue best left to the states. Still, the president can have a major impact on abortion policy through executive action.
In the meantime, Missouri is positioned to be the first state where a vote will undo a ban on abortion at all stages of pregnancy, with an amendment that would allow lawmakers to restrict abortions only past the point of a fetus’ viability — usually considered after 21 weeks, although there’s no exact defined time frame.
But the ban, and other restrictive laws, are not automatically repealed. Advocates now have to ask courts to overturn laws to square with the new amendment.
“Today, Missourians made history and sent a clear message: decisions around pregnancy, including abortion, birth control, and miscarriage care are personal and private and should be left up to patients and their families, not politicians,” Rachel Sweet, campaign manager of Missourians for Constitutional Freedom, said in a statement.
Roughly half of Missouri’s voters said abortion should be legal in all or most cases, according to AP VoteCast, a survey of more than 2,200 of the state’s voters. But only about 1 in 10 said abortion should be illegal in all cases; nearly 4 in 10 said abortion should be illegal in most cases.
Bans remain in place in three states after votes
Florida, Nebraska and South Dakota became the first states since Roe was overturned where abortion opponents prevailed on a ballot measure. Most voters supported the Florida measure, but it fell short of the required 60% to pass constitutional amendments in the state. Most states require a simple majority.
The result was a political win for Gov. Ron DeSantis, a Republican with a national profile, who had steered state GOP funds to the cause. His administration has weighed in, too, with a campaign against the measure, investigators questioning people who signed petitions to add it to the ballot and threats to TV stations that aired one commercial supporting it.
Marjorie Dannenfelser, president of the national anti-abortion group SBA Pro-Life America, said in a statement that the result is “a momentous victory for life in Florida and for our entire country,” praising DeSantis for leading the charge against the measure.
The defeat makes permanent a shift in the Southern abortion landscape that began when the state’s six-week ban took effect in May. That removed Florida as a destination for abortion for many women from nearby states with deeper bans and also led to far more women from the state traveling to obtain abortion. The nearest states with looser restrictions are North Carolina and Virginia — hundreds of miles away.
“The reality is because of Florida’s constitution a minority of Florida voters have decided Amendment 4 will not be adopted,” said Lauren Brenzel, campaign director for the Yes on 4 Campaign said while wiping away tears. “The reality is a majority of Floridians just voted to end Florida’s abortion ban.”
In South Dakota, another state with a ban on abortion throughout pregnancy with some exceptions, the defeat of an abortion measure was more decisive. It would have allowed some regulations related to the health of the woman after 12 weeks. Because of that wrinkle, most national abortion-rights groups did not support it.
Voters in Nebraska adopted a measure that allows more abortion restrictions and enshrines the state’s current 12-week ban and rejected a competing measure that would have ensured abortion rights.
Other states guaranteed abortion rights
Arizona’s amendment will mean replacing the current law that bans abortion after the first 15 weeks of pregnancy. The new measure ensures abortion access until viability. A ballot measure there gained momentum after a state Supreme Court ruling in April found that the state could enforce a strict abortion ban adopted in 1864. Some GOP lawmakers joined with Democrats to repeal the law before it could be enforced.
In Maryland, the abortion rights amendment is a legal change that won’t make an immediate difference to abortion access in a state that already allows it.
It’s a similar situation in Montana, where abortion is already legal until viability.
The Colorado measure exceeded the 55% of support required to pass. Besides enshrining access, it also undoes an earlier amendment that barred using state and local government funding for abortion, opening the possibility of state Medicaid and government employee insurance plans covering care.
A New York equal rights law that abortion rights group say will bolster abortion rights also passed. It doesn’t contain the word “abortion” but rather bans discrimination on the basis of “pregnancy outcomes, and reproductive healthcare and autonomy.” Sasha Ahuja, campaign director of New Yorkers for Equal Rights, called the result “a monumental victory for all New Yorkers” and a vote against opponents who she says used misleading parental rights and anti-trans messages to thwart the measure.
The results end a win streak for abortion-rights advocates
Until Tuesday, abortion rights advocates had prevailed on all seven measures that have appeared on statewide ballots since the fall of Roe.
The abortion rights campaigns have a big fundraising advantage this year. Their opponents’ efforts are focused on portraying the amendments as too extreme rather than abortion as immoral.
Currently, 13 states are enforcing bans at all stages of pregnancy, with some exceptions. Four more bar abortion in most cases after about six weeks of pregnancy — before women often realize they’re pregnant. Despite the bans, the number of monthly abortions in the U.S. has risen slightly, because of the growing use of abortion pills and organized efforts to help women travel for abortion. Still, advocates say the bans have reduced access, especially for lower-income and minority residents of the states with bans.
The issue is resonating with voters. About one-fourth said abortion policy was the single most important factor for their vote, according to AP VoteCast, a sweeping survey of more than 110,000 voters nationwide. Close to half said it was an important factor, but not the most important. Just over 1 in 10 said it was a minor factor.
The outcomes of ballot initiatives that sought to overturn strict abortion bans in Florida and Missouri were very important to a majority of voters in the states. More than half of Florida voters identified the result of the amendment as very important, while roughly 6 in 10 of Missouri’s voters said the same, the survey found.
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Associated Press reporters Hannah Fingerhut and Amanda Seitz contributed to this article.
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This article has been corrected to reflect in the ‘other states’ section that Montana, not Missouri, currently allows abortion until viability.
