PIH Canada presentation to Global Cooperation Caucus re. vaccination and GAVI

September 26, 2024

Partners In Health Canada extends our sincere gratitude to Results Canada and One Canada for their ongoing coordination and advocacy efforts on behalf of our sector. We also wish to thank the Members on this committee, and the other Members, for taking time to have this exchange with civil society. The work of this Global Cooperation Caucus is taking place at a time of declining fiscal space and an increasingly narrow focus on select domestic issues. You are here not because of political pressures, but because you care about what happens beyond Canada’s borders. 

There are significant shifts underway in global health and international development sectors that, while overdue, add complexity to decision-making. The rightful demands for local ownership, decision-making, and priority-setting can lead to better outcomes if communities are appropriately heard and their needs addressed. However, these demands also increase the due diligence and information gathering required of policymakers and Global Affairs Canada colleagues working at a geographic distance from these contexts.

That said, there remains a shared responsibility to engage—not only for Canada’s interests but also for the significant good the country can contribute to the world.

Canada’s constructive role includes financial support, certainly, but also a commitment to learning and participating in conversations about how to make investments in global public goods more effective. This includes ensuring that people everywhere have access to the same standards of health, education, and economic opportunities that are valued within Canada.

This extends to individuals supported by organizations like Partners In Health (PIH), who, through no fault of their own, lack access to adequate health care. To provide context, PIH is a global health and social justice organization that has been advancing the right to health for nearly four decades. Beginning with work in Haiti in the mid-1980s, PIH makes long-term, open-ended commitments to countries and communities, supporting governments in building and strengthening public health systems. The organization is guided by the principle that access to health care is a human right and believes that governments—not NGOs—are ultimately responsible for delivering on that right. PIH’s role is to accompany these governments to prove that high-quality, dignified care is possible, even in resource-poor settings.

A core element of PIH’s mission includes “bringing the benefits of modern medical science to those most in need.” Immunization—arguably one of the most transformative benefits of modern medicine—is an area where Canada’s leadership is critical, consistent with its 10-Year Commitment to Global Health and Rights.

Canada’s recent announcements, such as support for the Africa Vaccine Manufacturing Accelerator and the historic investment in polio eradication, reflect this commitment. Canada’s longstanding support for Gavi, the Vaccine Alliance, continues to be a vital investment that provides millions of children with the opportunity for a healthier future, delivering widespread social, educational, and economic benefits.

With the support of Canada and other donors, Gavi has prevented more than 17 million deaths through essential childhood vaccinations, vaccinated over 1 billion children, and strengthened vaccination systems in more than 60 countries. A child born in a Gavi-supported country is 70% less likely to die from a vaccine-preventable disease. The case for continued investment in Gavi is compelling, and the proposed $720-million pledge over five years would significantly contribute to achieving the 2030 Sustainable Development Goals.

However, vaccination systems perform best within robust health systems rather than as isolated interventions. This requires viewing vaccination programs through a “social medicine” lens—an approach that considers the histories and daily realities of communities served and builds health systems that respond to their lived experiences.

PIH’s experience demonstrates that demand for health services, including vaccinations, is high when care is delivered with dignity and respect, when services are accessible, and when communities trust that engagement with the health system will improve their well-being. This is achieved through what PIH calls the 5S’s of health systems strengthening: Staff, Stuff, Space, Systems, and Social Support.

For example, during the cholera outbreak in Haiti following the 2010 earthquake, PIH successfully conducted an oral vaccination campaign in one of the country’s most affected regions. Despite opposition from some in the global health community, the campaign achieved a 91% two-dose completion rate among 50,000 people. This success was due to existing community-based health infrastructure and strong demand for the vaccine, ultimately leading to broader adoption of cholera vaccines by the World Health Organization.

This example underscores the need for investments not only in vertical programs like vaccination but also in the health systems that enable these programs to succeed. Vaccination programs can serve as a gateway to primary care and a means of building—or losing—trust. Strengthening health systems using the 5S framework amplifies the impact of investments in global health, including vaccination programs.

Thank you once again for your commitment to these critical issues and for advocating within Parliament to advance them. Looking forward to the discussion.