By Peter Chow
If a COVID-19 vaccine is safe and gets approved, but there’s no one around to make it, does it still count?
It’s the question that sent sparks flying among federal politicians this week after Prime Minister Justin Trudeau admitted that Canadians are likely to be at the end of the line when the companies with Covid-19 vaccines start handing out doses.
Furthermore, lacking the capacity to make vaccines, Canada has not even negotiated the right to manufacture doses of them here at home, meaning we’re now waiting on shipments from companies in other countries.
Our lack of vaccine manufacturing ability is the result of the “hollowing out” of the biopharmaceutical industry in this country over the past 50 years.
We had great vaccine producers in Canada – world leaders essentially – 50 years ago.
Connaught Laboratories, founded in 1914 at the University of Toronto Medical School, was the vision of a Canadian doctor, John G. FitzGerald, a professor at the University of Toronto, who was appalled by the fact that Canadian children were dying of diphtheria at an alarming rate, even though treatment for the disease was available. The problem was that the $80 price for a full dose of treatments was far beyond the reach of working families, leaving all but the wealthy terrorized by the possibility of a child dying from diphtheria. After carrying out experiments on a horse in a makeshift barn, FitzGerald developed a treatment that could be produced and sold cheaply.
In conjunction with the University of Toronto, FitzGerald created Connaught Labs and made his diphtheria treatment available at low cost to provincial health boards across the country, which provided them to doctors without charge.
The minimal profits earned by the lab were ploughed back into research and development, and Connaught went on to develop low-cost treatments and preventative vaccines for other diseases that were killing large numbers of Canadians, including typhoid fever, tetanus, and meningitis.
Drug manufacturers and pharmacists objected to having their prices undercut by the upstart enterprise, and some druggists refused to carry Connaught products.
In 1921, Frederick Banting and Charles Best worked tirelessly through an especially hot summer and by early August had prepared a canine pancreatic extract they called “isletin,” which could reduce blood sugar levels in de-pancreatized diabetic dogs.
Calf pancreas was a more suitable source of the extract and Banting and Best developed a more purified form of the bovine extract that could be tested on diabetic patients. The first successful test was given to 14-year-old Leonard Thompson at Toronto General Hospital on January 11, 1922.
In his Connaught Labs office two floors below Banting and Best’s lab in the physiology building at the University of Toronto, John FitzGerald was fully aware of Banting and Best success.
After the discovery of insulin, Fitzgerald noticed the need of support and offered them Connaught’s facilities and $5,000 to expedite the process of production. On January 23rd, 1923 Banting and Best were awarded the American patents for insulin which they sold to the University of Toronto for $1.00 each, with the conviction to not profit from a discovery made for the benefit of mankind.
By November 1923, with the completion of a new lab, Connaught was able to produce 250,000 units of insulin weekly (the average person with Type 1 averaged 15–20 units a day), allowing them to drop the price from 5 cents to 2 cents per unit.
The price of insulin in 2020 is an extremely controversial issue. Between 2003 and 2012 the price of insulin in the U.S.A tripled. This has made insulin difficult and sometimes impossible to afford for those with Type 1 diabetes. Not to mention the cost of other equipment and devices to monitor blood sugar levels and administer insulin. Even in Canada, insurance does not always cover the total cost of insulin.
A Diabetes Canada research study reported that, “57% of Canadians with diabetes say they do not comply with their prescribed therapy because they cannot afford their medications, devices and supplies, thus potentially compromising their diabetes management”.
Looking back on the history and at Frederick Banting’s sentiment that insulin belongs to the world instead of any individual should inspire discussions surrounding these issues.
For the following seven decades, Connaught made significant and unique contributions to Canadian — and international — health care.
Connaught carried out basic research, funded partly by government and partly by its own profits. And its research was based on what its scientists and doctors considered important, not what promised to be lucrative. It had no sales agents out flogging its products.
And Connaught’s research turned out to be valuable.
In 1952, Connaught Labs developed a synthetic solution to grow the polio virus. They also developed the Toronto Method which allowed the growth of the polio virus in bulk in the medium in large vats. These two contributions allow Salk to produce enough polio virus to make vaccine production practical.
Connaught produced all the Salk polio vaccine used in 1954 in Dr. Jonas Salk’s massive field trial of half a million children in the United States, Canada and Finland.
Connaught manufactured eighty-three other products, including all of Canada’s insulin (“Toronto insulin”), at the lowest price on the continent, almost all of the country’s veterinarian products, and the vaccines against whooping cough, smallpox, diphtheria, tetanus, rabies, typhoid and measles. Connaught played an essential role in the successful complete eradication of smallpox throughout the world.
Connaught scored some dazzling firsts: first in the world to make insulin; first in the world to make commercial heparin, that made possible modern surgery’s “miracle” heart operations; first in the world to conduct a documented field trial of a new vaccine (diphtheria in 1927); first in North America to make diphtheria toxoid, penicillin and a combined antigen vaccine.
In 1972, the University of Toronto sold Connaught for $26 million to the Canada Development Corporation, an agency created by Pierre Trudeau’s Liberal government to develop and maintain Canadian-controlled companies, in response to public concerns about foreign ownership of the economy.
But, in 1985, Brian Mulroney’s Progressive Conservative government privatized Connaught and it was then bought by Sanofi, a giant French pharmaceutical company, which is headquartered in Paris, for $924 million.
The sale was a devastating attack on Canada’s struggling high-technology sector. Mulroney replied that protectionism “puts a Wall of China around Canada.”
Nationalistic sentiment supporting the Connaught Laboratories ran deep, because it became one of the world’s main producers of insulin following Frederick Banting and Charles Best’s discovery of insulin in Toronto in 1921. Connaught was also one of the few large Canadian biotechnology companies in an industry that had much potential for job and wealth creation in the future.
As a result, we no longer had a publicly owned pharmaceutical company that is a force in global health care — and that could have produced a Covid-19 vaccine.
To think we had a homegrown public enterprise, one that dazzled and triumphed on the world stage, developing life-saving treatments for the benefit of humanity — in bold contrast to rapacious Big Pharma.