{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T11:49:02Z","timestamp":1791546542288,"version":"4.3.4"},"reference-count":35,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T00:00:00Z","timestamp":1781740800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["International Journal of Social Determinants of Health and Health Services"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:p>In an attempt to avoid the inequitable outcome of the COVID-19 pandemic whereby High-Income Countries received the overwhelming majority of vaccine doses after they became available, the World Health Organization initiated negotiations in December 2021 on a legally binding Pandemic Agreement. This paper uses a variety of documents and personal experience to examine how the Canadian government communicated with its domestic stakeholders about the stances that Canada was taking during the negotiations and to illustrate what positions Canada was advancing at the negotiations table in Geneva. This article argues that the government lacked transparency in its communications and gave no indication that it was listening to the feedback it was receiving. During the negotiations, aside from advancing a progressive position of gender equality, the government pushed to weaken the obligations of countries and the commercial sector to ensure that vaccines, treatments and technology would be available on an equitable basis globally in any future pandemic. Now that the Pandemic Agreement has been adopted by the World Health Assembly, there is still the task of agreeing on an annex on pathogen access and benefit sharing. Past experience suggests that during these negotiations Canada will favor commercial over public health interests.<\/jats:p>","DOI":"10.1177\/27551938261458695","type":"journal-article","created":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T09:31:34Z","timestamp":1781775094000},"page":"442-450","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["The World Expected More of Canada: Canada and the Pandemic Agreement"],"prefix":"10.1177","volume":"56","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5120-8029","authenticated-orcid":false,"given":"Joel","family":"Lexchin","sequence":"first","affiliation":[{"name":"York University"},{"name":"Faculty of Medicine, University of Toronto, Toronto ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,6,18]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjgh-2021-006504"},{"key":"e_1_3_3_3_2","unstructured":"World Health Organization. The world together: establishment of an intergovernmental negotiating body to strengthen pandemic prevention preparedness and response. 2021. December 1 2021. https:\/\/apps.who.int\/gb\/ebwha\/pdf_files\/WHASSA2\/SSA2(5)-en.pdf."},{"key":"e_1_3_3_4_2","unstructured":"Government of Canada. Canada's role in the development of an international pandemic agreement. Updated August 8. Accessed December 11 2025. https:\/\/www.canada.ca\/en\/public-health\/services\/emergency-preparedness-response\/canada-role-international-pandemic-instrument.html."},{"key":"e_1_3_3_5_2","unstructured":"World Health Organization. Intergovernmental Negotiating Body. Accessed December 11 2025. https:\/\/apps.who.int\/gb\/inb\/index.html."},{"key":"e_1_3_3_6_2","unstructured":"World Health Organization. Zero draft of the WHO CA+ for the consideration of the Intergovernmental Negotiating Body at its fourth meeting. Updated April 4 2023. 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COVID-19 vaccine redistribution to save lives now. 2021. October 7 2021. https:\/\/msfaccess.org\/covid-19-vaccine-redistribution-save-lives-now."},{"key":"e_1_3_3_14_2","unstructured":"Health Canada Public Health Agency of Canada. Negotiation of a World Health Organization pandemic agreement (PA): 2024 regional stakeholder engagement series. 2024."},{"key":"e_1_3_3_15_2","unstructured":"European Union. Outline of EU textual proposals in the Zero draft of the WHO convention agreement or other international instrument on pandemic prevention preparedness and response (\u201cWHO CA+\u201d). Updated March 28 2023. Accessed September 5 2025. https:\/\/www.eeas.europa.eu\/sites\/default\/files\/documents\/2023\/EU%20proposals%20integrated%20into%20the%20ZD%2028%20March.pdf."},{"key":"e_1_3_3_16_2","unstructured":"Habibi R Wenham C. The world is running out of time to negotiate a global pandemic treaty. Globe and Mail. April 24 2023."},{"key":"e_1_3_3_17_2","unstructured":"York G. 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