Dear Retired General Hillier:
Re: Human rights principles and considerations for vaccine distribution
Congratulations on your appointment as Chair of the recently-established Ministers' COVID-19 Vaccine Distribution Task Force. Your career and experience with complex, uncertain and multifaceted projects equips you well for the magnitude of the task ahead.
The OHRC hopes that, given your past experience and the expertise of the Task Force, you will be able to integrate the divergent needs of various communities and stakeholders to ensure all Ontarians have equitable access to vaccines. Most importantly, your efforts and the work of the Task Force will play a critical role in ensuring that the people of Ontario can begin come together to rebuild and restore our communities.
While the coronavirus does not discriminate, data tells us that the COVID-19 pandemic has brought to the fore profound systemic inequalities, and has exacted a devastating social, economic and health toll on Ontario’s most vulnerable people and communities. I am writing today to stress the important role that human rights principles, considerations and obligations should play in vaccine distribution planning.
COVID-19 and human rights
Beginning in January 2020, the OHRC has provided guidance on human rights obligations during the pandemic, including broad-based policy and action statements.
On March 13, the OHRC released a Policy statement on the COVID-19 pandemic that urges Ontarians to keep human rights principles under the Ontario Human Rights Code, Canadian Charter of Rights and Freedoms and international human rights treaties at the centre of decision-making during the pandemic.
On April 2, the OHRC released a Policy statement on a human rights-based approach to managing the COVID-19 pandemic that provides guidance on the principles underlying a human rights-based approach across a range of potential policy, legal, regulatory, public health and emergency-related responses.
To be read in tandem with the policy statements, the OHRC identified actions consistent with this human rights-based approach.
The OHRC has also provided government, other duty-holders and the public with human rights guidance on several specific issues through letters, submissions and other communications, all of which are available on our website.
Since this work began in January, the OHRC has consistently stressed the need for government to:
- Provide all healthcare services related to COVID-19, including testing, triage, treatment and possible vaccination, without stigma, bias or discrimination
- Consult with human rights institutions and experts, Indigenous leaders and knowledge-keepers, vulnerable groups, and persons and communities affected by COVID-19, when making decisions, taking action and allocating resources.
The OHRC recognizes the herculean task of planning and distributing COVID-19 vaccines across Ontario. However, we cannot overstate how critical it is to make human rights principles and obligations, such as non-discrimination, central to this effort.
The OHRC recognizes that the Task Force includes cross-government and external representation with diverse expertise in operations and logistics, federal-provincial relations, health and clinical domains, public health and immunization, ethics, and information technology and data.
We encourage you to also include human rights experts and representatives for vulnerable groups in this work and to ensure there are entry points and outlets to consult with or seek input from certain impacted communities.
Human rights considerations in vaccine distribution
Many Ontario Human Rights Code-protected groups experience poverty and are more likely to be exposed to the risk of contagion, but are not as likely to be protected from COVID-19 by ready access to testing and health services. For this reason, it is imperative that access to vaccines is provided to all Ontarians without discrimination, and prioritized for the people who are most exposed and vulnerable to the risks.
A vaccine distribution strategy should be based on evidence of individuals’ increased risks of exposure, transmission or death rather than stereotypes; and should be framed in ways that avoid stigmatization of vulnerable groups.
A vaccine distribution strategy should also include disaggregated data collection and monitoring to ensure Code-protected groups experience equitable access to vaccines and are not disproportionately affected, and should make adjustments and accommodations where necessary; especially where evidence shows groups have historically unequal access to health services.
International human rights statements on access to vaccines
International human rights organizations, the United Nations and the World Health Organization have also stressed the centrality of human rights principles in pandemic response, access to treatment and recovery planning.
In April 2020, the United Nations General Assembly adopted a resolution urging member states and other stakeholders to “ensure fair, transparent, equitable, efficient and timely access to and distribution of a range of tools to address COVID-19, including future vaccines.”[i]
In November 2020, the United Nations Human Rights Office of the High Commissioner issued a statement reiterating state obligations to ensure that COVID-19 vaccines and treatments are safe, available, accessible and affordable to all who need them. This particularly applies to people in vulnerable situations who often face barriers in accessing health services. This includes people living in poverty, women, Indigenous peoples, people with disabilities, older persons, racialized communities, persons in overcrowded settings and in residential institutions, people in detention, people experiencing homelessness, migrants and refugees, people who use drugs, LGBTQ2S and gender diverse persons.[ii]
The OHRC recognizes the weeks ahead for the Task Force will be challenging and the importance of “getting it right” is a tremendous weight to carry. However, if a vaccine strategy is grounded in human rights principles and obligations, and informed by human rights expertise and by the people most affected, “getting it right” becomes a more likely and attainable goal.
I offer the OHRC’s expertise to support your efforts and I hope the OHRC’s insights can contribute to the important work that faces the Task Force in the weeks and months ahead. Please do not hesitate to contact me through my administrative coordinator if you would like to set up a meeting or conference call.
Ena Chadha, LL.B., LL.M.
cc: Hon. Sylvia Jones, Solicitor General
Ken Chan, Assistant Deputy Minister, Vaccine Distribution Secretariat
Hon. Christine Elliot, Minister of Health
Hon. Doug Downey, Attorney General
Vaccine Distribution Task Force members:
Dr. Dirk Huyer, Ontario's Chief Coroner and Coordinator of Provincial Outbreak Response
Dr. Homer Tien, President and CEO, Ornge
Dr. Maxwell Smith, Assistant Professor, Western University
Dr. Isaac Bogoch, Infectious Diseases Consultant and Internist, Toronto General Hospital
Ontario Regional Chief RoseAnne Archibald, Taykwa Tagamou Nation
Dr. Regis Vaillancourt, Director of Pharmacy, Children's Hospital of Eastern Ontario
Linda Hasenfratz, CEO, Linamar Corporation
Angela Mondou, President and CEO, TECHNATION
Mark Saunders, former Toronto Police Chief
[i] UNGA, “International cooperation to ensure global access to medicines, vaccines and medical equipment to face COVID-19,” April 8, 2020, para. 2.
[ii] OHCHR, “Statement by UN Human Rights Experts Universal access to vaccines is essential for prevention and containment of COVID-19 around the world,” November 9, 2020.