Domestic health security requires more than talk about global equity The Canadian government’s actions fell far short of its advocacy for global vaccine equity during the covid-19 pandemic.12 This discord is documented by Houston and colleagues as part of The BMJ ’s series on accountability for Canada’s covid-19 response (doi:10.1136/BMJ-2023-075149).3 The government waxed lyrical about the importance of accelerating vaccine access worldwide to end the pandemic and described itself among the leading countries contributing to this goal, but it failed to follow through on actual vaccine doses committed to Covax, engaged in excessive advance purchasing, and did not support an intellectual property (TRIPS) waiver that would expand global production. Was this glaring contradiction a result of tensions between domestic and global health priorities? Did the unfolding nature of the pandemic make it impossible for the government to fulfil its good intentions? Or was it simply business as usual