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South Africa outlines Covid-19 vaccine rollout plan

Health minister Dr Zweli Mkhize outlined South Africa’s Covid-19 vaccine rollout strategy in a public address on Sunday evening (3 January), as the country deals with a second wave of the virus.

Health minister Dr Zweli Mkhize outlined South Africa’s Covid-19 vaccine rollout strategy in a public address on Sunday evening (3 January), as the country deals with a second wave of the virus.

“We are targeting a minimum of 67% of the population to achieve herd immunity and the approach will be a phased rollout of the vaccine beginning with the most vulnerable in our population,” the minister said.

Dr Mkhize said that the government is mindful of the urgency of obtaining a vaccine.

“We have set up structures to expedite financing, sourcing and procurement and therefore the issue of the vaccine strategy will get undivided attention from the department and government.”

He said that the only way to deal with a second wave is to develop herd immunity through vaccination.

“The vaccines will need to be made available quickly so that most of our citizens are covered by the end of the first year of rollout – this year,” the minister said.

“Having secured for 10% of the population, we have embarked on other efforts to get the rest of the 57% of the population to be targeted by the end 2021 but, more importantly, we are making efforts to obtain vaccines much earlier, hopefully as early as February 2021,” he said.

The priority of the vaccine rollout will begin with healthcare workers, the elderly and those with co-morbidities.

“By the end of phase 3: 40,350,000 citizens will have been immunized which is equivalent to approximately 67.25% of the population as we have indicated,” the minister said.

Government said it it will need to raise the funds to deal with the remainder of the population. Mkhize said that the R1.8 billion set aside for vaccinations has already been used. The minister said that the government has approached the Solidarity Fund to assist in the procurement process.

Dr Mkhize said: “To optimize the availability of stock for ourselves we are negotiating with all the manufacturers and pursuing those who are indicating appetite to make vaccines available sooner.

“We are in sensitive discussions. I have been involved in some of these discussions and can mention a few of them, Astra Zeneca, Moderna, etc.”

Additionally, the minister said that the government has embarked on public-private partnerships “with very good outcomes and we have approached medical aids to be part of the co-financing”.

“The process is now at a stage where the Council for Medical Schemes has engaged various medical schemes and I have signed amendments of regulations to allow for vaccines and other therapeutics to be part of the prescribed minimum benefits,” he said.

Running out of options

Bloomberg however, reported that South Africa, along with many other African nations, has few options to procure Covid-19 vaccines.

Pfizer Inc and BioNTech SE have offered to supply Africa with 50 million Covid-19 vaccines for health workers between March and the end of this year, the presidency said in a response to Bloomberg on Sunday.

Moderna Inc has no supplies for Africa, while AstraZeneca Plc has no shots for the continent in 2021 and has directed the African Union to negotiate with the Serum Institute of India Ltd, which is making the vaccine on behalf of AstraZeneca.South Africa’s president Cyril Ramaphosa is the African Union’s chairman.

President Cyril Ramaphosa’s response comes after days of withering criticism in South Africa over the country’s vaccine strategy from health leaders, labour unions and opposition parties.

Even though four vaccine trials are underway in the country, South Africa has only arranged to purchase enough shots for 10% of its population of 60 million people through the Covax initiative, which is designed to ensure equitable access to the vaccines.

“We are working hard in South Africa and on the continent to protect our people against Covid-19,” the presidency said.

Discussions are taking place with Johnson & Johnson, which is conducting a trial in South Africa and plans to make 300 million doses a year at a factory in the country owned by Aspen Pharmacare Holdings Ltd when the shot is approved.

South Africa is holding direct talks with vaccine suppliers including J&J, AstraZeneca and Pfizer over supplies for the country, the presidency said.

Vaccine “not only weapon to end pandemic”

Leading experts in South Africa’s vaccine procurement strategy say while securing a Covid-19 vaccine is top of the country’s agenda, it is not a magic bullet that will end the pandemic.

“There is a general misunderstanding and we need to clarify that once the vaccines arrive on our doorstep, that is not the end of the epidemic.

“The first branches will go to protect healthcare workers and will have no effect on the population as such.

“Then there will be immunisation of the population and that is going to take a long time,” said professor Barry Schoub, who is the Ministerial Advisory Committee chairperson on vaccine development.

Schoub, together with the Health Department deputy director-general, Dr Anban Pillay, and South African Medical Research Council (SAMRC) extramural unit researcher, Safura Abdool Karim, engaged in a panel discussion broadcast by the SABC on the Covid-19 vaccine outlook in 2021.

“The Covax facility has indicated that we should expect delivery of the vaccine in quarter two [of 2021]. They are trying very hard to get us delivery before that. If they succeed with the manufacturers, then we may get delivery earlier but we do not have a specific date as yet.

“Covax indicated to us that in early January, they will have a firm date on when exactly that delivery will come through and we will certainly communicate that as soon as we hear what that date is,” said Pillay.

Dispelling some misconceptions that government failed to procure the vaccine on time, Karim explained the historic inequity within the procurement of medicine.

“The one thing I would want to dispute is the idea that our situation is as a result of poor planning. The reason South Africa is not able to access the vaccine is in the way the US and UK have is that we are not a wealthy country and that is a historic inequity.

“Poorer countries are always left behind when it comes to health interventions and that is not a result of our government not wanting a vaccine. That is a result of a system that prioritises profits over people’s lives,” said Karim.

Additionally, Pillay said South Africa wants to acquire a vaccine with the best efficacy, which will be easily stored for mass roll out.

“One needs to bear in mind that the Pfizer vaccine needs to be stored at -70 degrees Celsius. Many countries did not opt to go with the Pfizer vaccine as a mass vaccination programme because it is very difficult to do that, particularly in a country like South Africa and many other developing nations that do not have storage capacity for -70 degrees.

“We have commercially only two large storage facilities that will keep a -70 degrees vaccine. So we would not be able to keep the large quantities that are required to vaccinate many people,” he said.

“The vaccine rollout will be led nationally, there will be one procurement approach and we will then work with our provincial colleagues and the private sector for distribution,” Pillay said in a separate note on Sunday evening.

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