The pieces are finally fitting into place for mass vaccination in SA

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A healthcare worker stacks vials of Pfizer/BioNTech vaccine. Picture: Reuters
A healthcare worker stacks vials of Pfizer/BioNTech vaccine. Picture: Reuters

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Within the next month or so, we will be switching gears from the comparatively small-scale trial run of Sisonke to a mass vaccination programme. As with the onset of a new wave of infections, this presents a dramatic shift in the pandemic and our response to it – although in this case, the shift is finally a good thing, writes Spotlight editor Marcus Low.

Countries face two major challenges in vaccinating their populations against Covid-19 – getting hold of enough vaccine doses and managing the logistics of getting the jabs into people’s arms.

Though some might argue that it has taken longer than it should have, it seems South Africa has finally cleared the first of these hurdles, at least on paper.

In a statement released on Tuesday, Health Minister Dr Zweli Mkhize said: “We are pleased to confirm that the Pfizer agreement for 20 million doses of vaccines has been signed and that payment processes are under way to close the deal in the next few days. With the Johnson & Johnson agreement also fully concluded, this sets the stage for a significant and rapid expansion of our vaccination programme.”

Given the global competition for vaccines, there will probably be a few more supply hiccups and delays along the way.

The 20 million doses of the Pfizer vaccine are enough for 10 million people.

If you add the 31 million single-dose Johnson & Johnson vaccines that have been lined up, we have enough doses on paper to vaccinate 41 million people (around 69% of the population).

While Mkhize is right that the conclusion of these deals facilitates the “rapid expansion of our vaccination programme”, there is still a very long way to go.

Firstly, signatures on paper are not the same as vaccines in fridges.

Read: How to overcome covid-19 vaccine hesitancy

From what we’ve heard, vaccine deliveries will be staggered over many months and it seems very unlikely we will vaccinate enough people in time to significantly flatten a third wave, should such a wave develop in the coming months.

Given the global competition for vaccines, there will probably be a few more supply hiccups and delays along the way.

Things should get better, though, as hopefully more vaccines are approved, global production is scaled up and demand from wealthy countries drops as most of their citizens are vaccinated.

Secondly, much of the vaccine distribution in South Africa will depend on provincial departments of health.

One of the lessons of the last decade or two is that good policies made at national level often fizzle out when they run up against the dysfunction of some of our provincial health departments.

Transparency remains at best patchy, for example, the ministerial advisory committee did not make advice on vaccines public in a timely manner.

It is true that administering vaccines is simpler than running Covid-19 wards but, nevertheless, if you think of which entities to entrust with complicated logistical programmes, the Eastern Cape department of health, for example, will not be high on many people’s lists.

It seems obvious that South Africa’s significant private sector health infrastructure and logistical capacity should be roped in to help, but to what extent this will actually happen remains to be seen.

Even now, it seems some in national government are in denial about what some provincial departments of health can or cannot do – and, as a result, what additional help is needed.

And there are other ongoing areas of concern.

Transparency remains at best patchy, for example, the ministerial advisory committee did not make advice on vaccines public in a timely manner.

Public consultation also remains far from optimal. Government could have called for public submissions on a vaccine strategy and vaccination prioritisation as far back as November, but that hasn’t happened.

Read | Healthcare workers ask: ‘Why are we the guinea pigs?’

Instead, in Tuesday’s media statement, Mkhize dropped the news that the department of health had revised the vaccination strategy – we are not told why and based on what new information.

Mention is made in the statement of the need for “extensive yet urgent consultation” but, given how things have gone over the last year, one could be forgiven for thinking the extensive consultations are only with those already inside the tent.

Yet, be all that as it may, within the next month or so South Africa’s Covid-19 response will again change gears.

From the comparatively small-scale trial run of Sisonke, we will be moving into a mass vaccination programme.

As with the onset of a new wave of infections, this presents a dramatic shift in the pandemic and our response to it – although, in this case, the shift is finally a good thing.

This article was produced by Spotlight – health journalism in the public interest


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