South Africa’s government, lauded for its swift lockdown in March to curb the spread of the coronavirus, is now being pilloried for being slow off the mark to secure vaccines.
While developing nation peers such as Indonesia and Argentina are among more than 50 already administering shots, South Africa’s inoculation program has yet to get off the ground. In December, it pinned down sufficient doses to cover just 10% of the population from Covax, a facility that aims to distribute vaccines equitably around the world. But those are only due to start arriving next month and the authorities have been scrambling to source additional supplies.
The haphazard procurement process has angered South Africa’s top medical scientists and frustrated labor unions, business groups and opposition parties, who say the country doesn’t have time to lose. South Africa has confirmed 1.38 million infections so far, the most in Africa, and more than 39 000 deaths. Hospitals can barely cope with a resurgence in cases.
“It was poor planning on the part of the government,” said Shabir Madhi, a professor of vaccinnology and lead researcher for the South African arm of the AstraZeneca Plc and University of Oxford vaccine trial. “They failed the country.”
President Cyril Ramaphosa and Health Minister Zweli Mkhize have been shuttling between interviews to defend their approach. Their explanations, and those of other officials, range from not having the money to pay for shots upfront to proposed contracts breaching legislative and transparency requirements.
Much of the criticism is directed at the Ministerial Advisory Committee on Vaccines and its chairman, Barry Schoub. Shortly after the panel was appointed in September, Schoub recommended that the country eschew direct talks with pharmaceutical companies and get shots from Covax instead. The government followed his advice and agreed to buy half the doses it was entitled to from the facility.
Four months on, few suppliers can deliver at short notice, with a number of nations having prepaid to secure early access, sometimes ordering several times what their populations need. Some companies that are still taking orders are charging less than the prices available from Covax, which enables rich and middle-income nations to subsidise poor ones.
Schoub, Ramaphosa and Mkhize argued South Africa risked losing money if it entered bilateral agreements to secure vaccines that proved ineffective. Madhi said the deposits would be returned if the shots failed. Schoub didn’t respond to Bloomberg’s calls and messages seeking comment.
“Vaccines should not be driven by market forces,” Schoub said on a webinar on Thursday, urging equitable distribution of the shots globally. “It’s actually grotesque what has happened.”
Ramaphosa this month announced a deal with the Serum Institute of India Ltd. that will enable 750 000 health workers to get the AstraZeneca vaccines by the end of February. An additional 20 million courses, including the Covax allocation, have been secured from Pfizer Inc., Johnson & Johnson and other suppliers, according to the president. He insists that preparations to vaccinate two-thirds of the population of 60 million by year-end began months ago.
“We are going to be getting vaccines in the numbers we need,” he said at a Jan. 19 briefing, where he announced the formation of an inter-ministerial committee to oversee the inoculations. “It will be a game changer as far as dealing with the pandemic is concerned.”
The 1.8 million-member Congress of South African Trade Unions, a key ally of the ruling African National Congress, isn’t buying the government’s reassurances.
“We read them the riot act. This has been nothing short of criminal negligence,” said Matthew Parks, Cosatu’s parliamentary coordinator. “If this doesn’t get fixed it could destroy Cyril’s legacy or even his chances of a second term.”
A failure to bring the pandemic under control could also erode support for the ANC in municipal elections due to take place later this year, and may enable Ramaphosa’s detractors within the party to question his credibility.
Ramaphosa’s and Mkhize’s offices didn’t respond to Bloomberg’s request for comment.
In a letter responding to queries from a non-profit, Corruption Watch, the National Treasury said it told the health ministry on Jan. 6 it could negotiate directly with vaccine suppliers, deviating from normal procurement rules.
A charity had to pay the Covax deposit after the government missed a self-imposed deadline. Business organisations were only approached for help in early January. Medical insurers have agreed to pay for vaccines to cover their members as well as an equal number of others who don’t have cover.
John Steenhuisen, the leader of the main opposition Democratic Alliance, said he’d been reliably informed that talks with reputable vaccine manufacturers only started this year.
“The public has a right to know why, after six months of claimed negotiations, not one single bilateral agreement was signed and not a single dose secured for South Africa in 2020,” he told reporters this week.
Leading scientists were the first to raise the alarm in a January 2 editorial in several South African publications, calling on Ramaphosa to fire health department officials who oversaw vaccine procurement. They included Glenda Gray, the president of the South African Medical Research Council, and other scientists who were removed without explanation from Mkhize’s advisory council in September.
Schoub told the BBC that the scientists who penned the editorial “might have another agenda, which has caused them to go on a rampage” but didn’t say what the agenda might be.
“The delay is unfortunate but I don’t think its total gloom,” as is being portrayed by the media, Schoub said on the webinar.
A vaccination campaign covering 67% of the population will cost about R20 billion, of which about 30% would be covered by medical insurers, according to Mkhize. That compares with a R389 billion loss in economic output in 2020, a January 7 paper by South African scientists asserted.
Critics also say South Africa squandered the advantage of hosting as many as four Covid-19 vaccine trials — the only country in Africa to do so — as well as having Johnson & Johnson agree to use a South African factory that has the capacity to produce 300 million doses a year. All that should have helped secure deals, they said.
Instead, South Africa may face months more of lockdowns, further resurgences and increasing isolation as other countries race ahead with inoculations.
“They are simply going to close their borders to our goods and people,” said Parks. “Everybody is losing far more by not sorting this out.”
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