Non-pharmaceutical interventions still lead the way for public health and risk mitigation as vaccine is delayed.

As the African country with the worst confirmed coronavirus outbreak, SA is yet to provide clarity on how it plans to order vaccines, even as the global race to secure inoculations accelerates.

South Africa is hosting three trials, including for Johnson & Johnson and a partnership between AstraZeneca Plc and the University of Oxford, yet hasn’t announced a firm strategy to immunise a population that’s bracing for a potential resurgence of the pandemic.
Almost 22,000 people have died of Covid-19 in the nation, the 14th-highest worldwide.

South Africa did confirm last week that it plans to sign up to Covax, a global initiative that strives to ensure that poorer countries have access to shots.
President Cyril Ramaphosa says that the Solidarity Fund will make an initial payment of R327 million towards the procurement of a Covid-19 vaccine.

“As we have said in the past the only viable defence we will have against Covid-19 will be the vaccine,” the president said in an address to the nation on Thursday evening (3 December).

It comes after the country recorded in excess of 4,000 new infections for a second consecutive day, with the rate spiking since the beginning of November in what has been deemed a second wave of the virus.
This has forced the president to announce new lockdown measures in Nelson Mandela Bay.

There are now many initiatives in the world to speed up the development of a vaccine, the president said.

“We continue to collaborate with our partners in the international community to ensure that all countries have access to an effective and affordable vaccine.”

President Ramaphosa

Ramaphosa said that the country is participating in the World Health Organisation’s Covid-19 Global Vaccine Access Facility – known as the Covax facility – which aims to pool resources and share vaccine development risk and thus ensure equitable access to vaccines when they become available.

Lagging behind

Yet that proposal will initially provide doses for just 3% of South Africa’s population of about 59 million, according to Anban Pillay, deputy director general of the Department of Health, or 10% over the longer term.

The government has said that front-line health-care workers and the elderly will be given priority, meaning advance-purchase agreements with pharmaceutical companies will be needed to protect the wider community.

“What worries me about government is the clear lack of communication. We’re all sitting here terrified, not knowing if we get the vaccine.”

Prof. Francois Venter,
University of the Witwatersrand and a former member of the ministerial advisory council on the virus

The lack of progress comes at a critical time for South Africa, which is seeing a new surge in coronavirus cases in some provinces just as millions of people prepare to travel to home towns and holiday destinations.

A protracted lockdown starting in March hobbled the economy and caused millions of job losses, and a need for further restrictions is likely to undermine President Cyril Ramaphosa’s focus on revival.

While Pillay said the government has been talking to “a number of manufacturers” about bilateral deals, other countries have already put pen to paper. The U.K. has secured access to 357 million doses from seven different developers. Brazil has agreed to buy a total of 186 million from a combination of AstraZeneca and Covax.

In Africa, Botswana and Namibia agreed in November to procure sufficient vaccines from Covax for 20% of their populations of about 2 million people each. Rwanda plans to raise $15 million for its first batch of shots, Finance Minister Uzziel Ndagijimana said last week.

Lwazi Manzi, a spokeswoman for Health Minister Zweli Mkhize, said the minister will make an announcement “in due course.” Barry Schoub, the chairman of the ministerial advisory council, said he can’t comment on plans to pre-order vaccines.

Pfizer Inc., co-maker of the vaccine approved by the UK this week, said it has started engagements with the South African government, without giving further detail, but concerns from Bhekisisa have been raised over the viability of this, due to intense cold chain infrastructure being required.

Manufacturing Deal

Aspen Pharmacare Holdings Ltd, Africa’s biggest drugmaker, signed a deal last month to manufacture about a third of the one billion doses J&J hopes to produce next year in a South African factory.

Half of the total will be destined for emerging markets under the Covax program, according to Stavros Nicolaou, Aspen’s senior executive for trade.

J&J has offered the shots to South Africa at not-for-profit prices, according to Glenda Gray, chief executive officer of the South African Medical Research Council and co-chair of the local arm of the company’s trial.

South Africa should be “in a favorable position to start negotiations with manufacturers,” Shabir Madhi, a professor of vaccinology at the University of the Witwatersrand and lead researcher on the country’s leg of the Oxford trial, said by text message.

“However, government needs to engage with the manufacturers. I’ve no idea where government is with such negotiations.

Prevention the way forward: behavioural change for risk mitigation

This reiterates the necessity of non-pharmaceutical interventions, says Dr Jenny Coetzee, heading up the #HeroesWearMasks initiative to provide every South African with masks and education around preventative mechanisms.

It’s really important to highlight the importance of continuing to make choices that reduce your risk, as well as that of those around us. Responsibly masking up, distancing, washing hands and so on can save lives and livelihoods while we await vaccinations.

Dr Jenny Coetzee

The #HeroesWearMasks campaign says that there are still people without access to these facilities, however, and are looking for partners to assist with helping typically vulnerable communities in their effort to suppress both second wave deaths as well as further economic lockdowns.

heroes wear masks prevention vaccine