DEBATE ON THE PRESIDENT’S STATE OF THE NATION ADDRESS MINISTER OF HEALTH, DR ZWELINI L. MKHIZE, MP
16 FEBRUARY 2021
Honourable Speaker of the National Assembly, Ms Thandi Modise,
Chairperson of the National Council of Provinces, Mr Amos Masondo,
Honourable President, Mr Cyril Matamela Ramaphosa
Deputy President David Mabuza,
Ministers and Deputy Ministers,
Honourable Members of the National Assembly and the National Council of Provinces,
Ladies and Gentlemen
When the African National Congress took over national governance in 1994, we did so with the express intention of dismantling the shameful legacy of apartheid. Part of this shame was the abysmal state of the public health care system that we inherited. We have spent the past 27 years undoing the unjust and inhumane wasteland that we found when we were confronted with the task of rebuilding a health care system that is worthy of the people of South Africa.
Between 1994 and 2020 we have increased life expectancy; reduced the infant mortality rate, maternal mortality rate and under-5 mortality rate; established the largest ARV programme in the world and serviced 84% of the country’s public health needs. We have also eliminated polio and death by gastroenteritis or malnutrition. This is the work of the ANC government and our people know it.
Madam Speaker, allow me to commend His Excellency the President for a powerful State of the Nation Address. The address gave an update on previous commitments, a vision for the future and responded to the current COVID-19 crisis. The speech not only gave new information but it brought hope during the times of deep uncertainty in our country and in the global community as well- quite a difficult act.
The story about the fynbos is a poignant story because it is our story. We are not only a resilient nation, but we have high aspirations beyond mere survival. We are visionaries and world leaders, demonstrating innovation and expertise. This has been a recurring theme in our COVID-19 response. We were lauded for our community screening and testing campaign, which not only allowed us to identify high transmission and low transmission areas in our communities, but also allowed us to directly communicate with our
community members, thereby combating misinformation when we were confronted with the novel Coronavirus.
Our risk-adjusted response and differentiated approach to hotspots has given lessons to other countries that adopted the same approach we pioneered. Our centralized response strategy through the National Coronavirus Command Council became a model that was cited as one to emulate throughout the globe.
It was our scientists, enabled by the Department of Science and Innovation, that discovered the 501Y.V2 variant and in the process alerted the scientists in the United Kingdom who subsequently identified the dominant variant in their country- now commonly known as the Kent variant . It is also our scientists who are currently guiding pharmaceutical companies as they adapt their vaccines to accommodate the emerging variants. As a matter of fact, we are one of very few countries that is so precise in its vaccination approach by implementing the guidance from the genomics surveillance expertise.
When we said we were investing in science and innovation, we meant it and we knew that we were investing into our future. The future is here now and it found us ready and prepared.
Honourable Speaker, the President is very correct when he says
“there is no family, no community, and no place of work that has not
lost someone they knew, worked with, and loved.” We have all felt the devastation of the pandemic at a personal level. We know the painful manifestations of COVID-19 symptoms, the anguish of nursing sick relatives, the loneliness of isolation and hospitalisation and the grief of mourning our loss and bereavement. It is time we, the people, take charge and drive the virus out of our social and economic lives. This requires unity of purpose for all South Africans to form a united force to save our nation.
Across the world, governments have been in the invidious position of having to balance the mitigation measures that save lives with concessionary measures to save livelihoods. Our hope now lies in an effective vaccination campaign that will achieve population immunity across the world, for it will be useless if one country achieves population immunity while others are left behind.
To ensure that our battle against the pandemic remains grounded on the principles of “solidarity and compassion”, our strategy is that the State will be the sole purchaser of the vaccines for the country, irrespective of the manufacturer and source. The vaccines will be predominantly funded by the fiscus whilst the private sector, in particular private health funders, will augment the funding and other resources required to implement the programme. As such, vaccination will be free at the point of care and no citizen should pay out of pocket when they get inoculated. We are enthusiastic about this model because it advances the ideals of Universal Health
Coverage and will provide us with an opportunity to learn as we prepare for the implementation of the National Health Insurance.
Honourable Speaker, as government we are actively engaging manufacturers and suppliers of the COVID-19 vaccines through different but interrelated channels. These include the COVAX facility, bilateral arrangements with pharmaceutical manufacturers and other mechanisms such as the African Union’s Vaccines Financing Strategy and the Vaccine Acquisition Task Team. These initiatives have, to-date allowed us to engage with the manufacturers of multiple vaccines, namely AstraZeneca, Pfizer, Johnson & Johnson, Moderna, Sinopharm, Sinovac, and the Sputnik V. Recently, we have been in discussion with Cuba to engage them on the development of their candidate vaccine.
We have heard the clarion call made by the people of South Africa to accelerate our capacity to develop and manufacture our own COVID-19 tools, including vaccines. It is for this reason that we have been engaging our BRICS partners and the government of Cuba to collaborate in a technology sharing exercise that will see us advancing towards independence and self reliance in a future where there will be more public health threats.
The recent announcement around the limited efficacy of the AstraZeneca vaccine, which we had already procured ,was certainly disappointing, however we were determined not to be derailed from our commitment to rollout vaccines in February. I also wish to once
again put it on record that the vaccines have not expired and that the expiry date of April 31 was established through our quality control processes- a wrong impression was created that the vaccines have expired- this is simply not true. We would also like to categorically refute the speculation in media that we have returned the stock to India- we have not. The Astra Zeneca doses we purchased have been offered to the African Union platform, of which we are part of, and the AU will distribute to those countries who have already expressed interest in acquiring the stock. Therefore please be assured there will be no wasteful and fruitless expenditure .
In regard to the future role of Astra Zeneca- and all vaccines for that matter- we continue to be guided by the Ministerial Advisory Committee and experts, and remain committed to an approach that is led by science and is rational in its implementation.
As announced by the President, we have managed to successfully secure 9 million doses of the Johnson & Johnson vaccine, with the delivery of the first batch of 80,000 on course and the vaccination due to begin this week. His Excellency the President will announce the date and time of the first vaccinations.
Critically, an additional 500,000 doses are expected to arrive over the next four weeks, supplemented by another 20 million doses of the Pfizer vaccine that is expected to be received at the end of
March 2021. I can also say that we have actually secured enough doses to vaccinate all the people who will need to be vaccinated in South Africa.
I would like to take the opportunity of settling the matter of the Johnson and Johnson vaccine rollout because it must be understood that our sole purpose is to save lives and protect our healthcare workers. Firstly, it is without dispute that the Johnson and Johnson vaccine has a 57% efficacy against the 501Y.V2 variant and is fully protective against serious illness or death. On this basis, Johnson and Johnson is applying for Emergency Use Authorization and it is expected that it will be granted.
With this evidence in hand, we will begin by vaccinating our health care workers with the Johnson and Johnson vaccine. We will be doing this under a protocol which we have dubbed as SISONKE- this protocol will allow us to surveil the vaccination of health care workers and will further add to our understanding of the impact of mass vaccination.
The immediate rollout of phase one vaccination with Johnson and Johnson through the SISONKE protocol has been made possible by the fact that the 300 000 doses of the now proven and efficacious Johnson and Johnson vaccine were already tested and approved by SAHPRA for use under study conditions. It was the quick thinking of the leadership at MRC that brought us this solution when we were faced with this issue. This was smart thinking which
is worthy of celebration and I must thank the team at the Medical Research Council led Professor Glenda Gray, the officials at the National Department of Health led by the director General Dr. Sandile Buthelezi and Johnson and Johnson for essentially working a miracle to ensure that our plans are not derailed.
On the 3 February 2021 we launched the registration portal for the vaccinations campaign. I am pleased to inform you that as we speak nearly 380 000 healthcare workers have registered in just under 2 weeks. We salute the health care workers who have chosen vaccination for their own protection and the protection of their colleagues, families and community members. We continue to call on all frontline health workers to register on the EVDS portal.
We are ready to implement an efficient service for the rollout of the first batch. We have identified 20 vaccination centres in all nine provinces to inoculate 80 000 health care workers over the next two weeks. 164 vaccinators will vaccinate approximately 48 clients a day- that is about 6-7 clients an hour. As more doses arrive the service will be ramped up accordingly to ensure that we maintain a good rate of daily vaccines.
To help us overcome the vaccine hesitancy and increase confidence we are calling on all leaders in all sectors of our society (government, business, labour, political, traditional,faith-based, civil society, arts, sports, music, transport, traditional healer, and all sectors in our society) to stand ready to lead from the front by
availing themselves to be vaccinated early as and when they are requested.
Ladies and Gentlemen, I cannot end my inputs without taking a moment to thank the many healthcare workers that continue to be at the forefront on the fight against the pandemic. We pay homage and salute their selflessness and their willingness to go beyond the call of duty. We are proud to as a government to show our appreciation by keeping our promise to priorities their timely vaccination as we continue to battle it out with COVID-19.
As I alluded to in my opening remarks, we have been working hard to undo the injustices of the past and build health infrastructure that is worthy of our people. I wish to conclude by adding to the President’s account of our contributions as health to the infrastructure programme. From 2014 to Quarter 3 of 2020/21, 10 hospitals have been completed or replaced and an additional 23 have been revitalized. A total of 151 Community Health Centres and clinics have been constructed and replaced, whilst a total of 1232 facilities have been refurbished, renovated and rehabilitated. This has been possible because of the support by the Health Facilities Revitalization Grant-Direct grant” (HFRG) Both the HFRG and National Health Insurance Indirect Grant: Health Facility Revitalization Component (also known as the In Kind Grant).
Madame Speaker, I have sought to capture spirit of the Presidents State of the Nation Address in my own debate because we are
unified in our quest to grow South Africa. Contrary to some narratives being punted in the public, we have a good working relationship both within cabinet and with our experts. Our focus on co-operation in the fight against COVID-19 and reports contrary to this are misleading and fallacious
We are a government that is action orientated because, we understand what it takes lead an aspirational and diverse nation.
I thank you.
DR. ZL MKHIZE, MP MINISTER OF HEALTH