SOCIAL TRANSFORMATION CLUSTER
DEBATE ON MATTER OF NATIONAL IMPORTANCE
Rollout of a Covid-19 Vaccination Plan
ADDRESS BY MINISTER OF HEALTH, DR ZWELINI L. MKHIZE, MP 23 FEBRUARY 2021
Honourable Speaker
Honourable members (all protocol observed),
When Sister Azoliswa Gidi-Dyosi received the first Johnson and Johnson vaccine in her left deltoid on 17 February 2021 this marked the beginning of a historic campaign to save lives and livelihoods. We have joined more than 87 countries globally in the next phase of our fight against COVID-19 and our programme is rapidly gaining momentum. We have now vaccinated 23 059 HCW as of 6 pm yesterday, 22 February 2021. Beyond that cut off time, we vaccinated over 8000 health care workers in yesterday’s working hours- we are on course to complete the first 40 000 by Wednesday and the provinces have committed to the target of 80 000 vaccines completed two weeks from the date of arrival. It is also my pleasure to announce that the next batch of 80 000 doses of Johnson and Johnson vaccines will arrive this Saturday, 27 February 2021.
Our health care workers, who are our frontline soldiers and main defense in fighting this virus, have not been spared the devastating effects of the second wave in South Africa, driven by the 501Y.V2 variant. Statistics show that in South Africa, health care workers are 3-4
times more likely than the general population to develop COVID-19. This is reflected by the 54 685 health workers who have been infected in the public sector, with 779 having passed on. They have borne the brunt of the psychosocial distress of this pandemic by having to fulfil many roles for patients who have been in isolation in their facilities. For them, vaccination represents hope of relief from the unrelenting pressures of this pandemic.
It is for these reasons that we did everything in our power to ensure that key developments in the characteristics of the virus did not derail us from our plans to begin vaccination in February. We were never asleep- we chose a strategy that was guided by science as we did not have the financial muscle to make unhedged bets. Our approach has paid off as we have been able to be nimble and precise around the tricky issue of the variant.
The procurement of the vaccines has been a complex process that required negotiations with multinational manufacturers of vaccines in the face of vaccine nationalism and protectionism. Just recently, it was announced that more than 133 poor countries across the globe have not received a single dose of the vaccine – primarily because the richer countries have utilised their financial muscle to procure vaccines on risk and far in excess of what they need. Be that as it may, even those countries now battle to get the suppliers to meet their obligations as global production capacity is tested beyond its limits.
The fact is the world has never been here before- we all need the vaccines and we are now so closely interconnected that there is no choice but to achieve global population immunity. This is the most complex and ambitious public health undertaking in history.
Honourable Speaker, this is why as government we have opted to diversify our approach to vaccines procurement by engaging through various mechanisms – bilaterally through continuous engagements with individual manufacturers; multilaterally through the COVAX facility and regionally through the African Union’s Vaccine Financing and Vaccine Acquisition Task Team.
We have signed Non Disclosure Agreements with most of the leading manufacturers. This allows us to gain critical insight into their supply lines, their manufacturing plans and possible blockages in the manufacturing pipeline. It also allows us to pursue negotiations over prices, volumes and timelines for delivery. It is within these NDA’s that certain other conditions come to light- amongst these have been the principles of indemnity to be provided by government to its citizens for any adverse effects arising from vaccinations. Some companies have required that we create a no fault compensation fund as an expression of such indemnity. Having consulted a number of other countries it has become clear that these conditions are standard across the globe. Our signing of the final agreements has required that we thoroughly consult with treasury to provide guidance so that the PFMA and all relevant legislation is upheld before final agreements are signed. This process has proven to be quite onerous because we find ourselves without precedence in this new situation. Once all these contracts are signed they will be available for Treasury and the Auditor General’s office for their perusal. We are ventilating this to correct the erroneous impression that there are questions that we are avoiding because of the NDA’s. Rather, it should be understood that NDA’s must be respected in order to protect the process of timely acquisition of vaccines.
We have asked our Ministerial Advisory Committee on Vaccines to do regular reviews of available information about different vaccines. The latest of their advice has grouped vaccines into three groups. The first group are vaccines for current Implementation that should see considered for immediate use. These are J&J, Moderna and Pfizer. We have placed huge orders on J&J and Pfizer which will be finalized in the next few days and announced when concluded, whilst discussions are ongoing with Moderna and no finality has been reached yet.
The second category are vaccines in which we have an interest and appear very promising on available data, but currently require additional technical information. These include Gamaleya/ Sputnik V (Russia); Sinopharm and Sinovac (China). For these candidates, NDA’s have been signed and our negotiations are advanced. They have offered several millions of vaccines subject to the finalization of the outstanding information and price negotiation. Under our guidance they have made submissions to SAHPRA. Proposals have been made for joint research to be undertaken as well.
The final group are vaccines that may not be suitable for immediate use in South Africa and these include Astra Zeneca and Novavax. These relate more to the condition of the variant- these vaccines can be well utilized in different parts of the world.
We are constantly being pushed for delivery timelines and are often criticized for not providing these while we are still in negotiations, but we must indicate that these are only solidified once a prepayment is made. Even then we, like everyone else in the world, are at the mercy of the manufacturers ability to meet their commitments. So far, Astra Zeneca and Johnson and Johnson have honoured their commitments to South Africa and delivered when they said they would. It is important to say that both governments and private manufacturing companies are interested in keeping their promises because our fortunes are all tied to the achievement of population immunity throughout the globe.
As the first country to roll out a one dose regimen this means that we are able to complete and certify hundreds of thousands of Health Care Workers right off the bat and so we will gain time and numbers in that respect.
By pursuing vaccination under the Sisonke Protocol, which allowed us to use the Johnson and Johnson batches that had already been certified by SAHPRA under research conditions, we will be one of very few nations that undertakes a well designed impact assessment as we rollout vaccines to our health care workers. This information will not only be valuable for ourselves, particularly as we battle the 501Y.V2 variant, but will also benefit the rest of the world as everyone seeks to refine their vaccination strategies.
Department of Health and Treasury have concluded a proposal that will provide for a mechanism to compensate any citizen who suffers an adverse effect from the Johnson and Johnson and Pfizer vaccine. In principle, this proposed mechanism would provide for recourse for any adverse effect suffered from any vaccine that has been approved for rollout by SAHPRA. The Minister of Finance will make the announcements in his Budget Speech and expand on this mechanism.
Honorable Members, allow me take this opportunity to correct some misunderstandings around the vaccine rollout strategy. While many continue to grandstand, spreading myths and misinformation around the vaccine rollout strategy and the effectiveness of the vaccines, we have procured the vaccines that are good for us and have successfully started with the vaccination of healthcare workers across the country.
A well designed study by the Human Science Research Council showed that 67% of our citizens would either definitely take the vaccine or would probably take the vaccine and only 12% said they would not take the vaccine. This evidence assured us that the high level of vaccine hesitancy that was purported to threaten our ability to rollout vaccines was actually not true. We are encouraged by this finding and continue to target our communications campaign towards the vaccine hesitant and those who are interested but desire more information.
We have also seen, now that the vaccine is being rolled out, that the reality is there is high appetite amongst health care workers and high uptake. To date there have been over 500 000 registrations on the EVDS system.
We are aware that over the weekend there was a much higher turnout of private practitioners than we expected- we take this as a sign of confidence in the vaccine itself and confidence in the Sisonke Protocol. It must be understood that the Sisonke protocol is a joint operation of the MRC and the NDOH. It is the first part of our rollout strategy and we can assure all honourable members that most of the teething problems have been resolved.
As government, we salute the professionals who have chosen vaccination for their own protection and the protection of their colleagues, families, and community members.
The President, myself and several other provincial leaders received our dose of the J&J vaccine. The decision to have some leaders take the vaccination first was not taken lightly and came as a result of many debates and consultations. Our communities clearly relayed a message to Government that, to allay fear and anxiety of the J&J vaccine, it will give our health care workers much confidence if the leaders took the vaccine. This has proven to be motivating factor and none here can dispute that seeing our leaders take the vaccine has lifted the spirits of our people and inspired hope. We thank the leaders of the Unions and professional bodies who have ed from the front. We encourage all leaders: traditional, religious, civil society and community leaders to answer the call when the time comes to lead from the front and continue to inspire confidence in the vaccination programme.
In regards to the sale of the Astra Zeneca stock to the African Union I can confirm that we are selling the doses (not donating). Therefore there is no wasteful or fruitless expenditure. We have learnt from the AU that these will be distribute to about 20 countries in the continent, who will be in a position to begin protecting their frontline health care workers. This is a win win situation. We have further proposed that Johnson and Johnson be preferentially deployed to the southern regions of Africa so that we can rapidly deal with the variant that is predominating in South Africa and some parts of SADC. Having said that, we join the WHO and scientific community in supporting the rollout of Astra Zeneca, even in regions affected by variants.
We must commend his Excellency President Cyril Ramaphosa for his leadership and we also congratulate him for being declared a champion for COVID-19. He has played a critical role in securing vaccines for the continent through the AVATT and we support his efforts to create capacity for manufacturing vaccines in South Africa following a decision by the BRICS summit to create BRICS Vaccine Research and Development programme.
Finally, may I conclude by reminding citizens that the containment measures- washing hands, social distancing, sanitizing- remain important and in force until we achieve population immunity.
I thank you.
DR. ZWELINI L. MKHIZE, MP MINISTER OF HEALTH
