There has been an outcry over the government’s handling of vaccination against Covid-19. And it is well-justified!

This visceral anger has come from the Congress of South African Trade Unions (Cosatu), a key ally of the governing African National Congress (ANC); over 2 500 health professionals (in the form of a petition), and numerous NGOs.  The Institute of Race Relations (IRR) adds its voice to that anger.

The government twice missed its payment deadline for vaccines with the Department of Health focusing its communication efforts on its “vaccination rollout strategy”. The “policy” explains the “how” of vaccinating the country. At the same time the health care professionals’ petition said our health care system is well situated to set up the process.

Vaccines are not “a silver bullet” but are a crucial element of bringing the pandemic under some control sooner rather than later.

Vaccines are crucial to save both lives and livelihoods. If we don’t save the former, we’ll lose the latter. As parts of the private sector are crippled or collapse, jobs will be lost, the number of dependants will increase, and tax payment will necessarily fall so that the government will not be able to increase the payment of grants as the country slides into immiseration and poverty.

It’s not an ‘either/or’: the two are inextricably intertwined. The ANC doesn’t understand the necessity of a market economy and so it doesn’t forge many real relationships of trust with the private sector.

In the case of the provision of vaccines health minister, Zweli Mkhize has said: “While South Africa chose Covax as the best bet to access vaccines, the department of health and ministerial advisory team had also had bilateral discussions with potential vaccines suppliers including Pfizer, AstraZeneca, Johnson & Johnson, Moderna and Cipla.”

This is a start but Mkhize says that the government was “fighting” behind the scenes to ensure the country gets access to the amount of vaccines it needed to reach herd immunity. However as a developing country, there were hurdles for South Africa.

He said that it’s the “moral responsibility” of countries with greater stocks than the number of their citizens to supply other countries. “There is no justification for well-off countries to hog the stock,” he said. Mkhize is playing South Africa as the poor victim at the mercy of the First World, our eternal default position. The IRR understands that the vaccine manufacturers are ready to sell the vaccine to us immediately. Why are we not ready to buy them?

Is it because we’re trying to negotiate unacceptable deals because we are so cash strapped and can’t pay on the prescribed terms? A ‘back-of-the-cigarette-box’ calculation shows that for the money given to South African Airways as a bailout could vaccinate every adult in the country.

But there could be light at the tunnel, with an announcement made this week that the government had secured the supply of 1.5 million doses of the AstraZeneca vaccine from the Serum Institute in India. It would be used to vaccine health workers. One million doses were expected at the end of this month with another 500 000 to be delivered in February.

But South Africa’s increasing poverty is due to the corruption and bad policies of the ANC government for over a decade. The government needs to start behaving like an ordinary country that has no particular rights to the world’s largesse.

This doesn’t let the private sector off the hook. The IRR is led to believe that some in the private health sector were embarking on a program to purchase vaccines, were told by government that only it may purchase the vaccines and there seems to be some sort of threat of future ‘retaliation’.

The big business sector has generally failed in its duties to its customers and clients against the predatory policies of the government. Now is surely the time to grow some cojones.

The government has said that it wouldn’t allow the private sector to buy vaccines independently. Not allow? As Anthea Jeffery points out its the ideological push to socialism that the ANC uses to make itself the single supplier.

The private sector must not be cowed by the very ANC that has impoverished the country through corruption and bad policy. The private sector must step up and do what it needs to do. We have a very able private sector that appears already to be assisting the government to meet its obligations. If the relevant parts of the private sector stand up as one and called the government’s bluff what could the government do? Should they care? We suggest not.

We know that Discovery Health has formulated a comprehensive plan for inoculating its 2 million members and is working with government on a scheme to subsidise 30% of the population.

Maybe this sort of initiative and energy and by the private sector will help to undermine the proposed ruinous National Health Insurance.  

So too the provincial governments must not wait on the national government. There is precedence for this as happened during the height of the HIV/AIDS pandemic.

In 2002 the Pretoria High Court ruled that ‘[a] countrywide PMTCT [Prevention of Mother to Child Transmission] programme is an ineluctable obligation of the state’. The then Minister of Health, Manto Tshabalala-Msimang, appealed directly to the Constitutional Court, claiming that an appeal was necessary to “[clarify] a constitutional and jurisdictional matter which, if left vague, could throw executive policy making into disarray and create confusion about the principle of the separation of powers, which is a cornerstone of our democracy’.”

While on appeal a Health Systems Trust report commissioned by the department of health found that ‘There are no good reasons for delaying a phased expansion of PMTCT services in all provinces’.

Gauteng and KwaZulu-Natal broke ranks and announced decisions to expand their PMTCT pilot programmes. Former Gauteng premier, Mbhazima Shilowa, was publicly rebuked by the minister. He appeared to back down, but soon announced that PMTCT was available at 70% of public healthcare facilities in Gauteng. The Minister lost the appeal.

You can assess the merit of a strategy if the Economic Freedom Fighters (EFF) criticise it. Over the possibility of the Western Cape provincial government – which is controlled by the Democratic Alliance (DA) buying vaccines independently of the national government, EFF provincial chairperson Melikhaya Xego said that “the DA provincial government thinks the province is a republic” and “that they’re a law unto themselves”.

The message to the provincial governments is that it’s better to ask forgiveness than permission. They owe it to their respective provincial citizens.

DA leader, John Steenhuisen, points out that “Colombia, a country with almost identical socio-economic circumstances as South Africa has managed to immediately source a Covid-19 vaccine and has secured 9 million doses.” As of two weeks ago comparable countries which have purchased vaccines include: Argentina, Bangladesh, Costa Rica, Ecuador, Morocco, Peru, Uzbekistan, and Venezuela.

Israel is the current world leader in vaccine distribution. Its health minister, Yuli Edelstein, said to The Jerusalem Post: “The reasons are that we were prepared on time, signed on with the leading companies, and convinced them that if they gave us the vaccine, the health funds would know how to administer it in a very short time. That is exactly what is happening.”

Can the government for once do what is best for South Africans rather than its patronage network?

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