SA health-care experts are urging the government to share a detailed plan for administering Covid-19 vaccines with private-sector partners that are offering their help, warning infrastructure bottlenecks will otherwise delay the rollout.

With about 1.34-million total cases and 37,449 deaths as of Monday, SA is by far the African nation hardest hit by the pandemic and is grappling with a new wave of infections driven by a variant of the virus first identified in the country.

The government has said the first vaccine doses will arrive by the end of January, and SA will aim to vaccinate 40-million people by the end of 2021.

But with a public health system creaking even before the pandemic hit, experts say the vaccination drive will require a plan to co-ordinate with private health services, pharmacies, supermarkets, major employers and non-government sectors. “SA needs all hands on deck,” said Glenda Gray, president of the SA Medical Research Council (SAMRC). “If we rely on the current health-care system, then the plan is doomed.”

On Tuesday, the government released a statement saying a new inter-ministerial committee will oversee the vaccine rollout in both the public and private sectors. It did not say when the rollout would start, how distribution and storage logistics would be managed, or identify private companies that would be involved.

The health department did not reply to an e-mail seeking those details.

Experts contacted said they believe big private-sector players should already be on board. “Now, there is a single channel of procurement and no clarity on efficient and speedy delivery,” said Alex van den Heever, a professor at the Wits School of Governance in Johannesburg. “It is hugely constraining.”

Scale of the challenge

SA immunises about 5,000 babies daily for diseases such as measles and diphtheria as part of what is currently its biggest mass vaccination scheme. To reach its Covid-19 vaccination target, it would need to administer about 150,000 doses every day for the coming year.

A programme on that scale will need to manage reams of data on who must be vaccinated, who has received a dose of vaccine and who still needs a follow-up shot.

Tuesday’s government statement said the system would be based on a pre-vaccination registration and appointment system, but did not go into details on when and where people can get registered.

The vaccination drive will also require vast cold chain infrastructure at a time when SA is suffering from load-shedding, as well as a plan to deal with unprecedented amounts of biomedical waste, experts say.

Some private companies and industry bodies with the necessary expertise and infrastructure have already volunteered their assistance. The Independent Community Pharmacy Association (ICPA), which represents about 1,164 pharmacies, said last week that it had sent the government details of how it could assist the vaccination effort.

ICPA said it is working with the national department of health on vaccine rollout, but did not say if a plan had been agreed. Clicks Group, SA’s biggest pharmacy chain, said it is ready to offer the use of its vast distribution network but is awaiting clarity on how the government’s programme will work.

The Minerals Council SA said its members are developing plans to use the mining sector’s health-care infrastructure and delivery capability for the vaccine drive. 

Supermarket chains and retailers are also offering to help. “The Shoprite Group is ... ideally positioned to assist with the distribution and administration of Covid-19 vaccines in SA once the government provides final details,” SA’s largest retailer said.

Health experts said such private-sector support is encouraging, but added a detailed government blueprint is needed to avoid delays.

“It should have been developed already,” said Jeremy Nel, head of the infectious diseases division at Johannesburg’s Helen Joseph Hospital on the rollout plan. “The slower you are to roll out —  you will have to measure the cost of failure in deaths.”


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