Health minister Zweli Mkhize, top officials and advisers said at a briefing on Sunday evening that they were engaged in intense negotiations to gain access to a Covid-19 vaccine for priority individuals as early as February, but made clear that there were no agreements yet in place with any pharmaceutical companies.

The government also made clear that it will procure all Covid-19 vaccines itself for distribution and that private sector organisations or medical schemes will not be permitted to procure independently for their own members. Medical aid scheme members and the private sector will cross-subsidise the public sector.

Countries around the world are in a race to secure vaccine supplies with many of the wealthier countries having already secured orders through prepayment in the development stage. SA’s only definite promise of a vaccine is through the Covax initiative — a global pooled procurement initiative to assist poor countries — which is expected to arrive at the earliest by April. The Covax supply will be sufficient to ultimately inoculate 10% of the population.

Mkhize and his advisers have been publicly criticised for lacking a vaccine strategy and falling behind as other much smaller countries tie up deals with drug manufacturers.

Mkhize said he was confident that some supplies could be procured as early as February and that negotiations were under way with several companies. However, as the government has signed nondisclosure agreements it is unable to divulge what quantities of vaccines may still be available, by when and at what price.

“We are trying to get as many as possible by February. We are having bilateral negotiations with the companies, but not any company has confirmed at this date,” said Mkhize.

The companies engaged with include Pfizer, Moderna, AstraZeneca and Johnson & Johnson. Engagements have also been held with representatives of Russian and Chinese manufacturers.

Mkhize said he wished to reassure the public that South Africans will gain access to Covid-19 vaccination during 2021 and will “catch up with the world” in which vaccines are already being widely rolled out.

Rolling out a vaccination programme will be a massive undertaking with 40-million people — about 67% of the population — targeted during 2021. This number is what is estimated will be needed to ensure the country reaches herd immunity in order to stop the rampant spread of the virus.

The first to receive the vaccine will be health-care workers — about 1.2-million people; followed by essential workers and priority groups, which includes the elderly and those with comorbidities (about 16-million) — and then another 22-million people over the age of 18 who do not fall into these categories.

Despite the magnitude of the project, the government has said procurement will be centralised. A system in which medical aid scheme members and the private health sector will subsidise the state is under discussion, which would possibly see scheme members subsidising the wider public on a one-to-one basis.

Deputy director-general of health Anban Pillay said “a single procurement approach” was envisaged. “As a country we will buy a stock for the entire country and that will be used to distribute to our partners.”

This would include provinces and district health facilities but also private general practitioners and nongovernmental organisations.

Mkhize said a public private partnership on the basis of social solidarity was being designed.

“Funds from the private sector and the medical schemes will assist to cross-subsidise some of the public that require vaccination. There are 9-million people who are part of medical schemes so ... each (could) subsidise a similar number of people. We will look at the same sort of principle in the private sector,” Mkhize said.


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