Countries such as Germany and Taiwan, where public health systems and the experts staffing them held uncontested sway over a consensual regime of interventions to contain the Covid-19 pandemic — a health sovereignty of sorts — have performed better than others.

Chaos reigned in the US during the Trump administration, the mighty Centre for Disease Control (CDC) egregiously sidelined and the science of pandemic response perversely questioned at the highest levels of government. The best news of our time is that the Biden administration has begun the speedy reversal of a  cumulative recklessness the world has rarely experienced before.

In the UK the government’s official source of science advice, the Science Advisory Group for Emergencies (Sage), was challenged by an unofficial self-appointed group that described itself as Independent Sage, an oppositional voice calling for more stringent public health action than the Tory government pursued.

In SA, the health ministry’s advisory councils had public spats over which social measures to deploy, when and at what level of severity. More recently, acrimony over what appears to be poor advance planning for vaccine acquisition in a world of supply scarcity has drawn litigation from the opposition and a cycle of blaming that will not solve the extraordinary problem of medical rationing the country is about to face.

Worse, leaders in highly responsible positions have spread disinformation and misinformation about vaccines, the greatest achievement of the health sciences over the last 100 years. In SA we were stunned to learn that the most notorious progenitor of antivaccine views turned out to be none less than Chief Justice Mogoeng Mogoeng, who has defended public claims he made late in 2020 year that vaccines may contain satanic substances that “corrupt” the DNA of the recipient.

Praying at Tembisa Hospital in Gauteng, Mogoeng called upon God to destroy any vaccines “infused with the mark of the devil”. He suggested that he is not against a Covid-19 vaccine per se, and that he would not oppose a safe vaccine. But he also did not specify whether he considered the vaccines that will soon be rolled out in SA to be safe. These views are not new or exclusively local, and have been expressed in a variety of ways across the globe in religious communities such evangelical Christian circles, and by high-profile celebrities and faith leaders such as Louis Farrakhan, the outspoken head of the Nation of Islam in the US.

In most iterations of the theory that vaccines will advance a diabolical agenda it is argued that they will do so by causing dangerous side effects for recipients after being deliberately manufactured by pharmaceutical companies and scientists, who are acting as Satan’s conduits. Others claim that side effects will result from the perceived inadequacy of the clinical trials the vaccines have undergone.

Farrakhan’s view is an amalgamation of these claims. He has argued that Covid-19 vaccines are unsafe, developed as a conspiracy to reduce the human population, blacks in particular. The Nation of Islam’s vaccine messaging focuses on demonising the vaccine, likening it to the infamous Tuskegee experiment. It is a powerful anti-establishment narrative drawing on audiences’ mistrust of both science and white elites. In a message delivered in July 2020 Farrakhan urged his audience: “Don’t let them vaccinate you, with their history of treachery through vaccines, through medication. Are you listening? I say to the African presidents, do not take their medications!”

The concern that vaccines or their distribution are part of a white racist agenda have unsurprisingly gained significant traction in SA. In a widely shared voice note, ANC ward councillor Sifiso Mngadi repeated a cocktail of tenacious myths, including that Covid-19 is being spread by 5G towers, which ought to be dismantled, and that white South Africans have already been covertly vaccinated: “White people were vaccinated about five months ago. There was a truck that distributed the vaccine in boxes and white people from all over the province, including places like Ixopo and Vryheid, went there to receive these boxes. It was given to white people only.”

These anxieties are echoed in the concern expressed by some leaders that any vaccine not developed locally should not be trusted. Speaking at an ANC councillor’s funeral, ANC Gauteng secretary Jacob Khawe said: “We should not enter a global space of a debate about a vaccine. We must stand together as Africans and say there is no vaccine that is going to be tested on us if it has not be tested on its people.”

Similarly, Cosatu president Zingiswa Losi earlier in January warned that globally manufactured vaccines may have dangerous side effects, and advocated the exploration of alternative indigenous remedies to combat Covid-19: “Because some of the vaccines are not organic, some of the vaccines leave side effects. But as African people we have our indigenous herbs. We are not putting forward these issues as African women, to liberate SA and the African continent.”

While Losi’s view dispenses with direct references to conspiracies to harm (black) South Africans, it nevertheless expresses a similar mistrust of international pharmaceutical companies and other supranational entities associated with the vaccines.

Yet mass vaccination has tangible public health and economic benefits. It has been essential in the virtual elimination of once-widespread illnesses, reducing the burden of preventable diseases on healthcare systems, decreasing infant mortality rates and preventing an estimated six-million deaths annually. But the efficacy of these regimes depends on public support.

The government has already sought buy-in from leaders across sectors to share a united message to encourage vaccination, and at the close of the recent ANC lekgotla President Cyril Ramaphosa announced that the governing party and its tripartite alliance partners would embark on a dedicated campaign to combat vaccine hesitancy

The details have yet to be publicised, and in any event this is not enough. SA faces the daunting task of first securing vaccines and then rationing their distribution to a fearful population experiencing a second wave of infections that is showing signs of decline but is still resulting in terrible deaths and social misery on a vast scale.

Then there is the additional challenge of the country facing a Sars-CoV-2 variant that will require unanticipated vaccine adjustments to secure adequate protection. Pandemics always bring surprises and Covid-19 is no different.

A national nonpartisan lekgotla is required to mobilise an unprecedented level of resilience across all sectors of society. Leaders from all quarters must come to agreement about how to communicate risks in a consistent and factually accurate way.

SA’s greatest asset — our health workforce — has the trust of communities and must be resourced to prepare the country for a mass vaccination campaign. Immunisation usually focuses on children, but this campaign must be directed at the entire population — including the adults who hesitate to accept, or resist, vaccinations.

James is a Cape Town based independent researcher.


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