After months of bad news on the coronavirus front, there is finally a ray of hope.

Initial results for three late-stage trials of experimental Covid-19 vaccines look better than expected: Pfizer and BioNTech say their shot is 95% effective, and Moderna’s candidate appears equally good. AstraZeneca and Oxford University say the efficacy of their vaccines range between 70% and 90%.

With hundreds of coronavirus vaccine projects worldwide, it’s safe to say there will be more good news soon, something that has been reflected in global markets. For SA’s markets, it’s as if last week’s ratings downgrades didn’t happen.

But where is the plan for vaccinating SA? Finance minister Tito Mboweni suggested on Tuesday the country has joined an international initiative to ensure access, though the department of health said it hasn’t signed yet.

So far, the race to develop vaccines has been accompanied by an entirely predictable scramble by rich countries to secure advance purchase agreements with developers to ensure they can protect their own populations.

Despite being involved in several high-profile international clinical trials testing candidate Covid-19 vaccines, SA had neither nailed down a procurement plan nor finalised a distribution scheme with pharmaceutical companies.

Nor, to the frustration of many observers, had it yet signed up to the international vaccine financing vehicle Covax, jointly led by the World Health Organisation and the vaccine alliance Gavi. Speaking during the Bloomberg Invest Africa virtual conference on Tuesday, Mboweni said SA has indeed pledged R500m towards Covax, which in the face of it is good news.

Covax has mobilised more than $2bn in donor funding and entered into advance purchase commitments to support equitable immunisation. It aims to distribute 2-billion doses to participating countries by end-2021, starting with front-line health-care workers. But SA missed the first deadline.

Something cheaper

SA’s initial hesitation to enter into bilateral advance purchase agreements was understandable in the context of its poor finances and a reluctance to sign a contract that carries a hefty penalty should it want to pull out later. Another reason to be concerned was that as promising as they are, the early results from all the vaccine trials so far were still just that.

None of the shots have been approved by regulators and the duration of the protection they provide is still an open question. The last thing SA wants is to commit to buying an expensive vaccine requiring frequent administration, only to discover something cheaper and better a few months later.

That is where some scepticism about whether Covax was the right route to take came in. While it is relatively straightforward for a low-income country that qualifies for free or heavily subsidised vaccines to sign on the dotted line, SA is classed by the World Bank as an upper middle-income country. It thus falls into Covax’s self-financing category and is required to pay an upfront deposit to participate, as it seemingly has. This posed a practical problem for the government, bound by procurement rules and a medicines regulatory framework that effectively preclude it from agreeing to buy a product that does not yet exist at a yet-to-be determined price.

However, that is a bureaucratic headache easily remedied should there be the political will. Mboweni’s statement on Tuesday suggests that will has been found.

There is no question that immunising the nation will come at a price. But the numbers pale into insignificance compared with the latest, R10.5bn bailout for SAA: AstraZeneca has said it will provide its two-dose regimen at $3 a shot to developing countries, meaning vaccinating part of the population is affordable.

While the government’s commitment to obtaining and distributing a vaccine is welcome, the communication once again leaves much to be desired. The department of health still needs to inform the nation that SA has indeed signed on the dotted line, though Khadija Jamaloodien, its director of affordable medicines, was quoted by Reuters as saying this is just so that necessary administrative processes can be completed.

The last thing we need now would be a U-turn.


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