Razina Munshi FM Fox editor & columnist
Members of the health service in Alexandra, Johannesburg. Picture: ALON SKUY
Members of the health service in Alexandra, Johannesburg. Picture: ALON SKUY

The parks are full, the coronavirus is on the retreat, and there is optimism hanging over SA’s cities that is palpable, for the first time in months. Its spring!

But is this joy inappropriate? Are our hopes for a vaccine, for a resumption of the social lives that we knew, for a return to school and work, and for a well-deserved December break misplaced?

The pandemic, after all, is far from over. As soon as SA takes a decision to open borders, the country will import more cases. Once more people opt to work from the office, community transmission of Covid-19 will flare up. And if people relax enough to ditch their face masks and abandon social distancing guidelines, we may see a second wave.

Still, there are reasons to be optimistic, as this very short list sets out:

  • The virus has proven to be far less deadly (especially in countries such as SA) than models suggested;
  • Targeted treatments (such as dexamethasone) have already brought down fatality rates;
  • Local hospitals appear to have coped (even if that statement can’t be applied equally throughout the country);
  • The world has learnt a lot about the novel coronavirus in this time, and that knowledge is expanding at a rapid rate; and
  • A number of vaccines — our best hope of putting the pandemic behind us — are in various stages of development.

This last point is top of mind for most people looking ahead to a post-Covid future. Yet there are already worrying signs that trust in Covid-19 vaccines is diminishing, according to Jeremy Farrar, who is an adviser to the UK government and director of the research charity Wellcome Trust.

“Polls suggest that in countries with some of the highest global case numbers, such as the US, there could be low uptake of any Covid-19 vaccine, no matter how effective,” Farrar writes in the Guardian.

Shortly after his opinion piece was published, the results of a CBS News poll that reflects this diminishing trust was released.

The poll shows that just 21% of US voters would get a vaccine as soon as possible, down from 32% in July. The majority of people, 58%, would “consider it and wait to see what happens”, while 21% would never get vaccinated.

(Read this Bloomberg article on the speed bumps a Covid-19 vaccine could face when it comes to public trust.)

Farrar points out that a vaccine and effective treatments for Covid-19 form the only true exit strategy out of the pandemic.

But while the speed and scale of vaccine development is truly remarkable, it’s important to avoid false hope.

Farrar says: “The first vaccine, or even the first generation of vaccines, will most likely not be perfect; we need to be pragmatic and transparent on that front. The reality is that with these vaccines we will be taking small steps to return to a sense of normality.”

He says too much hype is still being applied to information about possible vaccines, and in some countries this discussion has a distinctly political overtone.

“There should be no place for notions of vaccine nationalism, with nations posturing that ‘their’ vaccine will cross the finish line first and be fully deployed by Christmas or for a political moment.”

Vaccine race

SA may have to compete for access to a vaccine with countries able to pay more and which already have deals with pharmaceutical firms in place.

So how can countries secure access to affordable vaccines?

Writing for the Bhekisisa centre for health journalism, public health lawyer Safura Abdool Karim says one of the ways around this is for developing economies to sign up for deals known as “advanced market commitments”, which pool the bargaining power of smaller countries to enable them to negotiate quicker and cheaper access to products under development.

It has been done before. In 2007, for instance, vaccine advocacy organisation Gavi created an advanced market commitment for a pneumococcal vaccine to speed up poorer countries’ access to it.

It meant developing countries were able to get the vaccine within a year after it was first made available, at a price more 90% cheaper than it would cost in the US.

Gavi and others have already established the “Covax” mechanism, which has an advanced market commitment for Covid-19. So far, 172 economies — which make up more than 70% of the world’s population — are engaged in discussions to participate in Covax, which has negotiated deals with the manufacturers of nine vaccine candidates under evaluation.

Abdool Karim says there are both benefits and potential pitfalls of sourcing vaccines through Covax. He says SA does not qualify to get a vaccine for free — the country is simply not poor enough — but it would be able to use the mechanism to buy a Covid-19 vaccine at the lower prices Gavi has negotiated.

* Munshi is News & Fox editor of the FM​

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