Vaccine rollout could show the way to a health system that works for all

Health minister Zweli Mkhize’s detailed announcement about the imminent rollout of SA’s stalled Covid-19 vaccination programme is good news. His tidings were a tonic for a country whose citizens are weary and battered after more than a year living with this affliction, which has cost so many lives and left a trail of human suffering and economic hardship. Here, at last, was the news we have all been waiting for, except perhaps those who deny Covid-19 is a threat more deadly than a seasonal flu, and aver that the vaccine is part of a plot masterminded by Bill Gates and his friends to control the world.

If the example of the world is to be followed, as it must in this case, the vaccine offers SA its only realistic chance of emerging from the doldrums the virus has created, if we are to rebuild the economy and revive employment. In SA the economic imperative is especially pressing, given that our democracy rests on the ability of the economy to offer a progressively better life for all. Without the necessary growth, constitutional democracy — already under reckless assault by our politicians — is dead in the water.

But like everything to do with Covid-19, the welcome steps forward are accompanied by a few steps backwards. So, just as we got good news on the vaccine rollout, we got bad news about the Johnson & Johnson vaccine, which the US (and SA) have temporarily stopped to examine cases of vaccine recipients dying from a rare blood-clot disorder.

Although statistically insignificant, any negative news about the vaccine is taken as proof by the anti-vaxxers that they have been right all along in criticising something that was produced in record time, and under pressure from governments desperate to reopen shuttered economies.

In SA the J&J vaccine has already been administered to almost 300,000 health-care workers.

What the anti-vaxxers fail or refuse to acknowledge is that cases of patients falling ill, or even dying, after getting the vaccine are played out in the full glare of media scrutiny. There can’t have been a disease, and its antidotes, that have received more news space than

Covid-19. In hindsight, in stopping J&J, even for a short time, a well-meaning attempt to reassure the public about the vaccine’s efficacy and safety has unwittingly played into the hands of the doubters, who characterise the decision as proof they were right all along.

The doubters aside, South Africans have welcomed the chance to get the vaccine, and the take-up from over-60s registering on the online portal has been enthusiastic.

Amid the doubts expressed about SA’s vaccine programme, the abortive AstraZeneca rollout, and the previous lack of any detail from the government, Mkhize’s statement also showed that the government has not been as asleep on the job as many had feared. There have been hard talks about pricing and indemnities, resulting in outcomes that weren’t as lopsided in their benefits to the pharmaceutical companies as they might have been. Of course, the real test will come with getting these shots into people’s arms. Previous experience has taught us to be realistic in our hopes and expectations when it comes to the government delivering on a complex project on time and in budget.

Therefore, a welcome feature of the rollout plans is that it builds in a close working relationship between private and public health-care systems. In what may be a first, almost all South Africans from all backgrounds and income groups will line up together for their jabs, the only difference between them being that those on a medical aid will have their vaccines paid for by their medical aid, and the others by the state. But no-one will pay upfront. Further, everyone will have vaccinations done in the same places, by the same health-care workers and at a time designated by a common electronic system. It is a small but significant step towards the ideal of a single, well-funded and well-managed health-care system for all. The outcome we hope for is a level of vaccination that allows us to return to life as normal, or the new normal of what society post-Covid will look like.

Close working between private and public systems