Tag Archive for: Flatten the Curve

Only a massive global rollout of an effective vaccine can end the Covid-19 pandemic in the short term. The vaccine is being rolled out in the United Kingdom and United States. It’s expected to become available in Europe imminently.

This is where things stand in South Africa.

The Department of Health is playing its cards very close to its chest. The department has been extremely reluctant to provide any details of how a vaccination plan would work.

In response to our questions, spokesperson Popo Maja said that the department is not commenting on any vaccine related to Covid-19, and that “the minister will pronounce on this at an appropriate time”.

Covax is key

Critical to getting vaccines rolled out across the globe is Covax, an initiative started in April with a noble aim: “people in all corners of the world will get access to Covid-19 vaccines once they are available, regardless of their wealth.”

It is coordinated by the Global Vaccine Alliance (GAVI), the Coalition for Epidemic Preparedness Innovations (CEPI) and the World Health Organisation. It is supporting the research, development and manufacturing of COVID-19 vaccines. But to do this effectively it needs money.

In that regard South Africa got off to a bad start. On 17 November, it was reported that the government failed to give the Solidarity Fund approval to pay a R327 million deposit to Covax, the 15% deposit that would guarantee access to vaccines secured through this facility.

The Department of Health said this was an administrative lapse, and that payment would be made by 22 December.

Department officials said on SABC 3’s Morning Live on 17 December that South Africa will only receive vaccines via Covax in the second quarter of 2021.

On 20 December, City Press reported that the allocation to South Africa of this programme would cover only 3% of the population (approximately 1.7 million people) in the first half of 2021, a considerable downward adjustment from the 10% figure touted by President Cyril Ramaphosa.

Even this diminished figure was not definite.

COVAX has positioned itself as the only means by which poor countries could access Covid-19 vaccines that have been snapped up by rich countries.

In a 3 September press release, Dr Seth Berkley, CEO of GAVI, said: “Covax is quite literally a lifeline and the only viable way in which [people living in poorer countries] will get access to Covid-19 vaccines.”

The health department appears to agree. Speaking on Morning Live on SABC 3, Deputy Director General of Health in charge of Health Regulation and Compliance, Dr Anban Pillay, said that, “We will hear from Covax as to which vaccine exactly has been allocated to South Africa.”

So far, Covax has agreements with nine manufacturers of candidate vaccines, including the Oxford University/AstraZeneca vaccine which appears to be safe and effective. But Covax’s vaccine candidates do not include the high-profile Pfizer/BioNTech or Moderna vaccines, which are, to-date the only candidate vaccines to have secured regulatory approval in the US and UK.

On 18 December, Covax announced that it had reached agreements with other pharmaceutical manufacturers including Johnson & Johnson, which is developing a vaccine the South African government may be keen on.

J&J’s vaccine

In his SABC interview, Pillay suggested that a shortage of refrigeration infrastructure would mean that the Pfizer/BioNTech and Moderna vaccines would not be vaccines that “many developing countries would be able to implement”. Moreover, for ideal effectiveness both vaccines need two shots administered weeks apart. The same goes for the Oxford one.

So clearly, we would be looking more for a vaccine we could roll out that could be stored at room temperatures and kept in a fridge,” Pillay said. He also said that a vaccine with a single dose is ideal.

He suggested that such a vaccine would be going through regulatory approval in January. The only current single-dose candidate vaccine is the one being developed by Johnson & Johnson (J&J). And it is the first candidate vaccine to seek regulatory approval in South Africa.

But the company has not released any results about the vaccine’s safety or efficacy, although this is expected to be announced in January.

J&J launched the second of its phase three trials of its candidate vaccine in mid-November. The first phase three trial was launched in September. (Phase three trials are the last stage of testing for a new drug or vaccine, in which typically thousands of people are assigned randomly to either get the vaccine or a placebo.)

Can Aspen manufacture a vaccine?

South Africa’s interest in the success of the J&J vaccine is significant, particularly as local pharmaceutical manufacturer Aspen has entered an agreement with J&J to manufacture its vaccine.

On 11 November, Ramaphosa remarked on South Africa’s capacity to manufacture and package vaccines, highlighting the deal between J&J and Aspen.

Ramaphosa also said that Biovac, a part-state-owned company, was in negotiations with a vaccine manufacturer to secure rights to manufacture a candidate vaccine.

The details of the agreement between Aspen and J&J are vague. It appears that domestic production will not include the manufacture of the vaccine itself; rather Aspen will be responsible for late-stage processing, including packaging the vaccine.

Further, it is not clear that this deal will grant South Africa any of the doses of the vaccine. There was no response to questions sent by GroundUp to J&J.

The Health Justice Initiative (HJI) has been calling on the government to release its vaccination plans, but has not received any response.

Speaking to GroundUp, HJI founder Fatima Hassan said that the government must explain how it will allocate limited vaccine supplies, in an equitable and rational manner. She is worried that government is not sufficiently prepared.

Will patents block access?

Despite the huge amount of public money from several countries that has been invested in vaccines, the pharmaceutical companies either own or have exclusive rights to the vaccines that have so far been shown to be successful.

For practical purposes they have exclusive say as to where, who, how and how much the vaccines are manufactured or sold for. (Moderna’s CEO has suggested his company will not enforce its patent rights on its vaccine.)

South Africa and India, with the support of over 100 countries and of organisations like the Nobel peace prize winner Médecins Sans Frontières, have called for the World Trade Organisation to suspend intellectual property rights related to Covid-19.

But this proposal has been blocked by the US, the United Kingdom, Canada and other high-income countries.

On 8 December, the International Federation of Pharmaceutical Manufacturers and Associations (IFPMA) released a press statement condemning the proposal, and any move to weaken intellectual property regimes that might allow people in poorer countries to access Covid vaccines.

IFPMA argued that any such move would “undermine confidence in what has proven to be a well-functioning intellectual property system,” and that the progress that has been made in vaccine development has only been possible due to “a thriving innovation ecosystem, underpinned by intellectual property rights.”

The press release goes on to say that the end of the pandemic is a possibility due to the “contribution of millions of people who joined clinical trials.”

Ironically for people living in South Africa, thousands of whom have participated in a number of clinical trials for Covid-19 vaccines, this participation alone does not mean anything when it comes to access to these vaccines.

In 2001, member countries in the World Trade Organisation released the Doha declaration on Trade-Related Aspects of Intellectual Property Rights (TRIPS) and public health, which affirmed that “the TRIPS Agreement does not and should not prevent Members from taking measures to protect public health.”

While South Africa was one of the countries that led the way to the now 19-year-old declaration, our domestic patent legislation has not yet fully incorporated the advances won in this declaration.

Nevertheless, existing patent law has provisions that would empower the government to circumvent patents in the interest of public health. Section 56 of the Patents Act allows the government to issue compulsory licences if “the demand for the patented article in the Republic is not being met to an adequate extent and on reasonable terms”.

This means that if a manufacturer cannot produce enough supply, it cannot stand in the way of those who have capacity.

Clearly demand for vaccines far exceeds supply and will do so for some time. Does South Africa have the capacity to produce a vaccine, if it grants a compulsory licence, or in the unlikely event that the TRIPS waiver succeeds?

In a 30 June op-ed, researchers from the NICD, Biovac, and animal vaccine manufacturing companies said that South Africa has the domestic capacity to produce certain types of vaccines.

A 19 November report in Business Day quotes Biovac CEO Morena Makhoana saying that his company has the capacity to manufacture mRNA vaccines, such as those developed by Pfizer/BioNTech and Moderna.

In September, Adar Poonawalla, CEO of the Serum Institute of India, the largest vaccine producer in the world, told the Financial Times that global vaccination coverage could only be achieved by 2024, with poor countries waiting the longest for vaccines.

It’s hard to think of a more pressing need for humanity in the short-term than ending the Covid-19 pandemic. Perhaps with a concerted global effort that puts lives and equality before profits and patents, Poonawalla’s pessimistic outlook will turn out to be wrong.

 

For information as to how Relocation Africa can help you with your Mobility, Immigration, Research, Remuneration, and Expat Tax needs, email info@relocationafrica.com, or call us on +27 21 763 4240.

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President Cyril Ramaphosa has announced that South Africa will move back to lockdown level 3, taking effect from midnight tonight.

In an address on Monday evening (28 December), Ramaphosa said that the move is being done to limit super-spreader events further, and will adjust previous level 3 regulations to keep the economy as open as possible.

It will also allow government to focus on the social distancing measures, and aims to ease the pressure on hospitals.

The change follows meetings held by the president and his cabinet as part of the National Coronavirus Command Council on Sunday, and come as the country surpasses 1 million cumulative Covid-19 infections and record daily increases.

“Nearly 27,000 South African are known to have died from Covid-19. The number of new coronovirus infections are increasing at an alarming rate. Infections are surging in KwaZulu-Natal, the Western Cape and Gauteng. Infections are alarmingly on the rise in Limpopo,” Ramaphosa siad.

“Infections are on the rise, in part, because we as humans are social beings. We feel the need to visit friends and family, attend religious services, and go to parties. But this is a time of danger,” the president warned.

Infections are being driven by super spreader events, the president said, which include year-end functions, family gatherings and music and cultural events.

“This is where infections happen most. This is cause for alarm, and points to an extreme lack of vigilance. We have let our guard down, and we are now paying the price,” he said. Venues are also being over-crowded, and social distancing and prevention protocols are not being followed.

Sale of alcohol

“One of the more difficult areas of regulation relates to the sale of alcohol,” the president said. “The liquor industry is a major employer and an important contributor to our economy. Our priority at this time, however, must be to save lives,” he said.

The president said that the consumption of alcohol has exacerbated the stress put on healthcare facilities, driving up the number of trauma cases in hospitals.

Worryingly, hospitals are reporting being at, or close to maximum capacity – while healthcare workers are exhausted and becoming infected in higher numbers. “They are almost at breaking point,” the president said. “All because of our actions, and failure to take responsibility. Unless we act now, and act decisively…thousands of more people will lose their lives.”

“Night clubs and businesses engaged in the sale and transportation of liquor will not be allowed to operate. The Level 3 restrictions will remain in place until 15 January 2021,” Ramaphosa said.

“These regulations may be reviewed within the next few weeks if we see a sustained decline in infections and hospital admissions,” Ramaphosa said.

Under the new lockdown level 3, the following takes effect:

  • All indoor and outdoor gatherings will be prohibited for 14 days, with an exception to funerals and places like restaurants and gyms. These exceptions will be clarified in the official regulations.
  • Nationwide curfew will be extended to 21h00 to 06h00. Aside from essential services, no one will be permitted to be out during this time. All establishments will close at 20h00, with a more specific list to be published soon.
  • Every individual will be responsible, legally, for wearing a mask in public. It is now compulsory for every person to wear a mask in a public place. Violators will be guilty of an offence, and could be prosecuted. They could be liable for a fine or imprisonment, or both.
  • Alcohol sales from retail outlets and onsite consumption are banned. The prohibition on the public consumption of alcohol remains.
  • Businesses will continue to operate, subject to guidelines. Nightclubs and businesses that rely on alcohol sales will not be allowed to operate.
  • All beaches, dams, rivers and public parks and public pools in hotspot areas will be closed to the public.

These measures will be in place until 15 January 2021, at which time they will be reviewed based on the situation, Ramaphosa said.

A notable change is that, from midnight, it is compulsory for every person to wear a mask in a public space. A person who does not wear a cloth mask covering over the nose and mouth in a public place will be committing an offence.

A person who does not wear a mask could be arrested and prosecuted. On conviction, they will be liable to a fine or to imprisonment for a period not exceeding six months or to both a fine and imprisonment.

This is a drastic measure but is now necessary to ensure compliance with the most basic of preventative measures, the president said.

People living and moving within hotspot areas are recommended to keep travel as limited as possible.

The following areas have been declared hotspot regions:

  • Eastern Cape: Sarah Baartman, Chris Hani, Buffalo City, Nelson Mandela Bay, Amathole, OR Tambo, Alfred Nzo.
  • KwaZulu-Natal: eThekwini, Umgungundlovu, Ugu, Harry Gwala, Ilembe, King Cetshwayo.
  • Gauteng: West Rand, Tshwane, Johannesburg, Ekurhuleni.
  • Western Cape: the West Coast District, Overberg District, Winelands District, Cape Town, Central Karoo District are hotspots. This is in addition to the Garden Route District.
  • North West: Bojanala District.
  • Limpopo: the Waterberg District and the Capricorn District.

For information about COVID-19 from the World Health Organization, click here. To track cases, click here. To read President Ramaphosa’s address to the nation, click here.

 

For information as to how Relocation Africa can help you with your Mobility, Immigration, Research, Remuneration, and Expat Tax needs, email info@relocationafrica.com, or call us on +27 21 763 4240.

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The South African Medical Association (SAMA) wants the country to be taken back to level 2 lockdown – with more stringent restrictions on gatherings.

South Africa has officially recorded more than one million cumulative cases of COVID-19, with the Department of Health announcing a total of 1 004 413. In the past 24-hour cycle alone, the country recorded 9,502 infections. An additional 214 deaths have been reported, bringing the total death toll in the country to 26,735.

Healthcare workers have flagged growing pressures in the as doctors and nurses say they were unable to cope with the increasing number of COVID-19 patients at hospitals.

SAMA’s director of the alcohol and tobacco unit Angelique Coetzee on Sunday said the rapid spread of the virus was caused by residents not wearing masks and failing to follow all heath protocols. Coetzee said level 2 lockdown should be re-introduced as gatherings and on-premises alcohol consumption were a problem.

“Moving to level 2 lockdown has certain advantages but it’s not enough to decrease alcohol trauma, which is putting pressure on hospitals at the moment and we should consider suspending on-premises liquor sales until 3 January. Meanwhile, it’s only a matter of time before President Cyril Ramaphosa addresses the nation once again after chairing an emergency meeting with the national coronavirus command council (NCCC).

The NCCC, which determines the lockdown regulations, met on Sunday amid a dramatic spike in COVID-19 infections. With government tight-lipped on what exactly was under discussion, expectations are that stricter restrictions will be implemented. Cabinet spokesperson Phumla Williams on Sunday said the outcomes of the high-level meeting were still being discussed. “Once that process has been completed, the president will then address the nation.”

 

For information as to how Relocation Africa can help you with your Mobility, Immigration, Research, Remuneration, and Expat Tax needs, email info@relocationafrica.com, or call us on +27 21 763 4240.

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Tighter lockdown restrictions might be coming our way should South Africans not up their COVID-19 safety measures.

This is a warning from COVID-19 ministerial advisory committee member Professor Ian Sanne recently.

Sanne, who’s also CEO of Right to Care – a non-government organisation, stresses the mounting burden the pandemic puts on the health sector.

“I think South Africa will have no choice but to lock down further if people don’t seriously practice social distancing.”

Sanne said studies were being done to weigh up the effect of an increased viral load against COVID-19 clinical outcomes.

Health Minister Zweli Mkhize last week announced that South African scientists have identified a variant of the coronavirus – and that the current second wave in the country is being driven by this.

Mkhize has raised concerns over complacency amongst young South Africans.

“It cannot be that our youth must only adhere to life-saving measures only after being policed to do so. We, therefore, call on parents, caregivers and youth to understand that it’s now not just a matter of thinking about others or even about yourself and therefore you yourself are equally at risk of dying of COVID-19.”

 

For information as to how Relocation Africa can help you with your Mobility, Immigration, Research, Remuneration, and Expat Tax needs, email info@relocationafrica.com, or call us on +27 21 763 4240.

Sources: [1], [2]. Image sources: [1], [2].