Sleeves rolled up for vaccine

SA's private sector is gearing up to deploy its formidable health-care infrastructure in the rollout of the vaccination programme, with business working closely to support the government on vaccine distribution.

The large pharmaceutical warehousing and logistics providers are ready to put their extensive networks and IT systems at the disposal of the government, as are private hospital groups, pharmacies and medical practices as SA embarks on the programme, which will launch after the first doses land on Monday.

Mines have also offered their extensive health-care facilities, which could rapidly vaccinate up to 3-million people in mining communities across SA.

Business leaders have re-mobilised under the auspices of Business for SA (B4SA) and are represented on the government-led national coronavirus vaccine co-ordinating committee, which is in charge of the rollout operation, as well as on a three-a-side team with the department of health and the Treasury that will respond rapidly to any operational issues that arise.

There appear to already be some issues, with the department of health on Thursday deciding to go out on open tender for the storage and distribution of vaccine doses, reversing a decision by the Treasury, which on Tuesday told a South African National Editors Forum (Sanef) briefing that it had approved a closed bidding process for six months for four of SA's largest pharmaceutical logistics companies - Biovac, Imperial Health Science, Clicks-owned UPD and Danish-owned DSV.

The Treasury said in answer to a Business Times query on Friday that the department of health had informed it that it would rather opt for an open tender process because elements of the bid such as shipping and customs clearance require "wider market participation".

The Treasury did not object to this approach. It said, however, that Biovac has been appointed for three months and will fulfil the role while the tender process is finalised for the longer term.

Business leaders emphasised, however, that they are working well under the leadership of the government to put the complex vaccination programme in place.

"We have mobilised the vast machinery of specialised resources required across business to mirror and complement the government workstreams so that we can ensure we have a co-ordinated and integrated approach in supporting the national effort led by government," said Martin Kingston, who leads the B4SA steering committee on the vaccine, which includes most of the leading executives in SA's private health-care sector, contributing their time for free.

"We are working beautifully together as a broader health-care sector to solve the problem," said Netcare executive Melanie da Costa, who is also a director of the Hospital Association of SA and is one of the business leaders on the three-a-side team with the government, along with Kingston and Aspen's Stavros Nicolaou.

Da Costa said phase 1A of the government's plan - which covers doctors, nurses and emergency service workers who interface directly with Covid patients - is giving the sector an opportunity to test the systems. Phase 1A is the first of four phases within phase 1 of the government's plan to start by vaccinating SA's 1.3-million health-care workers.

It is expected that most of SA's approximately 220 acute-care private hospitals will be enlisted in the rollout, as will pharmacy and GP networks. Private hospitals will vaccinate their own staff.

"Everything is aligned so we can rock and roll as soon as possible," said Da Costa.

Imperial Group CEO Mohammed Akoojee said there is sufficient capacity in SA's private sector to warehouse and transport the vaccines at the required temperatures, but the biggest value add is that it can access thousands of points of vaccination across SA. For example, Imperial Health Sciences already delivers pharmaceuticals, including vaccines, to more than 6,000 points of delivery in the private and public sectors, and pharmacy groups Clicks and Dis-Chem have networks of hundreds of pharmacies.

"That is the network we offer government and we are saying, let us support you in leveraging that to enable the vaccine to happen outside of the public hospitals."

Akoojee said Imperial, which is one of the largest players in the logistics sector in SA and elsewhere in Africa, also has the information technology infrastructure to be able to administer and record the doses, as well as ensure the quality and integrity of the supply chain to comply with the manufacturer's and regulators' requirements. "We are saying to government, let's leverage that - don't go and create your own," he said.

SA's mining industry has a well-developed health-care infrastructure because every mine has a clinic, where mineworkers have annual medical examinations.

Minerals Council spokesperson Charmane Russell said the industry estimates conservatively that it can vaccinate 60,000 to 80,000 people a day in mine medical facilities, enabling it to reach 3-million people - including mine employees as well as their families and communities - in a two-month period if vaccine doses are available.

She said the industry has offered this to the government via the department of mineral resources and B4SA, and it has been well received.

Nicolaou said SA already administers about 14-million vaccinations each year - mostly childhood inoculations and flu vaccines.

But getting out the 57-million to 60-million doses of three different kinds of vaccine needed to vaccinate the 40-million people required for herd immunity over 12 months is a much more challenging task.

The countdown to the launch of SA's vaccine programme comes after Treasury director-general Dondo Mogajane made it clear at the Sanef briefing on Tuesday that the government will find the money for the vaccine programme, which is expected to cost R20bn-R24bn.

The government has also said SA's medical schemes must pay for their own members as a prescribed minimum benefit, and will cross-subsidise the same number of doses again. That is expected to contribute about R7bn of the total cost of the programme.

Wits University professor Alex van den Heever said: "The private sector is capable of delivering the entire vaccine programme for SA.

"It has a very good logistics system that can reach high- and low-income groups and existing private hospital pharmacies and GP networks.

"It's just a question of whether government has the appetite for a coherent public private platform and rollout strategy."