Nationwide vaccination plan: how much will it cost you?

As reported in December 2020, the health department and the Solidarity Fund made a down payment of R283m for the Covax vaccine programme — only a fraction of its total cost.

Covid-19 infections and death toll numbers, and the 501. V2 strain which first emerged in SA in August last year, continue to threaten economic recovery and the livelihoods of many South Africans. Pharmacies are doing what they can ensure South Africans are able to afford health supplies and other hygiene-related items.

The affordability debate

So far, washing hands with soap and water has been one of the main methods promoted to keep the virus at bay. Most South Africans have been able to purchase hygiene products at affordable prices. The Clicks catalogue shows how the retailer lowered the price of handwashing liquid to R35 to ensure affordability, and a similar approach should be extended to vaccine accessibility.

While there is still some uncertainty about the vaccine rollout and affordability, the government and health-care experts have said that vaccines are likely to be provided by medical aids.  A number of voices have raised concerns at health minister Dr Zweli Mkhize’s announcement regarding the intervention of medical aid schemes.

On January 3 2021, Mkhize said: “We have embarked on public-private partnerships with good outcomes and approached medical aids to be part of the cofinancing. The process is now at a stage where the Council for Medical Scheme has engaged various medical schemes […].” 

This medical aid scheme plan is being challenged as inequitable and the government has faced pushback for refusing to allow private entities to procure the vaccines and distribute them commercially. In response to Mkhize’s announcement, UCT adjunct professor Nomboniso Gasa said: “The majority of South Africans are not on medical aid. What are your plans for the public sector?” 

In January 2021, Dr Aquina Thulare, a technical adviser for the health department, said during a webinar that the 33-million people who don’t have private health insurance will receive Covid-19 vaccines for free, while the seven-million insured South Africans would be covered by their medical aid.

Profmed CEO Craig Comrie offers a breakdown that takes into account vaccine costs, logistics and administrative fees. The vaccine could cost anything between R80 to R500, and after the doctor’s administration fee plus other distribution costs, it could amount to R1,200 initially.

A global scramble for vaccines has contributed to the financial challenges that many lower- to middle-income countries are experiencing when securing enough vaccines and providing them for free or inexpensively. Canada is said to have pre-ordered enough vaccines for four times the size of its population, whereas SA has had difficulties paying the initial Covax deposit — this is only 15% of the total cost needed to secure vaccines for only 10% of its population.

Is SA getting cheated?

Reports have shown that are discrepancies in the pricing mechanisms being applied when countries procure vaccines. SA was charged a $5.25 a dose for 1.5-million shots for the Oxford-AstraZeneca vaccine procured from the Serum Institute of India. Evidence shows European countries were offered a payment structure of $3.03 a dose for the same vaccine.

There are several vaccines available or in trial, however those that can be procured from the West such as the Oxford-AstraZeneca, the Moderna-Niaid and the Pfizer-BioNTech vaccines appear to be priced out of the reach of many African countries and are often extensively pre-ordered by wealthier countries.

If SA is to meet its target to vaccinate about 40-million people — about 67% of the population — to achieve herd immunity, then perhaps the government needs to seek alternatives to procure vaccines. The BBC recently reported that SA has so far secured enough doses for the target population of 40-million.

Wits professor of vaccinology Shabir Madhi has suggested that SA not put all its eggs in one basket when it comes to procuring vaccines. He says prioritising the acquisition of vaccines through the Covax facility at a premium price of $12 to $13 has resulted in a huge setback.

Health minister Zweli Mkhize told the Sunday Times he was “comfortable” the rollout should continue as planned.” It's not a setback at all. But we will do an implementation study with the first few batches. We will vaccinate the first few and monitor them.”

Bilateral arrangement approach is the way forward

Nonetheless, SA will need to focus on a direct-to-manufacturers bilateral agreements approach to securing vaccines which it failed to do in the beginning. As reported by the World Health Organisation, about 95% of the vaccines available have been procured by only about 10 countries, so SA might be able to get ahead with the single-dose Johnson & Johnson vaccine.

Details on the arrival of the vaccines have dominated the news for months, not giving room for enough engagement with the cost implications. At the recent presidential address, now popularly dubbed the “family meeting”, President Cyril Ramaphosa focused on announcing that the first batch of Covid-19 vaccines had arrived and was received by him and the deputy president David Mabuza on February 1 2021. There was no mention of what the cost will be.

However, the good news is that though the rollout of the Oxford-AstraZeneca vaccine has been put on hold as the latest findings indicate a lower-than-expected efficacy with regard to the SA variant, the government is pushing ahead with the rollout of the Johnson & Johnson and Pfizer vaccines.

This article was paid for by Latest Specials.