At the end of December Maverick Citizen reported on a process launched by the C-19 People’s Coalition to develop a vaccine alliance and plan. This week, what has evolved into the People’s Vaccine Campaign published a call to action (see below) which has already been endorsed by more than 500 organisations across civil society. These include the Black Sash, Treatment Action Campaign (TAC), Ahmed Kathrada Foundation, academic institutes, trade unions and the South African Council of Churches (Gauteng). The list is growing rapidly.

The call to action envisages a multifaceted campaign of vaccine literacy, monitoring and mobilisation to make sure no one is left behind. For example, one of civil society’s concerns is the silence on including migrants and refugees (documented and undocumented) in the vaccine campaign. As former health minister Aaron Motsoaledi should know, exclusion makes no sense from a public health perspective. As the president should know, continental solidarity with the African Union makes no sense if it’s not practised at home.

The campaign also insists on dealing with the structural determinants of the Covid-19 pandemic; the need for social relief, strengthened health systems and better-paid community health workers.

In certain respects the civil society mobilisation is beginning to resemble the broad social mobilisation undertaken by the TAC in the early 2000s for access to antiretroviral medicines for HIV. A mass meeting of the campaign will take place on Saturday afternoon to discuss campaign priorities for the next few weeks.

Beyond the political mobilisation to pressure the government to obtain vaccines and make them available fast and at scale, there are a large number of activities.

Vaccine literacy has been identified as a shortcoming that must be overcome to tackle the campaign of misinformation and fear being driven by an anti-vax campaign on social media. Materials have been developed by organisations such as SECTION27, which is also organising day-long training for activists next week by some of the country’s leading vaccine scientists. 

In this sense, too, civil society is showing its strengths and connectedness. WhatsApp is abuzz with discussion and careful sharing of emerging science from trusted sources (although civil society is leaving WhatsApp in droves after its surrender of personal information to Facebook). There are workshops and webinars and links are being reactivated with activists and experts internationally.

As this movement grows a challenge for the government is how to harness its energy and reach while respecting its independence and right to be critical. At this point, unfortunately, although President Cyril Ramaphosa frequently refers to consultations with civil society, the truth is that it’s not happening in a meaningful, inclusive or systematic way. 

On the other hand, the challenge for civil society is how to work with the government and business as an equal partner – listening, learning and mobilising but retaining its independence of voice and action.

South Africa will overcome Covid-19 through activating the strength of all its parts acting in tandem. That should be the goal. DM/MC

Notes from the official campaign

Towards a People’s Vaccine Campaign: A CALL TO ACTION

The Covid-19 pandemic is wreaking havoc in South Africa and globally, millions are being infected and dying. Vaccinating a significant part of the population is the only realistic way to defeat the pandemic. Achieving this will require international cooperation and solidarity, while unity in action across all sectors of our society is now urgent. We need vigilance and solidarity to slow the rate of infection and to ensure that health facilities are not overwhelmed. The reported acquisition of 1.5 million doses of C-19 vaccines for frontline healthcare workers is welcomed, but this must be the start of urgently acquiring millions more. It is estimated that between 40 to 80 million doses will be needed, along with a massive rollout effort to achieve herd immunity. This cannot be done by the government alone. We, the people, especially the millions of poor and working-class people, must be central to this effort. 

A People’s Movement for the Vaccine 

This call to action arises out of a broad-based demand for urgent mobilisation to ensure equitable vaccine access and allocation, which is endorsed by more than 500 organisations and individuals, who now raise a call for the creation of a People’s Vaccine Campaign. It is inspired by the People’s Vaccine Alliance and Free the Vaccine campaigns globally.

Our government’s poor record of public service delivery, widespread corruption and mismanagement, as well as the profiteering by the pharmaceutical industry, private healthcare and other corporate interests, are key contributors to the dire state of our health system, as well as risks to the equitable vaccine access required. While recent lack of transparency about the vaccine plans and delays in securing access to supplies have built little trust.

A people’s movement must participate actively in the discussions to shape and provide oversight to the national vaccination rollout programme. The role of labour (especially frontline workers), civil society, social movements, communities and people’s organisations is crucial to defeat the pandemic. 

Why Do We Need a United Response?

1. SA’s Unequal Health System(s)

South Africa is the most unequal country in the world. Our healthcare system(s) symbolise this with half of our healthcare expenditure serving only 16% of the population. The other half covers 84% of our people, mainly the poor and black working class. While the combined resources of both are critical to the success of a People’s Vaccine Campaign, without collaborative coordination free from predatory and profiteering practices, we will not see the end of this pandemic.

2. Gendered Disparities

Women generally carry the greater burden of health and care in society, and also suffer disproportionately from illness, poverty and violence. Continued delays in the vaccine rollout risks deepening the gendered divide, and increasing both their exposure to the virus and burden of responsibility for caring for their family in the event of infection and death.

3. Austerity in a Pandemic is disastrous

The scale of the required rollout requires massive funding for the public health system. Yet, the government remains committed to austerity, with the National Treasury cutting R3.9 billion in real terms from the public health budget in February 2020. While 2018 estimates put vacancies in the public health system at 37,000, those won’t be filled with such drastic cuts in the budget.

4. The Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS)

The World Trade Organisation (WTO) maintains patent monopolies, controlling information about how to make the vaccine. This prevents South Africa and others from being able to make and distribute affordable vaccines. TRIPS must be suspended for all vaccine-related information.

5. Vaccine Nationalism and Xenophobia

Many countries are addressing the pandemic on a narrow, nationalist basis. Wealthy nations in Europe, Canada and the US have pre-ordered large numbers of vaccine doses which exceed the need of their own populations. Some countries are refusing to vaccinate migrants and asylum seekers or populations under their occupation. The vaccine must be for all of us. 

6. Community Healthcare Workers (CHW)

Thousands of CHWs have been recruited, but their employment is insecure, irregular and low-paid. The majority of CHWs are women who are overburdened, with precarious employment. They must have immediate vaccine access and guaranteed job security.

7. Disinformation and Vaccine Skepticism

The rise of misinformation, science denialism, anti-vaxxer sentiments and vaccine hesitancy presents an incredibly worrying picture. While skepticism of the government, the pharmaceutical industry and the private health sector has created fertile ground for opportunism and fearmongering.

Towards a People’s Vaccine Campaign

We are building a campaign to ensure equitable access to vaccines for everyone. Without widespread vaccination we will not be able to end this pandemic. We must: 

Pressure the Government to Build the Public Health System and Reverse Austerity

There must be increased health spending to build the capacity of the national health system and National Health Insurance (NHI) to ensure decent and equal healthcare for all. 

This includes full-time public sector employment for CHWs and the appointment of additional nurses. The terms and conditions of the 2018 PSCBC collective agreement should be restored. In addition, in face of the socio-economic impact of Covid-19 and inequality in our country, the implementation of a Basic Income Guarantee (BIG) is now nothing less than a dire necessity. 

Mobilise Civil Society to Demand Meaningful Representation 

We must lobby for the inclusion of civil society and communities in various stakeholder forums where plans for the rollout of vaccines are being formulated. We can campaign and educate communities about vaccines as well as monitor implementation to call out any form of inequity, unfairness, corruption, theft, mismanagement or even inefficiencies. 

Combat the Wave of Anti-Vaccine Disinformation 

We learnt with HIV/Aids that disinformation amid distrust, uncertainty and fear costs lives. This requires national information and educative engagement on all platforms. Lives now depend on building public health education in many languages and with many stakeholders. 

Support Price Regulation, Control and Price Transparency of ALL Vaccines

We support measures that seek to ensure that the WTO, rich countries and the pharmaceutical industry do not continue to enforce intellectual property laws, patent and pricing barriers that undermine universal access to vaccines, and thereby also limit mass immunisation. 

We support the call for the vaccine to be declared a “public good”.

Let us join together to help grow a People’s Vaccine Campaign for South Africa. 

This is the abridged version, for the full statement and updated list of individual and organisational endorsements, please see here. To endorse, please add your details here. For inquiries, please contact: [email protected]. Follow for updates: Facebook: C19 People’s Coalition; Twitter: @CovidCoalition