The price is higher than the $3 a dose that South Africa and other countries on the continent are due to pay for the same vaccines under an African Union (AU) arrangement, and the price European Union countries have agreed to pay.

The SII doses are intended for South Africa’s frontline healthcare workers, who have been under huge strain during a second wave of coronavirus infections. They are due to start arriving before the end of the month, before the AU doses become available from March.

The SII declined to comment when contacted by Reuters. AstraZeneca did not immediately respond to a request for comment.

Health department Deputy Director-General Anban Pillay said SII’s price for South Africa was based on the country’s status as an upper-middle-income level country, confirming a report in the Business Day newspaper.

Developed countries that secured a lower price per shot did so because they contributed towards research and development costs of the AstraZeneca shot, he told Reuters.

Pillay said the South African government would try to negotiate a lower price if it procured more doses from SII but that it had been told $5.25 a dose was the standard global price for upper-middle-income level countries.

South Africa’s health department announced the SII deal earlier this month after being criticised by local scientists and trade unions for moving too slowly to acquire vaccines.

The SII is one of several manufacturers licensed by AstraZeneca to make its COVID-19 vaccine.

South Africa has recorded the most COVID-19 infections and deaths on the African continent, with more than 1.3 million cases and over 38,000 deaths to date. It is hosting clinical trials for the AstraZeneca shot. (Reporting by Alexander Winning and Emma Rumney in Johannesburg, and Ludwig Burger in Frankfurt Editing by Stephen Coates and Jane Merriman)