South Africa


Western Cape’s vaccination initiative — political contestation in the age of the pandemic

Western Cape’s vaccination initiative — political contestation in the age of the pandemic
A medical professional holds a Covid-19 vaccine at Groote Schuur Hospital in Cape Town on 21 February 2021. (Photo: Gallo Images / Brenton Geach)

As we await more vaccine doses and millions of people hope to be protected against Covid-19 as soon as possible, some of the debates could lead to more social tension rather than a united effort. One of them is whether a province, and in particular the Western Cape, should be allowed to buy and administer its own vaccine doses.

The debate is complex and difficult, revolving around issues of equality, the legalities of provincial and national government, and competence. A historical precedent also shows that something similar has actually happened in the past, but it may not be correct to follow this approach again.

Last week, Western Cape Premier Alan Winde said during his State of the Province Address that his government had started speaking to pharmaceutical companies about procuring the province’s own vaccine doses. He made the point that his provincial government has a duty to protect people living in the Western Cape.

Later, speaking on SAfm, he was careful to make the point solidly, while also attempting to dodge the claim that the Western Cape wants to be different from the rest of the country. He emphasised that his provincial health department is working with the national Department of Health, and that it was through this cooperation that President Cyril Ramaphosa had been vaccinated with health workers the day before.

For Winde and the DA, the political advantages are obvious.

If they are able to show that they can vaccinate their people before the ANC-governed provinces that would be an even greater victory than the fact the DA-run places are generally in better shape then the ANC-controlled ones.

Considering the recent past, it is likely that someone will accuse ANC members of profiting from the vaccine roll-out in some way, and if the Western Cape can be seen to be doing this without any corruption, that would be another win.

Some people might even move to that province to get their vaccine as quickly as possible, particularly if they had means and were particularly vulnerable to the disease.

For the national government, and the ANC, this opens the door to potential embarrassment. They may well feel that the potential for them being seen as incompetent would be substantial. It would indeed be difficult to explain to voters later in the year why they have not been vaccinated while residents in a province governed by another party have been.

Imagine being the councillor trying to explain to someone whose mother died from Covid-19 why they had not received their vaccination dose in time.

It is difficult to keep politics out of this debate, and how you feel about the issue may well speak to your political identity. But it is important to provide an objective analysis.

Legally, provinces have a responsibility to provide healthcare for their citizens. Hospitals, run by the provinces, save far more lives every year than the SANDF, which is run by the national government. This could strengthen the argument that a province could vaccinate its people.

But it would also pose significant questions about equality.

South Africans are supposed to be treated equally, particularly by the government. Vaccinating people against a killer virus is a fundamental issue. Allowing a province to go it alone could result in nationwide accusations that lives in the Western Cape are being protected more than lives elsewhere.

This would be hugely problematic.

And yet, an equal distribution of government services is practically impossible. No government in the world has been able to achieve this. Accordingly, are we going to wait for that ideal moment when everyone can be vaccinated easily and quickly before we start the process, or should we vaccinate all the people we realistically can and as soon as we can, even if some are left behind? 

Where do we draw the line?

Some might feel, understandably, that because this virus is something the entire nation is facing together, we should all be vaccinated together. A taxi driver in Gauteng might be more vulnerable to the disease than an office worker in the Western Cape, and thus vaccination must be done on that basis: vulnerability to the disease is more important than where you live.

It’s a strong argument and one that’s hard to oppose.

There is an example from our recent history that can illustrate how stark this can become.

At the turn of the millennium, HIV-AIDS was killing thousands of people. A drug, nevirapine, was able to prevent mother-to-child transmission of the disease. It allowed an HIV-positive mother to give birth to an HIV-negative child.

Private doctors wait in line to receive the Covid-19 vaccine at Groote Schuur Hospital in Cape Town on 21 February 2021. (Photo by Gallo Images / Brenton Geach)

But the national government of then president Thabo Mbeki refused to administer this drug, or make it available to anyone in a government hospital.

The Western Cape was governed by a coalition of the New National Party and the Democratic Alliance. They allowed hospitals in that province to provide nevirapine (while the politicians may like to claim credit for this, activists involved in this sector place the credit with the doctors and officials running the Western Cape Health Department at the time).

This led to a situation where a baby born to an HIV-positive mother in the Western Cape would not contract the disease while a child born to an HIV-positive mother in another province could be born HIV-positive.

It’s important to remember how things have changed since the days when being born with HIV was akin to being born with a death sentence. The introduction of ARVs from 2004, and then the acceleration of their roll-out when Jacob Zuma became president from 2009, changed this dramatically to where now people living with HIV have virtually the same quality of life and life expectancy as people who don’t live with it.

In the Western Cape, a pill saved hundreds of thousands of lives. In Mpumalanga, Health MEC Sibongile Manana (mother of the woman abuser, connoisseur of luxury, lockdown host and ANC NEC member Mduduzi Manana) called the drug “poison” and fired a doctor for giving rape victims advice to take a pill which would prevent them from contracting HIV.

The Western Cape may well argue that anyone supporting it giving nevirapine to women then could not argue against it providing vaccine doses now.

However, there is an important difference.

Then, the national government and the president at the time simply refused to institute measures that scientists had proved would save lives. The Western Cape could argue, quite correctly, that there was no indication that the national government was going to change its mind, and institute these measures.

In the Covid-19 pandemic, however, the national government is not ignoring science — rather it is embracing it.

This means that the issue at stake may not be one of principle as it was then, but one of implementation, of actually delivering the doses into people’s arms.

As a result, the bar that the Western Cape provincial government has to clear is slightly higher; it would have to show that the national government is unable to properly implement the vaccine roll-out programme.

Considering the regularly stated intent of the national government to do this, and that some progress has been made in procuring doses, it may be tough for the province to prove this. It may require proof of failure by the national government first.

This means the Western Cape government is unlikely to be in a position where it can justifiably embark on its own vaccination programme soon.

However, just the possibility that it might, or could do this, may encourage the ANC and officials in the national government to ensure that the problems with the national roll-out are addressed with the speed they deserve. 

If the national government is seen to be competent in its vaccine roll-out the entire argument will disappear and the programme will get a badly needed shot in the arm. DM


Comments - Please in order to comment.

  • Jon Quirk says:

    Why must we always run at the pace of the slowest, the lamest, the most corrupt who stops at every corner collecting rents and imposts from all and sundry?

    If we are ever to succeed as a country, ever to throw off the controlling cloak of the ANC and genuinely allow competence and initiative to flourish, we must.

    And not just with vaccines but also in all areas and aspects of life. Businesses, and societies best, and most quickly flourish, by growing and developing the pods of excellence. There simply is no other way.

  • Andrew Blaine says:

    Dear Stephen, it is you who are politicising this situation.
    If the national Government prevent the Cape from controlling the distribution of its own vaccine, it will be guilty of denying citizens their right to life?
    The disadvantage of centralised control is that we are restricted to move at the pace of the slowest, while decentralised control encourages the slow to compete with the fastest. This is driven by pride?
    The only limitation should be that should a Gauteng based wish to be vaccinated and can afford it, they should be able to do so by visiting the Western Cape to tour both the Wine and Vaccination routes!

  • Karl Sittlinger says:

    Considering what has been going on, its not like the ANC really did a good job during Covid. Corruption, late ordering, wasteful expenditure, illogical yet damaging lockdown rules, these have been happening without any accountability for over a year. A government failure is to be expected at this point.
    Another scandal of the past, also about HIV with one of our current MPs shows just how far the ANC is willing to go for money and power. Look up the Virodene scandal with our illustrious NDZ. So when it comes to playing politics with lives, the ANC is on a whole different playing field. By letting business and provinces procure additional vaccines, our economy could recover significantly faster, the loss of jobs would slow down and hopefully reverse, every part of the economy would recover. It would be easy to implement a system where for each vaccine procured in the Western Province, an additional vaccine must be purchased for another province or something similar.
    This is not about saving lives, or even being socially fair, this is about power and money only. This is about not being embarrassed. Should that really trump lives?

    • Glyn Morgan says:

      If the Western Cape supplies vaccinations in the WC that would naturally release a similar number to the rest of the country. Win Win. And Grootes put his bent oar in! Sies!

  • Laurence Erasmus says:

    It will be criminal if a high risk individual in the Western Cape is denied the vaccine simply because the ANC in another province is unable to chew gum and walk straight at the same time!

  • Sydney Kaye says:

    They may come to the WC to get vaccinated and then vote ANC. This is what happened when the escapees from the Eastern Cape came to the WC for a chance to survive economically . Go figure!

  • Glyn Morgan says:

    All provinces can vaccinate their citizens! So the DA led Western Cape wants to do it and this “would also pose significant questions about equality.”?? Stephen Grootes, it is about time that YOU got real and recognized the fact that the Western Cape is the best run province because it is run by the DA and not the anc! Does Grootes ever give credit when credit is due??

    • Karl Sittlinger says:

      Some contributers for DM seem to rather want to amputate their own pinky than admit that they hold the DA to an impossible high standard (as opposed to the ANC), while purposefully misreading their policies in the worst possible light.

  • Dieter Meuche says:

    If you apply your theory to other areas, must the Western Cape wait for the ANC led provinces before it fixes its potholes? Must the Western Cape hold back with Service delivery to not make ANC led provinces look bad? Do you believe that all ANC led provinces will roll out vaccine at the same time and in a fair manner (most vulnerable first etc)?
    If the Western Cape can save lives by proceeding quickly and efficiently it should do so.
    Any vaccine the Western Cape would be buying would be on top of what the National Gov is trying to acquire, they would not be taking anything away from the ANC led provinces.

  • Robert Mitchell says:

    Its time to do it for your town, city , province and even country! on a municipal level, KZN is done! nobody takes responsibility in the government. they are un attainable. All lipservice and no follow through! everything is so corrupt that if THEY had half a chance there would be rife corruption in dealing out the vaccine.( Range Rover would have a good year!) so let WC get on with it. I would happily pop down and take a wine tour while getting a shot in the arm too!
    Good article Mr Grootes. You leave it up to the individual to make their choice. And yes it is a tough one as you said!

  • Brandon VE says:

    Pretty sure the whole idea behind ‘local government’ includes a provincial healthcare department.
    A communist model would see all healthcare coming from one almighty central body.
    In ANC speak, this is an issue for the branches to sort out. I have a local clinic I should be able to get a TB, measles, smallpox, flu and Covid19 shot. None of that needs to be managed at a national government level.

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