An unprecedented collaboration between the public and private sector should see South Africa ramp up daily vaccinations to about 420,000 people per day by September. If this happens it is likely that more than 80% of the eligible adult population will have at least had their first vaccine before the advent of the fourth wave, expected in November.

What this collaboration means is that rather than two teams – one public and one private – trying to collaborate, there is one team, one set of data, one model, and one team of actuaries contributing to a single, integrated strategy to vaccinate the insured and uninsured across South Africa. This strategy has been developed by the National Department of Health and B4SA, the business alliance that is mobilising resources and capacity to combat the Covid-19 pandemic.

More than seven million vaccines have been administered to date, with the number of people vaccinated per day expected to increase rapidly from the current rate of about 230,000 a day. In fact, it is likely that almost 50% of the population over 35 could have had their first vaccine by the end of August. 

“South Africa’s programme had a slow start, with many teething problems,” says Martin Kingston, the chair of B4SA, “but these issues have been resolved and capacity is ramping up.”

While the supply of vaccines is still constrained, the country is expecting a veritable flood of vaccines within the next 10 days, says Stavros Nicolaou, chair of the B4SA Health Working Group. An estimated 31 million Johnson & Johnson and 31.3 million Pfizer doses have been secured at a rate that will ensure the country can vaccinate just over one million people every three days.

This is imperative if South Africa is to reduce the infection and death rate ahead of the anticipated fourth wave. “We need to vaccinate an average of 360,000 people a day going forward,” he says.

This will require a significant expansion of capacity (and demand), which is where the private sector has an important role to play. Aside from providing support at public sites like hospitals, schools, and mobile sites, the private sector is ramping up its workplace vaccination sites. Here the mining industry is leading the way. 

“We are all in the same canoe,” says Roger Baxter, CEO of the Minerals Council of SA, “and one of the ways through the rapids is an effective vaccination programme.”

The industry has significant healthcare and delivery capacity, partly because the mines are often located far from these facilities and partly thanks to its proactive stance when it came to the roll-out of antiretrovirals in the 1990s. 

“Together with our trade union partners, we aim to ensure that employees, their families and communities are vaccinated,” Baxter says.

The industry has identified 65 mining sites that are eligible to register as vaccination sites. It ran its first pilot at Impala Platinum in May, and now has 29 sites live across the industry, with more coming onstream in the next two weeks. 

“As of Wednesday we had vaccinated 42,000 people, which includes anyone over the age of 18 as per government policy,” Baxter adds. This capacity will double to more than 21,000 vaccinations per day as new sites come onstream. 

Across South African industry in general there are 150 workplace sites available, of which 57 are currently operating, with another 19 coming online within the next two weeks, predominantly in rural and peri-urban areas. 

“There is nothing more important in our country at the moment than successfully and efficiently rolling out the vaccine programme to our people,” says Nicolaou. “There is compelling data from around the world that show that in areas where the majority of people are vaccinated, 99% of deaths are attributable to those not vaccinated and 95% of severe hospitalisation also to those not vaccinated.” 

Government policy currently leaves to employers the sensitive decision of whether or not to make vaccinations mandatory. Making the Covid-19 vaccination mandatory is not a government policy decision, says Dr Nicholas Crisp, deputy director-general at the Department of Health. 

“Our Constitution does not work like that. We are not considering this at the moment.” DM/BM