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A Covid vaccine roll-out sans corruption is the panacea the state (and country) desperately needs

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Hloni Bookholane, MBChB MPH is a doctor from South Africa and a graduate of the Johns Hopkins Bloomberg School of Public Health. He is the author of Becoming a Doctor: Learnings and unlearnings about life and the politics of medicine. Follow him on Twitter @HloniBookholane

It is time to restore some pride and honour in public servants and government officials: a successful vaccine roll-out sans corruption may just be the panacea the government (and country) desperately needs.

The third Covid-19 wave is here, and it will be worse than the previous two. Months later, here we are. Intensive care units (ICUs) are expanding, surgical units are being decommissioned, and new wards are being (re) opened to prepare for the third wave of Covid-19 infections in South Africa. In Gauteng, the province hardest hit in this current wave, the situation is so dire that army medics have been deployed to buttress the response by healthcare workers.

Mounting evidence indicates that Covid-19 vaccinations likely reduce future transmission. However, in SA, not nearly enough people have been vaccinated to thwart what was a predictable third wave. Moreover, despite nearly 500,000 healthcare workers having been vaccinated through the Sisonke trial, the Herculean effort from the study team was not enough to prevent the current surge in infections.

The gravity of the third wave was preventable, yet our leaders decided not to act. First, SA has no shortage of accomplished scientists, professionals, and those with technical expertise to ensure mass vaccinations at scale. Second, the mass vaccination campaign appears to have been hamstrung by the government’s ineptitude and gross inability to meet service (and healthcare) delivery needs. What should be a well-coordinated and efficient process has been rendered a muddled process that cannot be improved as necessary. It does not help that there are no regular platforms through which to question and press government leadership on their failings, among other things. Third, despite the pandemic bringing life as we knew it to a grinding halt, government corruption has been thriving, implicating the current minister of health who has since been put on special leave in R150-million (± $11-million) worth of stolen pandemic funds through his close associates.

When it suits the narrative, SA can be compared to high-income countries. Our doctors bend the innovative arc of medicine, our universities are world-renowned, we nurture world-class athletes, and we have world-class cities. But what good is this when our government fails us time and time again in the consequential comparable acts like mass vaccine roll-out during a pandemic? President Cyril Ramaphosa has recently urged the G7 countries to plug the Covid-19 funding gap. Though this was well received, it rings hollow when his administration steals the very money which institutions like the International Monetary Fund provide in emergency financial assistance.

Despite the depth and breadth of expertise in SA, we seriously lag behind high-income countries and especially behind low- and middle-income countries. The vaccination rate in SA, on aggregate, compared to other African countries leaves much to be desired, notwithstanding the fact that SA has the largest proportion of Covid-19 cases on the continent. Given the inert pace of vaccinations in SA, foreign nationals are likely to get vaccinated sooner than their age mates as countries like France embark on an independent roll-out via their embassies abroad. Unfortunately, the SA government engenders no faith that they can turn things around, thus leaving us in this inequitable mess.

The only thing I think could help the government course correct is if they hand over the responsibility of the vaccine roll-out to the 2019 Rugby World Cup Springbok team, or to the Gift of the Givers Foundation. Between these two groups, South Africans could rest assured that the job would get done and they would be able to hold their heads up high, in spite of ongoing challenges.

However, great as it would be to have a rugby World Cup moment via a vaccine drive, this does not seem consistent with what is currently and likely to happen, unfortunately. We cannot be so ungovernable that our reputation hinges on the transient, unpredictable, and inconsequential nature of a sports tournament.

It is time to restore some pride and honour in public servants and government officials: a successful vaccine roll-out sans corruption may just be the panacea the government (and country) desperately needs.

There is an urgent need for this government to accept its shortcomings. Additionally, it ought to reconsider the fact that expert and technical services are poorly — if ever — delivered by career politicians and people without the requisite skills and expertise, let alone the integrity to be accountable. When these worrying predictions and realities come again, we need to have an established system of qualified and reliable professionals making the decisions, addressing the nation, meeting the moment, and taking accountability.

Failing to do this will likely result in new variants, lockdown iterations, and a fourth season of Covid-19 infections. Most importantly, it will be yet another government failure and during a pandemic, it will be a colossal public health failure. DM

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