Secured: 1.5mn doses of Oxford/AstraZeneca vaccine

South Africa has secured 1.5-million doses of the Oxford/AstraZeneca vaccine against Covid-19 from India’s Serum Institute (SII) for delivery this month, Health Minister Zweli Mkhize announced on Thursday.

Mkhize said the first million doses would arrive in January, the remainder in February, and that South Africa’s roughly 1.25-million health care workers in public and private facilities would be first in line to receive the vaccine.

To avoid delays in the vaccine’s regulatory process and rollout, local authorities would partly rely on the groundwork done in other countries where the drug has been approved and administered.

“We are happy that the SII/AstraZeneca vaccine has already been approved by various regulators and is being rolled out in other countries. Therefore, as part of expediting the regulatory process, the South African Health Products Regulatory Authority (SAHPRA) is applying reliance on that regulatory work,” the minister said in a statement after breaking the news to Parliament’s portfolio committee on health.

The vaccine has been acquired directly by the department of health to bolster the credibility of the negotiations and the government was settling payment directly with the manufacturer, he added.

This decision was motivated in part by the lessons learnt while procuring personal protective equipment last year during the pandemic’s early days. But the SII has also decided not to supply the vaccine to the private market at this point.

Mkhize has come under intense fire in the past fortnight over the government’s failure to move at speed on vaccination as daily increases in infection numbers dwarf those seen during the pandemic’s first wave.

A record high of 21 832 new infections in 24 hours was reported on Wednesday evening amid growing evidence that the virus’s latest variant is more infectious.

Mkhize acknowledged the criticism but again demurred that non-disclosure clauses in negotiations with suppliers had so far prevented the government from shedding more light on its procurement efforts.

“Today, I am pleased to announce that the Serum Institute of India (SII) has given us permission to make a public announcement and start engaging with all relevant stakeholders in preparation for the rollout,” he said.

“As recently as yesterday, our teams from the national department of health and SAHPRA were fine-tuning and aligning all the regulations processes to ensure that there are no unnecessary delays or regulatory impediments to activate this rollout.”

Mkhize said the department of health had begun discussions with all stakeholders to ensure the vaccination programme would proceed smoothly.

On Sunday evening, the minister had given the department’s vaccination target as 67% of the population by the end of the year, with a promise to prioritise healthcare workers in the first stage of the rollout, followed by the elderly, essential workers and those with comorbidities in the second. 

But until Thursday’s announcement, the only other agreement South Africa had in hand was that with the Covax global vaccine initiative, which had committed to supplying the country by April at the earliest. The Oxford/AstraZeneca vaccine has the logistical advantage of temperature stability and requires storage at 2-8°C, compared to Pfizer/BioNTech which needs to be preserved at -70°C.

The department of health did not immediately respond to an inquiry as to whether the volume of vaccine doses negotiated with the SII would mean that, for now at least, South Africa would not be able to give health care workers the required two shots.

But Alex van den Heever from the Wits School of Governance commented that to have enough doses to ensure complete vaccination of the country’s health care workers, the government would have needed to secure another million doses.

“What this suggests is that they asked for 2.5-million and the SII gave them 1.5-million,” he said.

“That is the kind of result you get when you go into negotiations with a begging bowl. 

“We have been given some scraps by India. But if they had begun talks in June, they would have a different result and they would have been able to meet their target.”

Van den Heever said he believed that the UK government, which has ordered 100 million doses of the vaccine, would have secured an agreement for this volume because it signalled its interest months ago.

Further, he said, the fact that the regulatory process was being expedited suggested that AstroZeneca had no reason to apply for approval because South Africa had not opened a bilateral negotiation process to procure its vaccine.

Van den Heever deduced that the deal Mkhize announced on Thursday was the result of a scramble driven by the public outcry over delays in developing a solid vaccine strategy. It meant however that the health department went knocking on the door at a time when the SII had taken a position of reserving most of its stock for India.

But, he added, it also showed that public pressure had an impact and “that we should keep up the pressure”.

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