Coronavirus: South Africa rolls out vaccination programme

South Africa has started Covid-19 vaccinations following the suspension of an earlier plan to use the Oxford-AstraZeneca vaccine.

More than a third of all Covid-19 cases in Africa have been in South Africa, with a new variant of the virus accounting for most of the new cases there.

South Africa is using the Johnson & Johnson vaccine which is administered as a single dose.

The country has received 80,000 doses of this vaccine, which has been shown to be effective against the variant first identified in South Africa.

President Cyril Ramaphosa says the country has secured nine million doses in total, and more doses are expected.

Pfizer has also committed 20 million vaccine doses, with deliveries expected at the end of the first quarter of this year.

Early in February, the country received one million doses of the Oxford-AstraZeneca vaccine from India.

However, it put the roll out of these on hold, following a study that showed "disappointing" results against the country's new Covid-19 strain.

The country is now considering administering the vaccine to 100,000 people to monitor its impact before deciding if it should be used more widely.

South Africa says it has so far secured enough doses for the target population of 40 million.

However, there has been criticism that the government was too slow to act.

Apart from bilateral deals with manufacturers, South Africa is sourcing vaccines from the World Health Organization-backed Covax scheme, as well as through an African Union programme.

Covax is a global initiative in which countries pool their resources to support the development of vaccines with a view to ensure that all countries receive a fair supply of effective vaccines.

South Africa expects to acquire doses for around 10% of the population - 12 million vaccine doses - through Covax and has been told it will receive them from April through to June.

The African Union established the African vaccine acquisition task team last year to source vaccine doses for the continent.

There's been concern that many poorer, less-developed countries are being left behind in the global competition to secure vaccine supplies.

However, critics suggest that South Africa - as the richest country in Africa - should not have been in this position.

"The stunning reality is that [South Africa] has neither a secured vaccine supply nor a plan for mass inoculation in the foreseeable future that can withstand scrutiny," the Progressive Health Forum, a group of leading medical experts in the country, said in January.

The opposition Democratic Alliance had earlier called on the government to give full details of its negotiations with vaccine suppliers, accusing the government of "dropping the ball".

It claims the government only started to talk to vaccine suppliers in early January.

And it's also emerged that South Africa will pay more than twice the price for AstraZeneca vaccines than countries in Europe.

Dr Anban Pillay, deputy director-general at the Ministry of Health, says the country was in touch with manufacturers as far back as last September.

"The vaccines that most of the other countries have procured are vaccines that may not be ideal for South Africa from various perspectives," he has said.

He said the Pfizer-BioNTech vaccine wouldn't be appropriate for mass vaccination, often in remote rural areas, due to its storage requirements of -70C.

And he added that the ministerial advisory committee advised against using this vaccine.

"We were waiting for the other vaccines that we can use as a mass rollout campaign, and those vaccines had not come through the production line yet," he said.

He also said some countries have gone ahead with some vaccines without completed clinical trial data, which wouldn't be allowed by the regulator in South Africa.

The government says it couldn't have signed deals early without knowing whether the vaccines were safe and effective, as this would have been in contravention of national financial laws.

Wealthy countries, such as the UK and others, signed deals for prospective vaccines as early as July last year while they were still in development and undergoing trials.

And countries who can afford to pay most at the earliest stage of development and production can often secure an advantage, according to experts.

South Africa did take part in a trial for the Oxford-AstraZeneca vaccine starting in July last year, and involving some 2,000 people.

It's unclear whether or not the authorities used this to begin negotiating for supplies from the manufacturer.

Research by Duke University in the US tracking advance vaccine commitments by country shows that the majority of doses purchased so far have been for high income countries.

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