Business can give Covid vaccine roll-out a big booster shot

28 May 2021

The sector has added muscle to the Phase 2 roll-out effort in the hope that a public-private partnership proves to be the secret ingredient to fight the virus.

Public sector vaccination sites went into ramp-up mode this week as dozens more came on stream. The aim is to meet the government’s target of 3,300 operational sites.

The business sector’s push to get vaccines into arms comes down to the bottom line: reviving a hurting economy during a pandemic starts with keeping more people alive.

But week two of the national roll-out still had glitches. Only about 1.6 million people are currently registered on the Electronic Vaccination Data System (EVDS). According to Statistics South Africa’s 2019 data there are about 4.6 million people in the country who are over the age of 60.

On average only about 28,000 people a day were vaccinated over seven days ending at midnight on Wednesday. It’s a massive shortfall. The government target for population immunity is 250,000 a day, or 16 million vaccinated by the end of the year.

More hiccups came this week when the EVDS, which the business sector under Business for South Africa (B4SA) helped set up, suffered a temporary shutdown. There’s also been confusion over the SMS appointment slots, questions over where and if walk-ins are accepted and some hits and misses on vaccine stock level management at the various sites – with some running out and others having so few feet through the doors they didn’t meet their daily targets. There has also been outrage over queue jumpers and deepening worry over thousands of people being left behind because they don’t have data, internet access or help to get registered. There’s also still vaccine hesitancy and distrust in the government’s ability to get the job done safely and effectively.

These are “teething problems, but given the circumstances I think we’ve been doing extremely well”, says Martin Kingston, chairperson of the steering committee of B4SA, which was set up from Business Unity South Africa structures as the pandemic hit in March 2020. Since September, B4SA has focused on supporting the government’s vaccine roll-out in Phase 2.

The nuts and bolts of the business sector effort have been an informal partnership – a mighty collaboration that has leaned on business’ resources, networks, technologies, skills and less clunky processes compared with government red tape.

The B4SA network for the vaccine roll-out has been broad – from medical aid schemes and pharmaceutical chains, to doctors through doctors’ associations, hospitals and even larger employers who might in future be accredited to vaccinate their employees, customers and clients.

As Kingston says, the reality is that the roll-out will probably continue into the first part of 2022 and possibly beyond.

“The most important thing we could do with the government was to assist in combating vaccine hesitancy by ensuring that people would register through the electronic vaccination registration system, turn up to receive the vaccination and actually be administered a vaccination,” he says.

“There is no profit in this. If there is profit it’s by manufacturers of the vaccine. The government, through the taxpayer, is paying for the vaccine at a fixed price and the government is paying for the logistics and distribution costs. This is a government-led show, with business putting its shoulder to the wheel to partner with the government. That’s the model.”

The lesson is that the government and the private sector need each other if we are going to make public health a priority.

The pandemic may be a wake-up call even for business. Corporate citizenship is more than a tick-box exercise, and short-term exploitation for maximum profit only sets economic recovery further back.

The mountain to climb for the vaccine roll-out does come against a backdrop of the huge economic challenge, in numbers business knows well: gross domestic product shrank by 7% in 2020 – after 2019 ended in a recession. Official Stats SA data for unemployment by the fourth quarter of 2020 stood at a record-high 32.5%.

Now, though, there are other numbers to consider, including more than 56,000 people dead from Covid-19-related complications, possibly more than double that given excess deaths. There is also a huge number of long-Covid sufferers who are not back to full productivity, and a mental health burden still to be counted from grief, anxiety, isolation and a sense of hopelessness in trying to survive the coronavirus.

Lizeth Kruger, clinical manager at Dis-Chem Pharmacies, says getting people vaccinated is “getting people back to work and giving people jobs so we can get the economy going again”.

But jobs are just one aspect, the public health imperative is paramount, she says. Dis-Chem is accredited to set up 11 mass vaccination sites that will become operational in phases, no later than the second week of June.

“The lesson is that the government and the private sector need each other if we are going to make public health a priority,” Kruger says.

Dis-Chem aims to vaccinate 500 people a day at each of the 11 sites. It will mean 20,000 daily, she says.

Accreditation is a regulatory requirement because it involves administering a vaccine that is a schedule 4 drug.

Dis-Chem’s sites will run separately from its main businesses and clinics. Kruger says getting these sites ready has come with “substantial financial output”, though she didn’t give exact figures. It had involved negotiating the use of open spaces in malls, ensuring they had the right freezer and refrigeration units to store the government-procured Pfizer vaccine. Extra nursing sisters and vaccinators needed to be trained to do the job under the Dis-Chem banner.

At just over a week in, Kruger says, “it’s been long hours for all of us but this what you do to fight a pandemic. It’s been a learning curve for the government and the private sector, but a good learning curve and trust is being built.”

Vaccines and Covid-19 testing are going to be part of future business, that’s already clear. Still not a money spinner though, Kruger insists. But already products are coming to market to offer cheaper Covid-19 tests that are as reliable as the current R850 PCR test that the pharmacy group offers.

By midweek about 6.4 million tests in the private sector had been conducted. But Kruger says Dis-Chem’s take is only about 10% of the R850 PCR test cost. This covers PPE costs, test kits, handling samples and the nursing sister’s salary. The bulk of the cost comes from laboratory test fees, she says.

Planning for the future costs of Covid-19, “even without a blueprint”, is top of mind for Lee Callakoppen, principal officer for Bonitas Medical Fund. He says: “We estimate the vaccine costs will be around 0.9% to 1.7% of annual contributions and we have set aside R320-million for this. The final costs will depend on the vaccines allocated to members (Pfizer versus Johnson & Johnson) and also the take-up.”

He added that the government had announced the costing of the vaccines to medical aids earlier in the month. Each Pfizer dose is charged at R345.75, with two doses needed, and each J&J shot at R330 with an R80.50 admin fee to cover the cost of vaccinators and consumables.

Callakoppen says that while there was initial frustration in defining the role of private medical schemes, the fact that the Phase 2 roll-out has begun shows that “perseverance pays” to get businesses, the government and the public aligned to a common goal.

Bonitas has applied to run 30 accredited vaccination sites across the country. Its first mass vaccination site opened in Roodepoort and inoculated 440 people on its first day. DM/MC

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