Sat, 27 Feb 2021

It must take an incredible amount of self-belief for a newspaperman to cold-call a contact at a pharmaceuticals company and ask if there are vaccines for a country - in the middle of a global pandemic. I can only imagine what kind of things I could have done in my life with that kind of superpower. I would probably just ask the South Africa-born Moderna representative nicely to spot me a dose after a little chat about the Springboks, since, as Peter Bruce's column suggested, there are lots of doses and the government just doesn't want to buy.

On Monday, Stella Kyriakides, the EU's health commissioner, expressed frustration at AstraZeneca's behaviour following delays in the delivery of Covid-19 vaccines. This, after the EU was informed that there would be significant shortfalls on the promised delivery schedule. The EU is so enraged, it has threatened to block Covid vaccine exports.

On Tuesday, President Cyril Ramaphosa decried wealthy countries for hoarding excess Covid-19 vaccines, imploring that the world needed to act together to fight the pandemic. The president's words followed Director-General of the World Health Organisation (WHO), Dr Tedros Adhanom Ghebreyesus', much stronger warning of a "catastrophic moral failure" in how rich countries were dealing with vaccine distribution.

Ghebreyesus said: "We now face the real danger that even as vaccines bring hope to some, they become another brick in the wall of inequality between the world's haves and have-nots."

Vaccine supply has concerned the WHO for some time. Rich nations, with cash on hand, were able to invest considerably in supporting multiple R&D efforts aiming to develop a vaccine in record time.

Bruce and his followers may have forgotten, but a year ago, no one knew that any of the projects would be a success. It's easy to look back now and wonder why South Africa isn't at the front of the line, but had South Africa invested in projects which yielded no vaccines, we would be having another type of "government incompetence" discussion.

Public policy experts use the term, "wicked problems", to describe complex problems where the nature and the solutions for the problems are deeply contested. These problems are difficult to solve because of divergence of goals, moving parts, information asymmetry, and coordination problems created because of multiple stakeholders all bringing different contexts, priorities, and power relations to the problem.

South African policymakers, for example, come into this pandemic with a very particular context. This country allocated about 13% of its total government expenditure on health, and health spending contributes around 4% of the total GDP. Over 80% of citizens received health services in the public sector, but only 50% of health spending is allocated to the public sector. The 20/21 budget projected a budget deficit of around 6.8% of GDP - before the pandemic lead to a sharp decline in the economic outlook. South Africa is an upper-middle-income country with a GNI per capita of 12 670 USD.

National Treasury is concerned with short-term affordability. The health department knows that there is an immediate cost in hospital admissions and loss of life - and the long-term costs to the health system, given the long-term effects of this virus on survivors, the pharmaceuticals companies view South Africa as a higher income country, that didn't contribute to R&D, and is charging it higher rates than contributors and poorer countries.

It can be true that buying vaccines is a "no-brainer", and it can also be true that finding the money to buy the vaccines is a process that takes time. It can be true that 200 billion rand is a small portion of a 1.8 trillion-rand budget. But those figures are allocated next to important public programmes that have been committed to in Parliament. Finding this money is not a matter of finding a bank account which it could be setting, but actually the slow process of changing annual performance plans.

There is no denying that the South African government has not always been at its best when handling this crisis. Communication from the government, particularly the Presidency, has been very poor, intermittent and has often failed to address the most pressing questions.

Often, updates have come from pressure that members of the media applied on the government to communicate. But many of these public thought leaders, particularly Peter Bruce, have also been detractors of government policies regardless of the circumstances or the science. Bruce has used his platform to argue against all manner of government intervention to contain this virus, at some point labelling support for the alcohol ban as "wokeism", the bottom of the lazy barrel retort. In his attempt to gain back favour from those he scorned when he endorsed Cyril Ramaphosa, he has become click baiter to atone.

If this were not a pandemic, these simplistic arguments built for crowd-pleasing would just be part of the scene. But this is a pandemic. Ill-conceived populist ideas from people with large audiences hurt readers and citizens because they give them the false impression that we are dealing with simple problems, instead of wicked problems.

After spending most of last year pushing ideas that would make SA's caseload higher, Bruce pushing a perception that vaccines have been produced and are sitting in some storeroom waiting for someone to make a call and make an order - that's not how this industry works. If it were so, the EU would not be making threats to AstraZeneca and Pfizer to protect the vaccines they were promised.

Source: News24

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