Question $2($Marks: $30)$

Read the case study below and answer question $2.$

South Africa has the highest number of Covid$-19$ cases on the African continent. It has more than $500000$ reported deaths. This may be an underestimate, looking at excess death statistics. The economic cost of the pandemic is evident on the streets and healthcare facilities have been under considerable strain during the waves of the pandemic. It was with much relief, elation, and a renewed sense of hope that many healthcare workers enrolled in the Johnson and Johnson vaccination trial mid$-$February and received their much$-$anticipated vaccination.

But the relief and elation has given way to frustration and disillusionment.

The country$$s rollout is proceeding at a pace much slower than expected. To date just over $293,000$ South Africans have had their jab, which represents only a fraction of the $1,25$ million healthcare workers who are first in line. This adds up to about $0\mathrm{.}5\%$ of the general population. The initial target of having $67\%$ of the country$$s citizens vaccinated by the end of $2021$ is now unlikely to be achieved. At the current vaccination pace, it will take over a decade for South Africa to reach herd immunity, with many lives lost along the way.

Amongst other issues, an additional factor was South Africa$$s slow start. The government has been criticised for not actively engaging in vaccine procurement through other avenues at an earlier stage. On top of this, there has been a series of problems with vaccines South Africa managed to secure$.$ And the evolution of new variants and uncertainties around the efficacy of vaccines to emerging variants has slowed the country$$s efforts to overcome this pandemic through prevention.

Another big issue that is likely to slow down the momentum of the country$$s vaccination programme is vaccine mistrust. In a survey done by the University of Johannesburg, up to a third of South Africans said that they would refuse a COVID$-19$ vaccine if it was offered to them.

This could be echoing a deterioration in trust in the handling of the pandemic. Misinformation, exaggeration, and de$-$contextualisation of facts on various social media platforms have led to a large degree of vaccine mistrust among people. Aside from conspiracy theories and grossly inaccurate misrepresentations of facts, there is an increasing mistrust in science, pharmaceutical companies, and authorities.

Balancing efficacy, safety, storage requirements and sustainability when it comes to vaccine selection is no easy task. But some countries have managed it better than others. South Africa is one of the countries that is lagging far behind. The human and economic cost of passively allowing the pandemic to run its course in an era where vaccines are available is unacceptable.

In addition, the emergence of variants is a compelling reason to step up vaccination efforts. Suboptimal levels of immunity will mean more people get ill and die. It will also increase the likelihood of new variants emerging. The South African government needs to shift gear on several fronts. It needs to make vaccine procurement a budget priority and procure more vaccines.

Secondly, it needs to clarify urgently what the requirements are for the involvement of private medical providers in the vaccine rollout. It also needs to expand the number of platforms $($such as local clinics, GP practices, pharmacies, and private and state facilities$)$ on which the vaccines are rolled out. If ever there was a need for public$-$private collaboration it is now $$ both in terms of funding vaccines and in providing platforms. This would enable large$-$scale vaccination to occur at the pace needed to turn the tide against COVID$-19$ in South Africa. The government also needs to do more to raise public awareness and dispel myths at community level. Clearly this will have to be a collaborative effort between all stakeholders $$ from international efforts for equity, to engagement by the pharmaceutical industry, procurement by government, the involvement of private sector players and widespread information and education of the public.

The Conversation $(2021)$The reasons South Africa$$s COVID$-19$ vaccine programme looks bleak$,26$ April. Available at: The reasons South Africa's COVID$-19$ vaccine programme looks bleak $($theconversation$.$com$).[$Accessed on $28$ January $2024].$

Q$\mathrm{.}2\mathrm{.}1$ Examine the COVID$-19$ vaccination rollout case study in South Africa, paying particular attention to the crucial stakeholder management issues that need to be resolved in order to speed up the immunisation programme. Examine matters concerning a range of stakeholders, including the general public, medical experts, pharmaceutical companies, government agencies, and for$-$profit hospitals. Examine issues with vaccination scepticism, purchasing, and public awareness; suggest tactics for productive stakeholder cooperation. Create a plan of action and give a thorough explanation for it$,$ backed up with facts from case study