South Africa: Country in need of a miracle

The deadly new mutant variant of Covid-19 continues to wreak havoc with new records on fatalities seemingly being established every week. The vaccination programme at this stage appears at sixes and sevens and salvaging the economy will require a miracle. Is there one around the corner, asks Mushtak Parker.

It’s almost as if Covid-19 is mocking humanity, degenerating into a hideous parade of mutant variants in the middle of a second wave of infections more contagious than the first.

The sources of the latest variants are the UK and South Africa. The two are unrelated, with the South African variant (501.V2) considered to be much more transmissible and potentially less vulnerable against the vaccines now being rolled out in the US and Europe.

For South Africa’s President Cyril Ramaphosa, Covid-19 mitigation will continue to define his government and the country’s prospects in 2021. He gained much kudos for his decisive response to the initial stage of the pandemic last March but 10 months is a very long time in South African politics at the best of times – and these are not those.

South Africa ranks 16th in the WHO’s list of confirmed Covid-19 cases – with a cumulative 1.4m infections in late January 2021 and over 40,000 deaths.

The surge precipitated a tougher lockdown regime which is difficult to maintain, given that it is mid-summer and mask-wearing and social distancing protocols are being openly flouted by some – especially the young. The virus in South Africa, according to the WHO, is largely spread through community transmission.

Globally, 85m Covid-19 cases have been confirmed, with over 2.1m deaths and rising – especially in North and South America and Europe.

Ramaphosa’s earlier policy gains have degenerated into an embarrassing failure on South Africa’s vaccine rollout strategy. This raises questions about his style of crisis management, which hitherto has been based on political consensus – admirable under normal circumstances, but these are not normal circumstances.

On 3 January, health minister Dr Zweli Mkhize, flanked by officials of his Ministerial Advisory Committee on Vaccines, announced that “the government has set up structures to expedite the financing, sourcing and procurement of a vaccine for Covid-19.”

The statement was predictably heavy on aspiration and light on transparency. It gave no details of procurement contracts, suppliers, volumes or delivery dates.

South African scientist Prof Shabir Madhi has led local trials for the Oxford-AstraZeneca vaccine while others were involved with the Johnson & Johnson one. For some inexplicable reason, the Department of Health failed to secure any orders from both.

Nine-month delay

South Africa has a respected genomics capability which has mapped a motley of Covid-19 mutations. It has a depth of available knowledge about the efficacy and safety of several leading vaccine candidates being trialled and evaluated.

Despite this, it became apparent by the New Year that the government’s vaccine rollout strategy, incredibly, was limited to dependence on the global COVAX facility, meant for the poorest nations on earth. COVAX is one of three pillars of the Access to Covid-19 Tools (ACT) Accelerator, which was launched in April by the WHO, the European Commission and France in response to this pandemic.

“At this stage we have secured the doses that will be acquired through COVAX, which will ensure that we immunise 10% of the population through this mechanism,” said Mkhize.

The vaccine supply through this facility could take up to nine months to arrive, which would mean South Africans having to wait that long for any vaccination programme to begin.

This prompted nine prominent frontline healthcare professionals, including Prof Glenda Gray, President of the SA Medical Research Council and Dr Aslam Dasoo, Convenor of the Progressive Health Forum, to speak out.

In an open letter, they warned of “the stunning reality that the Department of Health has neither a secured vaccine supply nor a plan for mass inoculation in the foreseeable future that can withstand scrutiny. This portends for this country the worst ravages of Covid-19 in the year ahead.”

They called for heads to roll for this “perilous fiasco” and for a reprioritisation of the government’s vaccine procurement strategy.

Frans Cronje, CEO of the independent think-tank, the Institute of Race Relations, warned that “South Africa is being left behind as advanced and emerging economies begin to vaccinate their populations. South Africa, including with support from its private sector, could easily and rapidly finance vaccine procurement. If it does not do so urgently then the human and economic toll of the virus on the country will be further catastrophically exacerbated.”

But, following legal action by NGOs to force the government to make public the details of its vaccine roll-out strategy, Mkhize in a U-turn confirmed in an update on 7 January that he had “been given permission” by the Serum Institute of India (SII), despite confidentiality clauses, to do so. SII is manufacturing the AstraZeneca vaccine under licence.

“We have estimated 1.25m health care workers, both from the public and private sectors, can be prioritised. South Africa will be receiving 1m doses in January and 500,000 doses in February from the SII. 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, South African Health Products Regulatory Authority (SAHPRA) is applying reliance on that regulatory work. The acquisition has been done directly by the Department of Health,” he added.

The global COVAX facility that South Africa is a part of involves countries pooling their resources to support the development of effective vaccines, with a view to ensuring that all countries receive an equitable supply.

“We will receive vaccine doses for around 10 per cent of our population through COVAX,” reiterated President Ramaphosa on 11 January. “While there are several promising negotiations with a number of different manufacturers that still need to be concluded, we have to date secured 20m doses, to be delivered mainly in the first half of the year.”

Misjudged mood

However, he perhaps misjudged the mood in the country when he invoked the spirit of ubuntu, claiming that “in the face of this unprecedented crisis, South Africans have demonstrated the true meaning of ubuntu”.

While this may be true of South Africans in general, many feel that successive ANC governments, especially the Zuma presidency, have betrayed this spirit, so evocatively personified by Nelson Mandela in 1994.

Ubuntu, according to Archbishop Desmond Tutu, literally means “I am because we are. It is an approach to life that speaks to the very essence of being human. My humanity is inextricably bound up in yours.”

Activists claim that the concept has been hijacked and commercialised and made bereft of its meaning of human dignity and recognising the other.

If Covid-19 is to be a rallying point for a resurgent sense of ubuntu, amidst the corruption of pandemic profiteering and economic paralysis, then says the current Archbishop of Cape Town, Thabo Makgoba, it has to involve a rediscovery of “who we are” and lead us away from individualism and greed.

Headaches for finance minister

To South Africans, any new normal in 2021 may be as painful as the ‘old’ normal, with measures of inequality, including income, remaining at some of the highest rates globally.

The socio-economic fundamentals make uneasy reading: a deeper than anticipated recession; a projected GDP contraction of 8.2% for 2020; gross national debt forecast to top R4trn ($270bn; 81.8% of GDP) by the end of 2020/21; rising unemployment at 30.1%, with youth joblessness touching 50%; the highest incidence of HIV infections in the world; a high crime rate; one of the highest incidences of gender-based violence; a ratings downgrade to ‘junk bond’ status; and entrenched corruption.

As such, 2021 will be consumed by Covid-19 containment, which leaves little room for short-term economic recovery, let alone longer-term planning. Finance minister Tito Mboweni can’t raise much-needed revenues through higher taxes if people are out of work, or SMEs gone bust and the cost of living is rising. His option is to borrow even more but the downside is an even higher debt servicing burden.

He can implore corporate South Africa to invest more, lure foreign investors, change the law to make it easier for pension funds to increase investment in the economy, or continue to cross the ANC red line by going to the IMF for more funding.

If Ramaphosa can rein in corruption and denialism at home, he can take advantage of positive developments abroad. The accession of US President Joe Biden, a conducive US Fed interest rate policy, the newly signed EU-UK trade deal, China’s economic recovery, and a  rebound in world commodity prices could impact positively on a global Covid-19 vaccination implementation. This in turn could kick-start the pace of global economic recovery and its knock-on effects on the South African economy.

The big challenge for Mboweni will come in April when he has to negotiate a new round of public sector wage agreement with the unions. He plans to freeze wages for the next three years by cutting the wage bill of a bloated state sector by $9.6bn. For the past 5 years, these wages grew by 7.2% a year on average.

South Africa’s future is weighed down by its contradictions – righting the wrongs of the Apartheid era, with unrealistic expectations in the democratic era; a governing party racked by factionalism; the question of introducing legitimate land reforms without resorting to expropriation without compensation; and of partnering with the private sector without the threat of prescribed assets!

Another test will come later this year when local elections are due. In the past, the ANC has shown remarkable resilience and maintained voter loyalty. Despite Ramaphosa inheriting a state steeped in kleptocracy, and society still being defined by the politics of race, inequality and violence – 26 years into democracy – it would be foolhardy to write off the ANC.

Only time will tell whether an opportunistic pathogen becomes a game-changer in the South African polity!