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How will the private sector support the South African government to vaccinate 40 million citizens?  

February 16, 2021

South Africans have been subject to the COVID-19 pandemic for almost a year. Many people have lost loved ones and the economic impact has been devasting on all of us. The fact that multiple vaccines have been developed has been heartening news and most of us wait eagerly for the day that we can finally have the "jab". Scientists say that at least 40 million South Africans must be vaccinated in order to achieve herd immunity. 

As South Africa prepares to start implementing its plan for vaccinating the nation, this would be by far one of the most ambitious and largest projects undertaken by government. The news that the initial Astra Zeneca vaccine that was procured for front line healthcare workers is ineffective against the COVID-19 variant 501.V2 has created some controversy. Notwithstanding this, plans for vaccinating the nation continues and this article addresses some of the challenges and proposes how the effort will be supported by private healthcare in South Africa.

The cost of this effort as estimated by Prof Alex van den Heever from the Wits School of Governance is R8,6 Billion[1]. The fact that the COVID-19 vaccine has been registered as a prescribed minimum benefit (PMB) means that the medical schemes will pay for part of the total cost. With a sophisticated network of facilities and staff, it is clear that the private health sector will play a large role in assisting the state to effectively enable us to reach herd immunity. 

The plans for vaccinating the nation is designed to be carried out in phases. The Department of Health (DoH) has outlined in broad terms a prioritisation strategy for rolling out a COVID-19 vaccine programme for South Africa. This involves three broad phases[2].

Phase 1 focuses on frontline health workers, including support staff and community health workers. The Department of Health (DOH) indicates this number at 1.25 million or 2.1% of the total population.

Phase 2 focuses on high risk groups, including the aged and people with comorbidities. Broadly speaking, this could amount to about five million people or 8.3% of the total population.

Phase 3 focuses on the rest of the adult population, excluding persons under the age of 16. The young are excluded as the vaccine trials did not cover them. Broadly speaking, this amounts to about 35.8 million people or 59.6% of the total population.

Government has launched a scheduling tool called Electronic Vaccination Data System (EVDS). This system will enable self-registration by healthcare workers (initially) and then all citizens. The high-level processes will include a notification and an administration system (see figure 1):

FIGURE 1

Other than information shared with the press, very little else is known about the EVDS. This system would have to have many components linked to it to make it effective. There are many questions that we don’t have answers for. These are important so that the process can be well managed. Some of these questions include:

  • Verification of the subject's information.  Will this be done by checking against the Home Affairs (HANIS) database? How will verification take place if the data is not on HANIS?
  • How will citizens be classified in relation to age, co-morbidities etc? This information is essential for scheduling high risk individuals as part of the Phase Two initiative
  • How will EVDS distinguish between a citizen that is covered by private healthcare insurance?
  • How will citizens be routed to the nearest vaccine facility?

We feel that this is a great opportunity for the DoH to use this opportunity to create a registry and allocate a master patient identifier (MPI) to each citizen. This will be valuable for the creation of a nationwide health information exchange (HIE) which will bring in many benefits for patient care and ongoing continuity of care across the health system.

We at CGM South Africa are following the developments of the proposed rollout so that we can enable our solutions to be able to support the effort.

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