Blog

The year 2021 did not have an easy start in the region. First, we met the new year with Cyclone Eloise in Mozambique, followed swiftly by the crisis in Cabo Delgado and surrounding provinces in Mozambique. COVID19 still rapidly spreads across the region as we speak, with a variant that is more deadly than ever. We also welcomed the arrival of vaccines to the continent and we now face governments crumbling under the pressure of the raging virus, healthcare crumbling with little to no resources and their slow roll-out programme across the region. Governments cannot squarely face the blame when you take into account that the countries with access to the most vaccines per capita are the countries in the global west that have enough vaccines to go around without this vindictive hoarding of vaccines. This in itself is a crime against humanity. The call for vaccines, clear narratives of the impact that the vaccines may have on those who have access to it and clearing out of Government corruption, is a high priority for us at the Rural Women\’s Assembly. 

We have been aligning with the People\’s Vaccine Campaign who draws from global movements like the People’s Vaccine Alliance and Free the Vaccine,  to call on the South African government for urgent focus on and mobilisation around equitable vaccine access and allocation. Since the arrival of our vaccines in the respective countries, the danger remains that elites, powerful or dominant medical schemes, private healthcare providers and other corporate interests will undermine access, through growing disparities in our two-tiered health care system particular in South Africa. The support towards access for rural women and children is our particular focus and to make sure that this is a matter that is centralised across the region.

To date, the Rural Women\’s Assembly is mobilizing rural communities to take up the vaccine and to make sure that access and quality treatment are given to rural communities that have generally marginalised access to healthcare.  In the current state of events across the region, we can only keep putting pressure on governments and make sure we align for a broad-based approach to access for all in the Global South. 

Namibia

WITH the third wave of the Covid-19 pandemic in full swing, demand for vaccination in Namibia is still very low; only about 110 600 Namibians received at least one dose and around 21 500 are fully vaccinated so far.

This has forced many to reflect on possible causes of vaccine hesitancy among the Namibian population.

Yet, across the globe evidence demonstrates that vaccines are one of the most successful and cost-effective interventions known to improve health outcomes. Vaccines save lives, improve health, and protect livelihoods, but only if they are used.

High vaccine uptake is dependent on several factors. The most basic requirements include an understanding of the need and value of vaccination, the availability of vaccines, as well as accessible immunisation services.

Namibia has vaccines available (that may change as poorer countries continue to struggle to get access to enough vaccines) and it has accessible immunisation services. Yet, a recent survey showed that slightly more than half (51%) the adult population is unlikely to get vaccinated.

Understanding vaccine hesitancy is a complex task because so many variables play a part in individuals\’ and communities\’ decision to delay or reject vaccination. The following are some of the features of vaccination hesitancy in Namibia.

Vaccine hesitancy is not equally spread among all the regions. Regions in which respondents report a higher likelihood of getting vaccinated include Kavango East, Zambezi, Omusati, Kunene, Oshana, Kavango West, //Kharas and Otjozondjupa. Except for Oshana, these are regions with predominantly rural populations.

Vaccine hesitancy is higher among women than among men. More than 55% of women indicated that they are unlikely to get vaccinated, whereas 47% of men did the same.

Men are more likely to get vaccinated in ten of the country\’s regions. The gender gap for vaccine hesitancy is largest in Zambezi, //Kharas and Kavango East. Here the likelihood of getting vaccinated among men exceeds that of women with more than 20 percentage points. More research is needed to understand why this gender gap exists.

There is more vaccine hesitancy among the youngest (18-35 years) and the oldest respondents (65+ years) in the sample. This may suggest that these age cohorts do not find the current vaccine promotion messages engaging enough for them to respond to it.

Urban respondents have higher vaccine hesitancy (54%) than rural respondents (48%).

Vaccine hesitancy is closely correlated to dimensions of trust. Those who show hesitancy are less likely to trust the government\’s Covid-19 statistics (64%) than those who have less hesitancy (53%). Those with vaccine hesitancy believe levels of corruption during the pandemic higher (53%) than those without hesitancy (39%).

Trust in the government to ensure that the vaccines are safe is lowest among those with hesitancy (82% trust government “not at all” or “just a little”) compared to those without hesitancy (52%) who felt the same way. Some 62% of those with hesitancy are very worried that an unsafe vaccine will be tested on Namibian citizens, while only 45% of those without hesitancy felt the same way.

Vaccine hesitancy is a complex problem that can be understood through further research on issues such as belief systems, attitudes, perceived risks, actual experiences and communication and the media environment. The variances in vaccine hesitancy call for vaccine messages that speak directly to each of the groups with strong vaccine hesitancy.

Rural communities have more trust in home remedies (herbs that heals) than vaccines.

Zimbabwe

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The state of COVID 19 Vaccine in Zimbabwe as of 23 June 2021

Zimbabwe began the year 2021 (January and February) under level 1 national lockdown (strict lockdown) due to the increase in COVID-19 positive cases. According to Zimbabwe Ministry of Health and Child Care, as of week ending 19 June 2021, the nation had 42 714 cumulative cases and 1691 cumulative death. The country received its first doses of vaccines and launched its COVID 19 vaccination programme in February 2021.

 COVID 19 Vaccination programme in Zimbabwe

In the initial plan the first group of people who were to receive the first doses were the essential workers and the elderly. However due to the low uptake of the vaccine, the vaccination process was opened to everyone. The most common vaccines in the country is the Sinopharm and Sinovac vaccines. The government used its hospitals, clinics, health centres and some public places in the CBDs as the vaccination points. The rural women accessed the vaccine from their local clinics and their local health centres.

When the vaccine was launched in February and March there was a low uptake and mixed feelings about the vaccine due to lack of trust in science, efficacy and lack of information on vaccines.

• Those vaccinated will die after 2 years
• The vaccine is linked to the religious belief of satanism (666)
• Those vaccinated will have different side effects which include chronic diseases and blood clots

In May 2021, the uptake of the vaccine began to increase as people had monitored those who were vaccinated to have not experienced any side effects of any sort.

To date most of the clinics and hospitals are out of the vaccine and the demand of the vaccine has increased. In most centres the people are registered in books and queue them for vaccination when the vaccine arrives/when the country receives its next donation/s.

Overally, a cumulative number of 715 056 have received their first dose of vaccination in the country, while the cumulative number for those who got the second dose is 451 793. There are rumours that the country has run out of the second dose with few centres still having it.

Listen to a representative of the Zimbabwe Health Ministry speak in our Regional Vaccine Webinar

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Madagascar

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In Madagascar, initiatives to combat Covid-19 consisted mainly of the observance of barrier gestures and social distancing, as well as the consumption of CVO (Covid Organics), an organic medicine produced locally. There was some hesitation around a vaccination campaign, as the government did not seem to favor laboratory vaccines.

Nonetheless, in early May, the Malagasy government finally began its campaign with the arrival of 250,000 doses of the CoviShield vaccine. However, there has been a lack of enthusiasm and a certain distrust of the Astrazeneca vaccine among the Malagasy population. This is partly due to the vaccine’s bad reputation following the tragic event of a doctor who passed away after he got vaccinated.

In rural areas, on the other hand, we are witnessing a real refusal to be vaccinated. Behind this refusal is a very specific reason: the President has not yet been vaccinated. Rural men and women are convinced that the reason why the President has not gotten the vaccine is that it’s actually harmful and will only make our health condition worse. In addition, there is some fear due to misunderstanding and lack of information in rural areas. People who get vaccinated are shamed by members of their communities. They are cast aside and marginalized, as people believe those who get the vaccine are responsible for aggravating the situation by spreading the virus even more.

The Malagasy government\’s communication strategy is not effective, and the result is that essential information does not reach people in rural areas. As a result, the vaccine is feared by the population. Especially since rural people take their cues from their leaders, and the President of the Republic not getting the vaccine only adds to their narrative that says the vaccine is actually a danger.

Eswatini

Eswatini received 32 000 doses from the COVAX vaccine produced in India, as well as a few doses of the AstraZeneca vaccine in March 2021.  Since then, Eswatini hospitals have been administering these doses to the elderly and the frontline workers, which include health workers. There are concerns reported by the Eswatini Minister of Health, Senator Lizzie Nkosi, about the second dose of the vaccine.  According to the Minister, another 500 000 doses of AstraZeneca is being secured. Though this sounds promising, Eswatini is in crisis and already had 40 citizens shot and killed by the royal soldiers. A vaccine roll-out seems to not supersede the crisis that Eswatini is currently embroiled in. 
It is worth mentioning that the hospital, Luke Commission, has been at the centre of a few vaccine scandals. These remain unaddressed, including the fact that since April those who got the first jab have not received the other jab as the government is failing to purchase vaccines for the people but we received another donation of 14 400 jabs which the country have not yet used.

When speaking to our member Mrs Thab’sile, who got the first jab, about her experience; she said she felt dizzy only on the day but was worried as nobody had communicated to her about the side effects. “Some people were already telling me that it may last for two weeks” said Mrs Thab’sile. Her current concerns are that her return date for the other jab has passed and the health facility is saying they don’t have the vaccines yet.

Lesotho

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The vaccine arrived in Lesotho on the 3^rd March 2021. The Covid-19 vaccination campaign was launched almost immediately, on the 10^th March 2021 at Scott hospital in Maseru district. His Majesty King Letsie III was the first to receive the vaccine. The vaccination campaign was rolled out for all health workers in all districts from 15 March 2021 by the World Health Organisation (WHO).

The second consignment of Covid-19 vaccine was the total of 36 000 doses of Astra Zeneca, as part of a donation made by the republic of France through the COVAX facility, which is expected to vaccinate 394 000 people.

The Lesotho government refuses to authorise Covid-19 vaccines purchases with no grounded reasons. The health ministry has refused to grant the private sector permission to purchase the Russian Sputnik V to fight Covid-19. Minister Semano Sekatle said they could not approve it because it had not been approved for use by the World Health Organisation (WHO).     

Though our government’s making an effort to help people get vaccinated, Basotho are still sceptical about the Covid-19 vaccine. They say the vaccine is going to kill them after two years of getting vaccinated, they also say they will have the 666 dragon sign or they are going to be infected by Covid-19 through when vaccinated. They have mixed feelings about which vaccine is the best to fight the virus and they are saying the virus is fake as it was created by China to depopulate the world.

They would rather opt for traditional medicine than to get vaccinated. This is because there is not much awareness raised about the virus in the country. Most of the information is shared on the internet and radio stations, which most of the people in the rural areas do not have access to, and creates stereotypes around the virus and vaccines. It has gone to an extend that the people who live in rural areas think the virus is affects  people who live in urban areas only.

The vaccination roll out has only reached 36 000 people who have received who are believed to have received their 1^st and 2^nd jabs. Most of these people are front line workers mostly in the urban areas. Now we are experiencing the 3^rd wave in the country and there is no vaccine for the citizens not even proper places for isolation, as most people who have symptoms are diagnosed  with the COVID-19, are told to go back home and treat themselves.

Because of all these we see:

• A Covid-19 outbreak at Leribe schools and villages.
• The National Health Training Centre suspending 2021 intake due to High Covid-19 numbers. 

We are in desperate need of the vaccine in Lesotho.

South Africa

People’s Vaccine Campaign: Statement on slow vaccine rollout and third wave

 
The third wave is now officially higher than the first and second waves in Gauteng Province and is showing no signs of slowing down. Hospital admissions have increased by more than 5000 people in the past week and ICU units are struggling to keep up with demand, while key Covid-19 facilities have yet to be brought back on line, with thousands of health workers not yet contracted to ensure patient care
 
We remain gravely concerned about the failure to prepare for the third wave which we all knew would arrive. The combination of an unequal healthcare system and slow vaccine rollout are partially to blame for the devastating nature of the third wave the country is now experiencing. This all while hospitals in the Gauteng Province are having to deal with water shortages. The total death toll including excess deaths is estimated to reach over 200, 000 by 1 October 2021. 
 
Experts inform us that most provinces will experience a fourth wave in December and a fifth wave thereafter. We must increase the speed of vaccinations if we are to lower the death toll and learn the lessons from previous waves if we are to save the tens of thousands of lives at stake. The total number of those vaccinated is just over 2 percent of the population with many still requiring a second dose.
 
Vaccine Selection and Acquisition
 
We must indicate to all those producers of vaccines that have been internationally approved our interest to acquire so applications can be registered with SAPHRA. These include Novavax, Moderna, studies have proven that mixing vaccines that have different platforms work best, for example one dose J and J and Astrazeneca with Moderna or Pfizer. We need government to pronounce, to be transparent on vaccine selection, procurement, payment and delivery  
 
 
Class Discrimination Slows Vaccine Rollout
 
The lack of clear communication from government is also a major issue. The president announced last week that walk ins for over 60s were now welcomed across the country. It seems that some vaccination sites have not gotten that message and it is causing confusion.
 
The People’s Vaccination Campaign is deeply troubled by class discrimination in the vaccine rollout. This is related to income and language and has racial implications. The country should be pulling together against the common enemy of Covid-19, but government policy is creating divisions.
 
This discrimination is holding back the level of vaccination at a moment when it should, and could, be speeded up. It is likely that in the ‘third wave’ people will die needlessly; not just poorer old people, but also though the multiplier effect of infected people infecting others
 
This is how the discrimination works.
 

1. People who are insured (i.e. covered by medical aid) can get a walk-in injection at a public site, but people who are not insured cannot go to a private site unless they are over 80 (which is only 5% of the over 60s).^[1] In terms of logistics this is unnecessary, because, at least in theory, the EVDS can send people with appointments to a private site, thus a payment system exists.

1. According to one academic source, vaccine is divided between 24% to private sector sites and the remainder to public sector sites.^[2] This is far higher than the 16.4% of the population covered by medical aid in 2018.^[3] According to Discovery, this figure has since fallen to about 15%.^[4]

1. People with a car find it relatively easy to drive around until they find a site with a small queue where they can get a walk-in injection (at least in urban areas).^[5] In contrast, there are very many cases where poor people cannot get to a site because they cannot afford the transport.^[6] Some of these might find funds if they receive an appointment, but appointments are slow to arrive, which is why Premier Makhura, among others, has encouraged people to go for a walk-in vaccination rather than wait for an appointment.^[7]

1. The registration system requires a phone or online access, which many older people don’t have if they are poor, and it requires knowledge of English, which discriminates against a large proportion of the black population, especially if they are old and poor.^[8]

We have vaccine apartheid between poor and rich countries, but there is also vaccine apartheid separating poor and better-off people in South Africa. We call upon the government to do the following:

• Allow people without medical aid coverage to get walk-in vaccinations at private sites.
• Withdraw any policy that gives a higher proportion of vaccine to people with medical aid.
• Open new public sites or provide mobile units close to where people live and provide free transport for people to get to vaccination sites. 
• Make sure the whole EVDS system is easily accessible to people who do not know English.

The People’s Vaccine Campaign calls on the public to continue following Covid-19 protocols: wear a mask that covers your nose and mouth, wash your hands regularly and avoid gatherings. While we do need more vaccines and urgently, we condemn recent calls from the Economic Freedom Fighters to ignore lockdown protocols. We call on government to speed up its process of procuring vaccines and reiterate our stance that the TRIPS waiver needs to be dropped so that the global south can manufacture our own vaccines. No one is safe until everyone is safe.


Ends. 

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^[1] National Department of Health Guidance to Vaccination sites, 4 June 2021, Section 4, especially 4:1.^[2] Seekings and Nattrass, ‘Can the vaccine rollout be sped up?’ GroundUp, 7 June 2021. It is possible that this policy was not finalized of never fully implemented.^[3] StatsSA, General Household Survey, 2018, p. 26.^[4] Dr Ryan Noach CEO: Discovery Health, Cape Talk 6 January 2021.^[5] Countless observations and WhatsApp messages.^[6] Alexander & Xezwi, Vaccine Rollout Report, South African Research Chair in Social Change, University of Johannesburg, 3 June 2021.^[7] EWN, 4 June 2021.^[8] Statement by President Cyril Ramaphosa on progress in the national effort to contain the COVID-19 pandemic.