Is Discovery sincere in its push for 'social solidarity'? - News24
Gabriel Crouse
When Discovery Group "forecasts [the] possibility of a deadlier third wave", everyone should grab the edge of their seats.
Its key estimate, in this News24 report, is that the difference between mass vaccination before versus after the third wave is about 48 000 extra deaths.
Yet South Africa has rolled out, on average, only 7 700 vaccine jabs per day since its rollout programme began. Even at the rate of 11 000 jabs per day, the fastest on record, it would take just under 10 years to vaccinate two-thirds of the country.
Meanwhile, Discovery warned that the next potential super-spreader to trigger the third wave is Easter in April. Simply put, we are not vaccinating fast enough to avert disaster.
Discovery has the resources to procure vaccines for all its members immediately, to speed things up. According to the News24 report, "Discovery says it has used very little of its R3.4 billion Covid-19 provisions it set aside".
But Adrian Gore explained why, "we don't just procure the vaccines ourselves for our DHMS members and rapidly vaccinate them". "First" he said, "pharmaceutical companies manufacturing the vaccines will currently only sell to national governments, and not to any other entities".
Privately purchased
This was not true when Gore wrote that, on 16 February.
Lamar International, a South African pharmaceutical, said on 8 February that Sputnik V vaccines could be privately purchased and brought in as soon as the South African Health Products Regulatory Authority (SAHPRA) registered it, a process that only seems to have begun at the end of February.
The jabs, Lamar said, could be privately imported "as soon as a flight is available".
The Institute of Race Relations has confirmed that a major Western vaccine producer could be privately imported by South African companies on the same basis.
Internationally, Gore's claim is also obviously not true.
In December, a deal to sidestep exclusive "national government" purchasing power was struck in the "state" of Sao Paulo, which, in South African nomenclature, functions as a "province".
The governor of Sao Paulo not only criticised national incompetence while making a separate deal, but also established a public ceremony, starting with Mônica Calazans, who was vaccinated in defiance of the national government, before the national rollout began.
This led to accelerated national government action the next day.
As the Irish Times headline put it, "Bolsonaro forced to bring forward Brazil's national vaccination campaign".
Private companies applied similar pressure in Mexico, forcing its president to capitulate there, too.
In India, private pressure has resulted in the Serum Institute of India agreeing to sell vaccines to private companies "for about five times what it charged the government".
In Indonesia, the fourth-most populous country on the planet, thousands of companies grouped together to buy vaccines. To force the government's acceptance, required loud lobbying by private companies over time, but the initiative has recently – after Gore's original missive – been approved.
Vaccine nationalism
Still, Gore seems to believe in "vaccine nationalism", meaning only national governments can or should be allowed to compete for vaccine purchase. While this rule should only apply to things like nuclear missiles, the truly amazing thing is that Gore and his entire team failed to realise the rule does only apply to companies too meek to ask for an alternative.
Perhaps Discovery's inability to find a single vaccine seller on earth makes sense in the context of Gore's second argument, namely that South African health companies should not to buy any vaccines over and above what the Command Council secures because, "We need social solidarity".
By this Gore means "the vaccination programme must be planned and implemented at a country level", to maximise health benefits.
Yet several studies have modelled the prioritisation schemes that are expected to save the most lives and show that the Command Council's plan is not the most lifesaving.
As a recent peer-reviewed article that Harvard professor, Mark Lipsitch, co-authored in Science put it: "In almost all circumstances, reducing fatalities required distributing the vaccine to those who are most at risk of death, usually persons over 60 years of age and those with comorbidities."
The Command Council, however, is not prioritising the elderly in the name of "social solidarity". Rather it lumped the elderly and co-morbid alongside millions of young workers in "phase 2".
Nor is South Africa prioritising the "virally naïve", meaning those who have never been infected with SARS-CoV-2, who are, according to Discovery, a minority of the population. Moreover, Discovery models that only "a third of people who have had Covid-19 before can be reinfected by new variants".
If "social solidarity" means anything, it should mean prioritising the most fragile. As Daniel Larremore, co-author with Lipsitch, said, prioritising the virally naïve gives "more bang for your buck" on a societal level, for every vaccine.
Is Discovery sincere in its push for "social solidarity"? Not if its silence on prioritising the virally naïve or the elderly in a country it believes to already be half-infected is anything to go by.
But the simpler point is that, on all models for any rollout regimen, if you increase the quanta of jabs per unit time in addition to what is already in place, you decrease expected deaths and transmissions.
A win-win
If Discovery bought vaccines that are otherwise sitting in cold storage, waiting for purchase by private entities willing to pay more (extra resources that can accelerate vaccine production for the rest), that would not be "robbing Peter to give to Paul", as Gore implies. That would simply be a win-win.
Short of reading Gore's mind, it is impossible to say why he pretends Discovery could not speed up vaccination by supplying its own customers, but it is worth considering the possibility that he has confused real solidarity with polite "cockpit culture".
This refers to the case of Korea Air, which decades ago had more plane crashes than almost any other airline, despite good equipment and training. Malcolm Gladwell found its pilots "were struggling with…a cultural legacy" of deference to those in command. "You are obliged to feel deferential to your elders and superiors", Gladwell observed, to the point where captains would rather crash and burn than seem rude to ground control.
From companies in Indonesia to provincial leaders in Brazil, we know what happens when you replace cowardly "cockpit culture" with the courage to speak truth to power.
How many unnecessary deaths will it take for Gore to discover the difference?
- Gabriel Crouse is a writer and analyst at the Institute of Race Relations.