WORLDVIEW: SA vulnerability to killer measles epidemic exposed. Nobody listening.

Most South Africans have acquired a binary position on the country's future. Pessimists believe it is sliding to a Zimbabwe repeat. Optimists believe the 2019 election will usher in political change and a new era of prosperity. Real life is rarely so dramatic..But as Johannesburg's new Mayor Herman Mashaba has discovered, one can never over-estimate the effort required to rebuild after years of mismanagement. My Biznews colleague Chris Bateman reminds us of this in his timely warning of dangers SA is exposed to by its conscious neglect in healthcare. As you'll read, the sting in this tale comes at the end..Chris writes: "The value of comprehensive integrated planning is incalculable when it comes to disease prevention and control. SA's dysfunctional and provincially-disjointed public health system could soon prove it's undoing if recent measles outbreaks are any indication..___STEADY_PAYWALL___.Measles is preventable via vaccination. The disease can be eliminated. Yet this year we've had two outbreaks, three months apart; in Stellenbosch and Lenasia South, Johannesburg. Both are lower-middle to upper income areas – not places of abject poverty – yet they've had seven and 11 known cases respectively..The national and respective provincial health departments are warning of further outbreaks as winter kicks in. South Africa boasts a R1,4 billion national budget for vaccine purchases, yet hugely underprioritizes human resources, social mobilization and surveillance, supervision, and monitoring and evaluation..Health officials constantly boast about our massive child vaccination campaign, stopping just short of comparing it to the world's largest anti-retroviral drug roll out for HIV/AIDS. They claim a country-wide vaccination coverage figure of 90% – a full 20% higher than the WHO/UNICEF estimate..We're seeing some red herrings here. And we're having avoidable outbreaks. Sure, the current numbers are small, but measles is highly infectious and emergency blanket re-vaccinations were immediately carried out on thousands of children at affected schools..No epidemiologist would label this insignificant. Witness copper-mining Katanga province in the Democratic Republic of Congo; August 2015: measles killed 315 people and infected at least another 20 000, according to UN figures..No imagination in necessary on the numbers that would be affected in a SA township measles outbreak in SA. The DRC ranks 186 out 188 countries on the UN Human Development Index while South Africa ranks 116th, with poor, but slightly better healthcare access..Why raise all this? Well, in April last year, one of my final stories for the SA Medical Journal was an expose' of the country's close to rudderless, understaffed and woefully-managed Expanded Programme on Immunisation (EPI). Inaccurate data collection and the lack of an electronic register of births at the Department of Home affairs means accurate calculation of immunization coverage for diseases is virtually impossible..Johann van den Heever, who resigned in anger as national EPI manager in December, warned of inevitable outbreaks and said SA had yet to implement WHO recommendations for minimum-standard vaccine-storage fridges. At that time only six of the original 13 national EPI posts were filled, all with relatively junior incumbents. Things may have improved, but the delivery machine needs fixing. Urgently.".Chris has stepped up to help Van Den Heever ring a warning bell. But those who should be hearing it seem distracted. Perhaps it will require a catastrophe before pays attention. If you thought education was expensive, try ignorance.

WORLDVIEW: SA vulnerability to killer measles epidemic exposed. Nobody listening.

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