Will the rich, high-income earners jump queue for Covid-19 vaccines?

With South Africa in the eye of the Covid-19 storm, the pressure is on government to secure vaccines for mass vaccination – and fast. Earlier this week, President Cyril Ramaphosa said the roll out of vaccines would be in 3 phases, starting with health workers and moving on to people in crowded conditions, including prisons. So where do the individuals on private medical schemes fit in to this schedule? We spoke to Dr Lungi Nyathi, Managing Executive for Clinical risk and Advisory at Medscheme – part of the Afrocentric Group which has about 15 schemes and 4m people in its net – for what the private sector is doing to assist with vaccine procurement. – Jackie Cameron

Dr Lungi Nyathi on securing vaccines for medical scheme members:

In our country, a decision has been made that all vaccines are going to be centrally procured. So, the National Department of Health will be the one that is conducting negotiations on behalf of the whole country. What we have to do is provide guarantees for funding, for the lives that our schemes look after. Once that’s been done, the Department of Health can then procure on behalf of those lives. So we’re on the process now of getting into agreements with the Department of Health on how that process will roll out.

On the Covid-19 vaccine priority:

What’s critical to know about the vaccine is that it is important that those that are at highest risk for severe infection would get the vaccine first. This is because we are trying to prevent not only infection, but also sustainability of the healthcare system. So being able to vaccinate those who are likely to have severe infection is critical. That would be the main reason, really.It’s based on clinical reasons. It’s not because one is more deserving of the other, per se.

On government involvement in Covid-19 vaccine procurement:

Indeed, it would be great if we could get the vaccine sooner. The whole vaccine story is a global crisis. Not everyone can get vaccines at the same time. The manufacturer’s aren’t making vaccines fast enough, necessarily, to service the entire globe. So, the key thing is for us to do all the steps we need to take. The first critical one is to get enough funding for us to be able to vaccinate the lives in our country. Once we have secured the funding, we have to wait for the vaccines to be manufactured and then delivered.

On the Covid-19 vaccine funding and how the funding will work:

The funding is there, but as I said, we’re centrally procuring. The decision has been made to centrally procure. So, we have to buy in those batches. Not all of those [funding] details are ironed out. The first thing is that the department has to find a sufficient number of doses from the various vaccine manufacturers – whether it’s AstraZeneca or Pfizer – or whoever has the sufficient number of doses for our lives. once an agreement has been made with the manufacturer – on the correct price that we will be charged – then we as medical schemes would no then, based on that price, what we would be paying for that. Then, we would buy those vaccines thereafter. We are going to buy them from the central procurement vehicle that the department and us agree on.

As a medical scheme, we can only pay on claims. But for the manufacturers, they’d like us to procure the vaccine in bulk. We have to create a vehicle that enables medical schemes to be able to purchase within the medical schemes act and a vehicle of that nature has to be set up. I don’t think we are very far from it. I’m sure in the next few weeks, we’ll be done with all of those steps. Then we have to wait for the vaccine to land.

On what the Afrocentric Group is doing to ensure the money isn’t misappropriated:

There are several elements to this conversation. The one is getting the drug itself. So, juts purchasing the vaccination from a manufacturer is the core discussion point with the Department of Health. We are looking at setting up a structure – a special purpose vehicle – outside of the government, that has a board that will manage the finances relating to the drug. So, the agreements will be signed between the special purpose vehicle and the manufacturer, is the current thinking. After we have received the vaccine itself, we are busy negotiating on how we can use existing infrastructure in the private sector that we’ve used all these years – to make sure we move from the central depot, where the vaccine lands, into the arm of our members. If we are able to use all those structures, we are in control as it were.

On whether medical schemes can source vaccines for members outside government structures:

At this stage, no. It’s not against the law, per se. But it’s what was agreed. I think it makes sense, if we think about the fact that it has to be equitable, the rollout of vaccines. In a similar way that organ transplants have to be equitable. We can’t have those who have money take up all the organs as they come up. We have a central registry, so that those that need an organ the fastest get that organ. The same principle is being followed because it’s a national crisis. We are better off following a clinically sound rollout plan, which is the same in all countries. It’s not special in South Africa. All countries have a rollout plan that does begin with those at highest risk first.

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