Six key lessons SA learnt from its fight against the pandemic
DURBAN: Health Minister Dr Zweli Mkhize has highlighted key lessons that the country has drawn from its experience with the Covid first and second waves.
Addressing a webinar commemorating World Health Day, Mkhize said there were important lessons that could be taken from SA's experiences with the pandemic.
"If we take these to heart and appropriately contextualise them, we can use them to leverage our health-system reform programmes and build more resilient health-care systems, capable of absorbing the next public health threat that may come our way, whilst protecting the people from the devastating outcomes we have seen during the Covid-19 pandemic," he said.
Mkhize shared some of the core experiences used to address the pandemic and how they had faired for the health reform agenda.
"These lessons are drawn from our experiences with the first and second waves, as well as the the proactive interventions we are implementing to mitigate against a subsequent wave."
Mkhize said one of the earliest interventions was to create reliable mechanisms for health-system governance, to ensure that the effort was co-ordinated and efficient.
"This was supported by a robust surveillance system with high-quality data input. With this evidence-based approach, our central structure, the National Coronavirus Command Council, and the the various ministerial advisory committees created to support government were able to foster confidence in the interventions proposed, especially those that required a great deal of social and financial sacrifice by sectors and individuals."
He said the second lesson was the involvement and consultation with private sector stakeholders.
"I do not think there is a country that has not recognised the relevance of strengthening the health system’s preparedness through assessing gaps and ensuring health services availability according to need.
“Taking into consideration the World Health Organization’s six building blocks, our health system preparedness approach has strategically focused on mobilising and fairly distributing the available human resources for health, assessing the existing hospital bed capacity, and creating innovative and sometimes expedited procurement processes to support a proactive response.
“In all these interventions, we have kept our door open for the ongoing involvement and consultation of our private sector stakeholders.
The third lesson, Mkhize said, was that SA ensured that the response remained government led with close collaboration across all sectors.
"The role of the private sector was defined in the context of a unified system- and this is indeed a fundamental ethos enshrined in the NHI Bill. Thus, our approach has been based on an all-inclusive strategy to draw on the full capacity of the health system. As examples, we combined all laboratory efforts and shared resources, combined all beds and moved patients in equal volumes between public and private facilities and now, for the first time in history, we have one digital system for capturing and certifying all vaccinated individuals."
The fourth lesson was in the field of data management, integration, sharing and reporting. Early in the evolution of the pandemic locally, SA made deliberate decisions to establish and, in some instances, leverage systems to support the co-ordination and sharing of information with the private sector and the public.
Mkhize said that had proved essential for effective and timely monitoring, planning and decision making.
He said that in this time of the Fourth Industrial Revolution, SA used the opportunity to build technology. One example was the Covid Connect App for tracing contacts and engaging asymptomatic cases. Another was the Covid Alert SA app, a free exposure notification application that lets people know when they have been in close contact with someone who has tested positive for Covid-19.
"As mentioned previously, the efficiency of our vaccination programme has been greatly enhanced by the Electronic Vaccine Data System," he said.
The fifth key lesson learnt was the importance of diversifying procurement strategies.
"In our case, for instance, our diversified approach included bilateral engagements with individual manufacturers, multilateral involvement through the Covax facility and engaging a regional approach through the African Union’s Vaccine Acquisition Task Team.
“At all costs, our vaccine acquisition plan avoids the notion of vaccines nationalism. We subscribe to a regime that globally ensures fairness in access, equity in financing and is founded on the principle of social solidarity and equity. It is only in this way that the most vulnerable, locally and globally, will be best protected. Without this, the poorest people in the world’s poorest countries are most affected by a lack of access to vaccines.
“Inevitably, the consequent slower roll out of vaccines in lower income countries will negatively impact on economic prosperity and development in those countries. However, the greatest lesson that vaccine nationalism has taught us is the critical urgency for Africa to develop, manufacture and distribute its own biotechnology."
The minister said the final lesson related to the need for alternative reimbursement models that were practical, easy to implement and transparent.
"In our efforts to draw on the expertise and capacity of the private sector – hospitals, laboratories, and healthcare professionals – it quickly became apparent that there is a huge gap in this expertise.
“Having said that, this has created the inclination for continued engagement between the public and private sectors, a clear departure from the past when this type of discourse could not happen without landing in court. This lays strong foundation for the National Health Insurance Fund provider accreditation and contracting environment."
He said that as the pandemic evolved, the lessons treasure trove expanded.
"And, through our participation in the global economy, we continue to learn new things from other contexts. What is important for us is to ensure that we use what we learn to inform our broader policy reforms around the phased implementation of Universal Health Coverage."