Health system boosted to respond to COVID-19

Health system boosted to respond to COVID-19

Government will in the next financial year avail an additional R8 billion to the health system for the country’s COVID-19 pandemic response.

This will be in addition to the R20 billion the state allocated in the 2020/21 financial year, Finance Minister Tito Mboweni said on Wednesday, while delivering the 2021 Budget Speech, in Parliament.

In a Budget Review document, the National Treasury said the funds were to enable the sector to expand prevention, screening, testing and hospital capacity.

The R8 billion, which will be allocated to provincial health departments through the provincial equitable share, is expected to enable the sector to sustain these activities and respond to possible future waves of COVID-19 infection.

“Provincial governments receive an additional R8 billion in 2021/22 to continue the public health response to the pandemic, and the potential for additional waves of infection. Provinces can mitigate the negative impact of COVID-19 and the associated lockdowns on their revenues by improving efficiency, particularly in the procurement of health equipment,” said the Minister.

In total, the health expenditure function will over the medium term make up 14.2 percent of total government spending, declining from R247 billion in 2020/21 to R245 billion in 2023/24.

“Provincial health departments receive about 92 percent (R678.7 billion) of these medium-term allocations.

Reductions to the sector, mostly focused on compensation spending, are estimated at about R50.3 billion over the 2021 MTEF period,” the document reads.

To achieve this, other reductions would be required from health departments to increase efficiency. This included generating savings through centralised procurement of certain goods, reducing variations in unit costs in HIV programmes and improving management of overtime costs.

The COVID-19 pandemic has had a massive impact on the South African health system. As at 16 February 2021, the country had 1.5 million confirmed cases and over 137 000 excess deaths as reported by the South African Medical Research Council.

Over the MTEF period, R29.4 million is allocated to Tygerberg Regional Hospital and R100 million to Klipfontein Regional Hospital in the Western Cape through the health facility revitalisation grant.

COVID-19 comorbidities uncovered NCDs = 90%

Better late than never. And it is only until October last year. Comorbidities are published once and not routinely by NICD. Oh now, the second wave is over “we will publish another list.” Really?

This requires some myth-busting action from the National Department of Health. I am tired of the comorbidities listed in media interviews by NDoH officials as going in this order: HIV, TB and more recently malaria (really). Then perhaps diabetes…. take a look and weep.

Read pages 6 onwards in the NICD Covid report

Vaccine rollout to healthcare workers in South Africa

Vaccine rollout to healthcare workers in South Africa

Sisonke! Working together to protect healthcare workers

Day One of the first phase of COVID-19 the vaccine rollout to health workers was a huge success today. South Africa secured the single-dose Johnson & Johnson (JnJ) vaccine for use in the Sisonke (‘Together’) programme. Sisonke will be rolled out to up to 500,000 healthcare workers starting in 18 public sector hospitals across all nine provinces.

As a demonstration of confidence in the safety and efficacy of the vaccine leaders from organised labour took their shots at Steve Biko Academic Hospital today. These are leaders who are health workers themselves from organisations like DENOSA, HOSPERSA, NEHAWU, NAPSU, NUPSAW and others.

Protecting our healthcare workers is an urgent priority

Phase 1 of the vaccine programme is focused on healthcare workers. This is the first step in rolling out a comprehensive vaccine distribution strategy for the nation. Healthcare workers are the frontline of the country’s COVID-19 response and are 3-4 times more likely to contract COVID-19 than the general population. To date 40,000 South African health workers have contracted COVID-19, 6,473 have been hospitalised and 663 of our colleagues have passed on.

Phase 1 of South Africa’s three phase vaccine rollout strategy was paused temporarily earlier this month following concerns regarding the efficacy of the Oxford-AstraZeneca (also known as CoviShield) vaccine against mild-moderate COVID caused by the 501.V2 variant. CoviShield may still play a role in the National Programme. However, more research is needed to determine how and when it will be used. Vaccination using a safe and efficacious vaccine must start without delay to protect healthcare workers during a likely 3rd wave this winter. The switch to the JnJ vaccine allows for the country to restart Phase 1 vaccine rollout to keep our health workers safe.

Single-dose JnJ vaccine

The single-dose JnJ vaccine protects against severe COVID-19 in South Africa. The safety and efficacy of the vaccine was assessed in the international Phase 3 study, ENSEMBLE, which was conducted across Latin America, USA and South Africa with more than 43 000 participants. South Africa contributed around 7,000 participants to the trial between October 2020 and February 2021, including participants who were exposed to the 501.V2 variant. The long-term follow-up of study participants is still ongoing, as is required for the process of regulatory approval by the South African Health Products Regulatory Authority (SAHPRA) for commercial or emergency use. However, since the safety and efficacy of the vaccine has already been proven, the current rollout is being conducted under The Sisonke Open Label Program, to assess real world effectiveness among health care workers, who have already been prioritised for vaccination by the South African Government’s Covid-19 Vaccination Strategy.

The JnJ vaccine has been shown to be safe, with no safety concerns reported from past trials or rollouts. The ENSEMBLE trial showed excellent protection of a single-dose vaccine against severe COVID-19, including in South Africa, and as such a delay in rolling out the vaccine would be unethical.

There is a clear process for vaccine rollout to healthcare workers. To receive the vaccine, healthcare workers must:
(1) register on the South Africa Electronic Vaccination Data System,
(2) respond to an SMS invitation, and
(3) provide informed consent to take part.
Healthcare workers will receive a vaccination voucher and communication once a vaccination centre is open to render the service. To register use this link:

The Sisonke rollout will include meaningful collaboration between the original team who were involved in the ENSEMBLE trial, JnJ, and the NDoH and the SAMRC. The partners will closely monitor, track and assess the real-world rollout of the vaccine. They will measure:
(1) the occurrence of hospitalizations and deaths,
(2) the incidence of severe SARS CoV-2 infections,
(3) the diversity of breakthrough infections; and
(4) evaluate vaccine uptake among healthcare workers in South Africa.

This experienced team will utilise their trained and qualified staff including pharmacists, clinicians and others to receive, store and oversee the dispensation of the JnJ vaccine. Sisonke staff will work very closely with national and provincial health public and private vaccine centres to ensure that the vaccination of healthcare workers is done safely and carefully managed.

The protection of our healthcare workers through the rollout of the safe and efficacious vaccine is an urgent priority for South Africa.