“Although cabinet adopted a policy change in 2018 – changes in policy mean little if not manifested in law,” wrote.Umunyana Rugege, executive director of SECTION27.

South Africa’s patent law has not been changed since the 1970s

The FTPL, a group of over 40 organisations working to reform SA’s patent laws, is requesting the finalisation of draft amendments to the Patents Act to ensure that the government has the tools to address all public health issues. Not only the prospect of a vaccine against COVID-19, but also new drugs for HIV and TB, highlights critical importance of fixing SA patent laws.

“When it comes down to it, we cannot allow people to die while treatments that may save their lives remain out of reach because of legal obstacles,” wrote Rugege.

 There are 7.7-m people living with HIV in SA. Last year 200 000 new infections and 72 000 AIDS deaths were reported.

“Meanwhile, COVID-19 claimed the lives of about 22 000 people in the roughly past 10 months.

Although SA has one of the highest incidences of this virus in the world, it also has one of the most effective awareness and treatment systems. People have to be responsible for their own health when it comes to HIV and to COVID-19.”

Pfizer says 50-m doses will be available by the end of 2020, and 1.3-bn doses will be produced by the end of 2021.

AstraZeneca claims that it will be able to produce 3-bn doses (of the Oxford vaccine) by the end of 2021.

Moderna says it can produce 20-m doses in 2020, and between 500-m and 1-bn doses in 2021.

According to the Financial Times, the Oxford/AstraZeneca vaccine is the cheapest at $3-$4 (R45-R61) a dose; one dose of Moderna’s vaccine is reported to be $37 (R565), while one dose of Pfizer’s is $20 (R305).

*On 24 November Finance Minister Tito Mboweni announced the allocation of R500-m to “participate in the process of the production of the vaccine”, and that the state is prepared to spend R5-bn to access vaccines. In South Africa, the three to four hundred thousand health workers should arguably be first in line.

 According to the Council for Medical Schemes (CMS) the total cost of fraud in the SA private healthcare system amounts to about R22-bn a year. Mothudi said the majority of cases involved false claims, where healthcare professionals claim for services not rendered or claim for incorrect services. Fraud, abuse or waste accounts for about 15% of the R160-bn in claims that medical aids pay out annually.

A Corruption Watch report on corruption in SA’s public hospitals found that the most common form of corruption was employment corruption (39%), followed by procurement corruption (22%), and the misappropriation of resources (16%).

The Western Cape health department signed a deal with private healthcare providers earlier to enable state patients to be referred to private facilities should the need arise, but has so far not needed to do so. According to Western Cape head of health Keith Cloete hospital admissions were three times higher on the Garden Route than they had been on November 1. George and Knysna recorded their highest number of new Covid-19 cases to date on November 23, exceeding the peak of the first coronavirus wave in late July.

Both Mediclinic International and Life Healthcare, which between them operate five private hospitals in the region, said they were approaching maximum capacity for Covid-19 patients. Mediclinic has sent extra nurses and medical equipment to its hospitals in George, Oudtshoorn and Plettenberg Bay. Life Healthcare regional manager Riaan Croupcamp said the numbers change “almost hourly” and hospital managers are in constant contact with one another.

Cuts were projected by the National Treasury and were blamed on weak economic growth. Mkhize said the government’s competing priorities necessitated rebalancing and reprioritisation of finances. He said we have been through a difficult time where a number of departments had funds mobilised from them to actually support the Department of Health. Mkhize said the cuts were likely to affect all health programmes in one way or another as they would make it difficult for the department to fund all critical vacant posts and key supplies, given the constraints.

By November 24, the country stood at 769 759 cumulative confirmed cases, with 2 080 new infections recorded out of the 14 377 new tests. This meant a 14% positive rate, while experts say a below 10% positivity rate was more ideal. The increase appears to have been due the country moving to Level 1 lockdown.

 "Today, Netcare, which used to be the biggest of the three, internationally and locally, only has its South African operations, but is still the biggest in South Africa. It has now focused on growing in the country through a digitisation strategy, CareOn, that is aimed at creating paperless administrative systems, online training for doctors and nurses, as well as mobile information access for doctors, so they can check on their patients anywhere they are."

SAMA chairperson Dr Angelique Coetzee said the placement of interns is a difficult process, and many doctors are unfortunately not placed where they want to be. For those fortunate enough to have found placements to now sell them to the highest bidders is not fair on others waiting for legitimate placements.

Khadija Jamaloodien, the director of affordable medicines at the department of health, said that while SA had not yet signed the commitment agreement to participate in the Covax facility, it will do so once necessary administrative processes had been completed. Mboweni said he would make.

Patients are claiming that they have not yet received full payment, in accordance with an arbitration award handed down by former deputy chief justice Dikgang Moseneke in March 2018 after1 600 psychiatric patients were caught up in the scandal when they were moved from Life Esidimeni centres to ill-equipped and underfunded NGOs in Gauteng in 2015, resulting in 144 deaths.

According to trial data the vaccine was 90% effective in preventing Covid-19 when it was administered as a half dose followed by a full dose at least a month later. The vaccine’s cost to governments works out at just a few dollars a shot, a fraction of the price of shots from Pfizer and Moderna, which use a more unconventional technology, reported Reuters (23 Nov 2020). It can also be transported and stored at normal fridge temperatures, which proponents say will make it easier to distribute, especially in poor countries.

 Unlike the Western Cape, which reached an agreement earlier this year with private hospitals to admit state Covid-19 patients should the need arise, no formal arrangement is in place for the Eastern Cape health department.

Netcare Financials: Revenue declined by 12.7% to R18.84-bn. Normalised earnings before interest, tax, depreciation and amortisation (Ebitda) were 52.4% lower at R2.09-bn, with the Ebitda margin contracting to 11.1%. The group estimated lost revenue at R3.7-bn and a loss of R2.3-bn in Ebitda as a result of the pandemic. Its profits after tax declined by 78.1% to R515-m. Adjusted headline earnings per share declined by 72.2% to 47.6 cents a share. The group opted not to declare a final dividend in light of the uncertainty created by Covid-19. – (Business Day 24 Nov 2020)

Epidemiologists and experts in infectious diseases and vaccinology agree that a change in social behaviour was the only way to halt the increasing speed at which the virus was spreading.

According to the latest figures released by Health Minister Zweli Mkhize, the cumulative number of people confirmed to have COVID-19 is 43 434, with more than 850 000 tests having been conducted to date. The number of recoveries remains a bastion of hope as the country a recorded 23 088 recoveries – translating to a rate of 53.2%.