South Africa: The ICJ is concerned about unfair and non-transparent prioritization of individuals to receive Covid-19 vaccinations

Jun 25, 2021 | Advocacy, Open letters

The ICJ is concerned that the South African Health Products Regulatory Authority (SAHRPRA) are prioritizing young fit healthy persons to receive vaccinations. In the context of severe shortages of vaccines in South Africa and Southern Africa more generally, and in light of the stated aim of South Africa’s own vaccine roll-out plan to prioritize the most vulnerable in line with WHO advice, the vaccination of younger ‘elite athletes’ and young diplomats would appear unjustifiable on public health grounds. They are simply not priority groups for vaccination, especially where there is vaccine scarcity, inequality, and the promise by government of equality.

ICJ Africa Director, Kaajal Ramjathan-Keogh stated,

“To date South Africa has administered just over 2.23 million vaccines mostly to health care workers and persons over 60 years old. This represents just 3.76% of the population. South Africa has the highest number of confirmed cases in Africa with more than 1.86 million who have been infected and where 59 000 have lost their lives. According to the South African Medical Research Council the excess deaths, which represent a more accurate representation of Covid-19 related mortality, is at 173 000. In this context the slow pace of vaccination coupled with the unfair and unequitable prioritisation of certain groups is contributing to a devastating third wave.”

A decision taken by SAHPRA appears to contradict the eligibility criteria of the Sisonke vaccine trial (a process where a vaccine was made available to health care workers using a research programme prior to the requisite approvals and licencing processes) to include among others ‘elite athletes’, enabling them to enjoy special privileged access to some of the remaining clinical trial stock, while others at risk could have been study subjects instead.

No reasons or public health-based justifications have been made publicly available as to why athletes and other persons working in sport as well government officials were given priority access. Ramjathan-Keogh added,

“No reasons or public health-based justifications have been made publicly available as to why these athletes and as well as sports and government officials have been prioritised to receive these vaccines from the Sisonke trial. If they cannot be justified on public health grounds, we are concerned that they may be non-compliant with human rights imperatives, and we question the ethical considerations of the approach”.

According to the Africa Centre for Diseases Control and Prevention as of 24 June there are 5.2 million cases reported across Africa, with 139 000 total deaths in Africa. Most new cases are from these five countries – South Africa (35%) Ethiopia (5%), Egypt (5%), Morocco (10%) and Tunisia (7%). The highest number of new cases are emerging from Southern Africa and from these countries: South Africa, Zambia, Namibia, and Uganda representing 63% of new cases in Africa.

The ICJ calls on South Africa to follow the World Health Organization’s guidance which is to prioritise those who are more vulnerable in respect of equitable access and fair allocation of vaccines.  Further, South Africa has an international legal obligation to protect the right to health as a State party to the International Covenant on Economic, Social and Cultural Rights.

The supervisory body for that treaty, the UN Committee on Economic, Social and Cultural Rights (CESCR) has affirmed that all healthcare goods, facilities, and services must be available, accessible, acceptable and of adequate quality. In addition, these goods, facilities, and services should be “accessible to all, especially the most vulnerable or marginalized sections of the population, in law and in fact, without discrimination on any of the prohibited grounds.” The right to health should be accessible without discrimination “even in times of severe resource constraints” such as those brought on by the COVID-19 pandemic.

Read the letter.

Further Reading:

ICJ, “The Unvaccinated Equality not Charity in Southern Africa” (May 2020): https://www.icj.org/wp-content/uploads/2021/05/Africa-The-Unvaccinated-Publications-Reports-2021-ENG.pdf

ICJ and Human Rights Watch, “More than words: it is time for urgent action on COVID-19 vaccines (UN Statement)” (21 June 2021): https://www.icj.org/more-than-words-it-is-time-for-urgent-action-on-covid-19-vaccines-un-statement/.

WHO, WHO SAGE values framework for the allocation and prioritization of COVID-19 vaccination (September 2020): https://apps.who.int/iris/bitstream/handle/10665/334299/WHO-2019-nCoV-SAGE_Framework-Allocation_and_prioritization-2020.1-eng.pdf

UN CESCR, Statement on universal and equitable access to vaccines for the coronavirus disease (COVID-19) (December 2020): https://tbinternet.ohchr.org/_layouts/15/treatybodyexternal/Download.aspx?symbolno=E%2fC.12%2f2020%2f2&Lang=en

UN CESCR, Statement on universal affordable vaccination against coronavirus disease (COVID-19), international cooperation and intellectual property (23 April 2020): https://tbinternet.ohchr.org/_layouts/15/treatybodyexternal/Download.aspx?symbolno=E%2fC.12%2f2021%2f1&Lang=en.

Contact

Kaajal Ramjathan-Keogh, ICJ Africa Director, Kaajal.Keogh(a)icj.org