Is SA committed to vaccinating all people?
South Africa’s anticipated vaccine roll-out has had some hiccups. The question of AstraZeneca Covid vaccine’s efficacy against the different COVID-19 strains has brought caution and heightened hesitation for many South Africans about the vaccine and the government’s plans to ensure its effective distribution.
As South Africa moves from preventative interventions to vaccine interventions in curbing the spread of COVID-19, an opportunity arises to commit to protecting vulnerable and marginalised people living in South Africa.
Cyril Ramaphosa, in his national address on 1 February 2021, confirmed that the COVID-19 vaccine will be available to all adults in South Africa, regardless of their citizenship or residence status. His assurance that measures will be put in place to deal with challenges of undocumented migrants is a welcome commitment.
In response to COVID-19, including testing and contact tracing, we have seen various processes and information systems that may inhibit or prevent people from coming forward to access these services. Most notable are people with different forms of documentation (refugees, asylum seekers, migrants, undocumented persons) and homeless people with no proof of residence. Historical and entrenched barriers and hostility to these groups prove another hurdle in ensuring public health.
As we make sense of various personal, community and national responses to COVID-19, imagine yourself in any one of the following situations. Your child is turned away from receiving emergency treatment because you have been unable to secure a birth certificate. The terminally ill partner you are caring for cannot receive hospital treatment because they are undocumented. You suspect someone in your home has COVID-19 and a hospital won’t admit or test you because your permit has expired. You are a medical doctor with refugee status. You have been on the frontlines protecting people for almost a year. Yet, when you register online for the vaccine, your document number is not accepted because you are not a citizen.
As we all consider our own views towards the vaccine roll-out, contemplate who may not have the privilege to access the vaccine or choose to receive it – those who may be turned away or are afraid of the consequences of presenting themselves. How we protect ourselves from COVID-19 is intertwined in the possibilities of how other people are protected.
A commitment to protect and include all persons is a start. However, the systems which enable vaccine distribution need to reflect this commitment.
There needs to be a widespread public health campaign to ensure that people affected by healthcare barriers, and medical professionals are aware of all people’s right to access the vaccine. Vaccine registration and tracing systems need to be compatible with all forms of documentation, including for persons who are undocumented. Perhaps alternative routes for vaccine registration can be found which do not require a residential address for those living without secure accommodation. Information gathered during vaccine registration needs to be kept confidential and a guarantee given that this information cannot be used by other government departments, most notably for immigration purposes.
It is in the best interests of human rights, the health and safety of all people living in South Africa that the commitment to vaccinate all people is realised.