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Friday 26 March 2021 is the first anniversary of South Africa’s Covid-19 initial lockdown. In an effort to stem the spread of the pandemic, the government effectively banned any non-essential public interaction. Streets emptied, borders closed and businesses shut their doors and our new reality became face masks, hand sanitiser and social distancing as some of the world’s strictest lockdown regulations took effect.
An economy already reeling from the ravages of corruption, mismanagement and power shortages was about to take another blow, further plunging the country into economic crisis. But saving lives had to be top of the agenda. At the time it was almost impossible to know what lay ahead.
“When we went into lockdown we had the belief that we would be able to control the virus and stop transmission and get back to our normal life, which I think in retrospect was pretty naïve,” says Professor Glenda Gray, President and CEO of the South African Medical Research Council (SAMRC).
Gray, co-principal of the Johnson & Johnson vaccine trial study in South Africa, was speaking during a Focus Talk with Julia Taylor, National Medical Sector Head for Investec Private Bank.
She reflected on her long and internationally-lauded career as an activist for universal healthcare – from the fight to bring anti-retrovirals (ARVs) to victims of HIV/AIDS, to the battling the spread of Covid-19 over the past 12 months.
And what a battle it’s been: over 1.5 million South Africans infected; over 52 000 deaths recorded.
While the official vaccine rollout, targeting some 16 million South Africans, is due to start in April, the effects of the pandemic on livelihoods will continue to impact the country in years to come. Gray believes this could have been mitigated with a more agile approach to lockdown in South Africa: “One needs to move in and out of lockdown periods much faster and more nimbly than we have done… to open up the economy and to try and preserve jobs at the same time.”
Could we have done more? Or better? That’s a raging debate.
“When you look back, I am not too sure whether we can really judge whether we did anything right or wrong,” says Gray. “I think we have to accept that we did the best that we could with the available evidence.”
Prefer to listen on the go?
Listen to the full discussion between Professor Glenda Gray and Investec's Julia Taylor on this podcast.
Vaccinating the frontline
With a healthcare system stretched to the limit, health workers were faced with additional challenges of inadequate PPE, a lack of oxygen and the emotional toll of a high Covid mortality rate.
Witnessing this firsthand only made Gray more determined to secure vaccines for the health fraternity; a mission she ultimately achieved by using her contacts and reputation to secure 500,000 doses of the J&J vaccine.
“Our healthcare workers are the most courageous, hardworking, and selfless human beings. For scientists like us, our job is to find solutions to protect the foot soldiers. My job was to find a vaccine – a wonderful gift to them for all the hard work they've done.”
Tens of thousands of healthcare workers have been vaccinated – but that is a fraction of the 1.2 million workers in the country.
It’s now a race against time to get health workers vaccinated ahead of the “inevitable” third wave of Covid-19 infections as we go into winter, says Gray.
The private sector has a role to play in the vaccine programme
When it comes to vaccinating the rest of the population, global supply chain shortages are proving challenging. Gray anticipates a global vaccine shortage over the next two to three months along with a lack of syringes and needles.
“We have to make sure that in our country we have enough supplies. It will be terrible to have vaccines in the country and no syringes or needles,” says Gray.
The global dash for coronavirus vaccines is also heating up and growing “vaccine nationalism” in India and the EU, two major producers, is seeing countries holding on to their vaccine supply for domestic use – bad news for countries like South Africa who are at the back of the vaccine queue.
The South African private sector is champing at the bit to be allowed to buy their own vaccines, but when it comes to procurement, Gray believes that it would be challenging for private companies to go it alone due to indemnification issues – “the sheer volumes one needs to purchase to be taken seriously” – and the issue of quality assurance and combatting counterfeit vaccines.
What’s needed, she says, is a closer public and private sector partnership: “I do think that there should be collective bargaining. The public and private sector should be going to the manufacturers together with their money. We also want to ensure equity, we don’t want to be in a situation where we procure vaccines in the private sector at the peril of poor people.”
Critical areas where Gray believes that private sector skills will be in demand is in logistics, supply chain management and quality assurance to overcome the challenges involved in rolling the vaccine out to South Africa’s most far-flung corners. “We're going to have to think outside the box and use a lot of innovation in terms of logistics” – things like mass vaccination events in public spaces and mobile vaccine units to reach rural areas.
Covid-19 vaccine Q&A
To debunk myths and manage expectations around the vaccine, Investec Life invited Professor Francois Venter, one of South Africa’s foremost experts on the virus, to share his insights on a webcast.
An activist is born
While Gray’s work on Covid is making headlines, her public health and HIV research spans over 30 years. As a world-leading perinatal HIV researcher, and her name became synonymous with HIV/Aids activism in the 80s and 90s.
Her compulsion towards advocacy, says Gray, came in two parts. “One was being a pediatrician, starting my career when there was no HIV and then as you qualify every third child in your ward is HIV infected and dying and young mothers are also dying.”
The second was during her time at medical school: “As a young doctor, I was involved in progressive health organisations. In those entities, you learnt about universal health coverage and we learnt about the importance of equality.” This built in Gray a strong foundation for the work she did in mother-to-child HIV transmission and in ensuring an equitable rollout of ARVs.
As a young doctor in training, she also learnt the power that science has to change the world. “I quickly realised how critical science is for advocacy and how critical science is for activism because you have to have data and evidence. Only evidence and data changes policy and impacts on life.”
I quickly realised how critical science is for advocacy and how critical science is for activism because you have to have data and evidence. Only evidence and data changes policy and impacts on life.
“HIV has gifted this pandemic in many ways”
Despite initially telling colleagues when Covid struck that she was going to “sit this epidemic out,” Gray soon found herself at the centre of planning the Covid research strategy and found that a lot of lessons and resources from her HIV work could be applied.
“HIV has gifted this pandemic in many ways. One is in vaccine design, two is the [existing] clinical trial infrastructure in South Africa that was able to be deployed.”
Even the infrastructure was already in place, thanks to HIV research from laboratories to cold chain storage and backup generators, along with medical professionals who could rapidly roll out the vaccine trial.
It’s a two-way street though, says Gray, because the ground-breaking mRNA technology developed for the Covid-19 vaccine will also now benefit HIV and TB research. “I think the mRNA technology will be a game changer [for HIV and TB] and the greatest gift for the world.”
Scientists vs politicians: a balancing act
Scientists and politicians worldwide have been at loggerheads trying to contain the virus, but Gray says it’s a healthy learning process that is bound to happen during a fast-moving pandemic.
“Scientists are vocal; they believe in freedom of expression and always want their opinions to be heard and that’s always going to cause conflict… You have to find a balance. For politicians they have to find a way of listening and understanding and for scientists we have to find a way of advocating that doesn’t cause hostility.”
How to prepare for future pandemics
In closing, we asked Gray what changes she hoped to see in healthcare in five years’ time. She listed three: having systems in place for pandemic surveillance, ramping up our own pharmaceutical manufacturing capability and increased investment in medical research and development.
On surveillance: “I hope that our country would understand the importance of making sure that we have systems in place to rapidly deploy diagnostics, and to optimise surveillance, so that we become very good at developing the kind of intelligence you need to pick up an emerging pathogen and deal with it.”
On manufacturing capability: “I think that the fact that we don’t have vaccine manufacturing capability that can go to scale in South Africa is a huge problem for both our country and for Africa, and a huge missed opportunity for revenue, research & development and innovation.”
On R&D investment: “If we've learnt anything in this last pandemic, is that we do need to invest in research and development, we do need to invest in manufacturing, we do need a vibrant, pharmaceutical manufacturing programme in our country. And we also need a vibrant scientific endeavour.”
* One year on from the start of national lockdown, and freshly emerged from a second wave, South Africa heads into Easter amidst talk of a revised lockdown level. President Cyril Ramaphosa is expected to make an announcement on the government’s decision over the next few days. Visit https://www.gov.za/Coronavirus# to view the adjusted alert level.
About the author
Digital content specialist
Lenyaro is a key member of Investec's Global Content team, based in Johannesburg, who focuses on relevant and topical issues for internal and external audiences including clients. She is a well-travelled multi-skilled multimedia journalist who previously held roles within eNews Channel Africa (eNCA) and Eyewitness News (EWN).