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Reflections on COVID-19 vaccine rollout



Last month President Emmerson Mnangagwa held a state of the nation address where he indicated that a COVID-19 vaccine was expected into the country “quite soon”. He indicated that further announcements regarding the process would be made “in the coming days”.

On February 4, 2021, the President addressed the nation again and confirmed that the government was in the process of developing and finalising a State-funded national vaccination strategy and a national vaccine deployment framework, respectively.

Subsequently, a national rollout, deployment and vaccination plan (DVP) was presented before Parliament on February 16 2021.

As the COVID-19 global pandemic continues to spread, the bringing to market of several vaccinations against the virus has been met with mixed feelings across the world.

In a developing country such as Zimbabwe, the rollout of a COVID-19 vaccine has inevitably raised more questions than answers.

In view of the fact that it is a constitutionally guaranteed right that every citizen and resident of Zimbabwe has access to basic healthcare and bodily and psychological protection, it becomes necessary to examine the fundamental rights and freedoms that are inherent to the DVP.

In Zimbabwe, the primary legislation on public healthcare is the Public Health Act [Chapter 15:17] (the Public Health Act) which, amongst other things, stipulates crucial guiding principles that are incumbent to public health practices.

Section 31 of the Act provides that public health policy and practice ought to be guided and informed by, a respect for human rights, the employment of precautionary and protective measures when there is uncertainty or incomplete information about a public health risk, the involvement of the community in decisions and actions that affect their health, the promotion of access to information and education regarding public health and respect for international commitments as they pertain to public health.

In view of the provisions of the Public Health Act, and pursuant to the state of the nation address given by the President on January 23 2021, the Zimbabwe Human Rights NGO Forum, in a letter dated January 26 2021 sought clarity and access to information from the Health and Child Welfare ministry regarding the rollout of the national vaccination strategy.

In a letter of response dated January 28 2021, the ministry indicated that it had taken a “measured approach” in the acquisition of COVID-19 vaccines due to a varied number of considerations.

It was further indicated that the choice of vaccine to be used, its importation and distribution would fall within the purview of the State.

On February 4 2021, the President addressed the nation, and in addition to echoing the contents of the letter received by the Human Rights NGO Forum, highlighted the following in relation to the national vaccination strategy:

  1. That the government has set aside resources for the acquisition of vaccines together with related partners;
  2. That the acquisition of vaccines would be State-funded and available to the public at no cost;
  3. That frontline essential staff, the elderly and those with specific health risk considerations would be prioritised in the first phase of inoculation; and
  4. That China had donated 200 000 doses of the Sinopharm COVID-19 vaccine to the State.

The indications made by the President were further elaborated in the DVP presented before Parliament by Vice-President and Health and Child Care minister Constantino Chiwenga on February 16 2021. Highlights emanating from the DVP included the following:

  1. Vaccines will be received every two to three weeks for distribution;
  2. An operational budget to fund the rollout plan has been shared with the Treasury;
  3. Vaccinations will be targeted at reaching 60% of the population to achieve herd immunity;
  4. Vaccinations will be registered with the Medicines Control Authority of Zimbabwe;
  5. The pharmacovigilance and clinical trials committee will implement vaccine vigilance plans to monitor the safety and electiveness of the COVID-19 vaccines in use;
  6. The ministry will set up and implement a safety monitoring plan to enable swift detection of any adverse events following immunisation;
  7. The Health and Child Care ministry will implement effective deployment of the COVID-19 vaccines through the national EPI programme;
  8. The total estimated operational budget for COVID-19 vaccination over all phases is US$6 778 777. The total cost for Phase 1, Stage 1 is US$1.3 million;
  9. The vaccine will be received at the airport and distributed to provinces and districts under police escort;
  10. Generators will be utilised to ensure that vaccines do not get spoilt; and
  11. The government has come up with a budget of $100 million and the private sector has also come up with their budget to contribute towards vaccines.

An account has been opened where the corporates are putting their money and all this is under the Finance and Economic Development ministry.

In terms of section 62 of the Constitution of Zimbabwe, every citizen has a right to access information in so far as the information is required in the interests of public accountability.

In terms of the same section, access to information may be restricted if it is in “the interests of defence, public security or professional confidentiality, to the extent that the restriction is fair, reasonable, necessary and justifiable in a democratic society based on openness, justice, human dignity, equality and freedom.”

Albeit after pressure from various sections of civil society, the government presented the DVP in relatively quick fashion, which is commendable.

However, in spite of the DVP, information and education around the national vaccination strategy has remained insufficient in as far as dissemination of information pertaining to the DVP, its modalities and public accountability mechanisms.

As has been previously alluded to, it is a matter of law and good practice to engage and educate the citizenry in matters that have a direct bearing on public health interests and risks.

Currently, the generality of the indications by the government belie the fact that it is not clear what protective and precautionary measures have been taken in the acquisition of vaccines.

This entails the scale used in the determination of which vaccinations to use and the checks and balances that have been implemented to ensure their safety.

From the statements made by government, it appears that various vaccines will be imported, with the first delivery of the 200 000 doses of the Sinopharm vaccine donated by the People’s Republic of China having been received in the country on February 152021.

On February 18 2021, the vaccination programme commenced with Chiwenga volunteering to be the first recipient of the vaccine as a measure of assurance.

Although designed to encourage the public to participate in the DVP, the lack of information dissemination and supporting civil engagement structures may very well hamper the effectiveness of the rollout strategy to the detriment of the citizens.

Public concerns remain valid in so far as the possible partisan distribution of the vaccines, the efficacy of the vaccines and the modalities of the monitoring structures of the DVP rollout.

Generalised provisions do little to combat citizen apathy and the prevalence of misinformation, fear, scepticism and confusion which has marked the vaccination strategy.

As it presently stands, the DVP still requires additional considerations and provisions that speak to the enhancement of public confidence, accountability and transparency, and regular information dissemination.

The effectiveness of the DVP hinges on the engagement of the government with its citizens and the collective participation of us all.

  •  Yassin Nhara is a senior researcher at Zimbabwe Human Rights NGO Forum. She writes here in her personal capacity.

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