God, AIDS, Africa & HOPE

pensées of a Catholic priest

A window of opportunity

We all welcomed the relief of bringing back South Africa from Covid-19 alert level 3 to 1 in the last days. But having said this it is also noticeable that more and more voices are raising concern about the possibility of a 3rd wave as early as the second half of May, when winter is knocking onto the door – especially the Western Cape with cold temperatures and rain will be exposed to more indoor activities raising the bar.

So the next 8 weeks are a window of opportunity to get things right and especially to see to our tools available preventing another peak of death and hospitalization figures. Vaccinations are new in our tool box – but the way they were introduced have clouded for many the willingness to receive them. Instead of using 1.5 million jabs already in the country of a clearly death and hospitalization avoiding vaccine the countries leaders decided to give away 1.5 million protection and opting for a trial run with another vaccination provider needing volunteers to conclude phase 3.

I got quite some flak for criticising Linda-Gail Bekker for wearing two heads as the co-principal of the J&J study and at the same time being part of the running of the country’s vaccine drive. In a tweet reply she assured me that there were no financial implications for her and that several ethic committees have given the green light for this conflict of interest to overcome. I have no reason to not believe her – but I am still of the opinion that this is not really the point:

Looking around and listening to various virologists there is a clear line: vaccinate with what you can get your hands on – the WHO has approved AstraZeneca also for the mutant discovered in South Africa – and I would expect from anybody running the show in this arena to stand up against any government decision to miss the opportunity vaccinating to at least avoid dead and hospitalisation in the 3rd wave. Vaccinate your health workers with the J&J trial as it most likely produces a higher protection rate, but there are millions of South Africans who are not in the health sector – they are working in schools and crèches, in retail, in hospitality, yearning for that extra protection they can get.

While many African countries started a vaccination drive – with AstraZeneca – South Africa stands lonely with a marginal vaccination trial programme having rejected what was already in the country. Judge for yourself whether this decision costing lives in the third wave was right. There will be many who are already dead when in the third and fourth quarter the promised vaccine drive starts in this country. To get a sense of where we are the vaccinations done by now:

And there is more: the writing is already very clearly on the walls: no vaccination no freedom of travel internationally; what this means for business travel you might be able to imagine. We are in the process of missing the boat and we all know, South Africa cannot afford it.

Lastly another question mark: The whole drama about AstraZeneca was triggered by a small – not even peer-to-peer reviewed study – and knowing how the battle is on between pharmaceutical companies to get their product on the market and to cash in – it is understandable that there remain questions how convenient this study was put into the public domain. The amount of studies being published for a greater audience without the filter of academic review and academic knowledge is a danger in itself.

As lives are in danger on different levels: health, economy, social we have to ask the hard questions and to scrutinize what is done and how it is done on the level of decision-making.

We have now a window of opportunity before the virus hits us anew in another wave – and we have to expect from government more than just warm words and promises…. Lives are at stake!

Filed under: Africa, Medical and Research, Politics and Society, Reflection, Society and living environment, South Africa, Uncategorized, , , , , , , , ,

The vaccine confusion

AstraZeneca vaccine stopped – so the headlines around the world when South Africa decided to re-think the use of the vaccine it bought for a higher price without checking the expiry date – and one could think this is a typical story – or another example of the incompetence of South Africa’s national government. That may be the case, but I guess, in this time and situation government bashing should not be first priority but to look a bit deeper into this headline creating event.

The first batch of vaccines in South Africa was designated to be used for the health worker at the forefront of the fight against the pandemic; and obviously the aim is to protect those doctors, nurses and health workers against the virus. It was known that the AstraZeneca vaccine was not a 100% protection, but a small and not peer-to-peer reviewed study, which in itself poses more questions than answers was cited as the reason to stop the vaccination drive before it started.
And here the first critical thought has to be mentioned:
This discussion is way above the heads of the general population. The South African government, in its drive to be as transparent as possible, decided to bring into the public a level of medical research discourse which created more confusion than it helped to motivate people to make an informed decision on wanting to be vaccinated. It also laid bare the underlying belief of many, that a vaccine is either the miracle cure or not helping at all.
In reality, we are far from understanding the virus and the potential of vaccinations in this case. Questions about how long the vaccine will work, what possible boosters are needed, how mutations will change the course of strategy and whether vaccinated people can still be infected or pass on the virus are questions in transition of answers. Combinations of vaccines would be another question which warrants an answer.

The advent of highly expert driven expert discussions in the public and political domain is creating more havoc and uncertainty then intended by those allowing for it. And looking through publications and mini studies and opinion pieces one can’t stop thinking that some so-called or self-identified experts have their own popularity as priority number one on their agenda. Also here social media are at parts more a curse than a blessing, when it comes to relay information which are factual correct and done in a way which enlighten ordinary people.

The additional problem in South Africa is that even those, who vote for the governing party not necessarily trust anybody in government, knowing what they know via the Zondo Commission. Too much lies, too much deception, to many people in charge just looking for their own advantage and having their own hidden agendas.

As it stands at the moment, no decision is taken what happens to the amount of expensive vaccines waiting in the cold storerooms of South Africa. It would be a pity if they would be given back or expire- as they still prevent severe illness and death for those being vaccinated with them.

Generally speaking we have to learn to appreciate what medical advances can do – and to understand that all are building blocks to prevent the pandemic from raging on – none is currently the golden bullet which stops the virus in the track. And there is something else to learn: that health experts should only cover parts of the political decision-making process in pandemic times for complex societies. There is more to balance and if one part is dominant, it will derail the process of taking with them the people governed.

Filed under: Africa, Politics and Society, Reflection, Society and living environment, South Africa, Uncategorized, , , , , , , ,

The vaccine greed

The human race, encountering an enemy small but quite powerful, shows in our days that despite all advances in organising itself in various forms and shapes and with the help of modern technology it fails to act with integrity and common sense.

While it is amazing how fast global research and cooperation has brought powerful weapons in the form of vaccines to the forefront, distribution shows that humans are the worst enemy of humans.
We all know and currently experience that lockdowns, border closings can slow down the onslaught of the virus, but it can’t stop it, and it certainly can’t stop mutations to occur which would make beating the pandemic more difficult because of the changes the virus undergoes.

Common sense would dictate to stop the mutated virus in the track and to avoid the dissemination of a more difficult to beat virus mutant, in our current case the mutations which occur in Great Britain, South Africa and most probably Brazil. Vaccinations in these countries to get rid of dangerous mutations should be the first price while also starting the vaccination drive in all other countries. It would benefit the human race in its entirety.

What we see instead is the run of rich countries to get the hands of as many vaccines as possible, determined to only look for themselves first and then the rest of the world. Looking at the global village and acting as one human race against the virus is not on the agenda – the gaps between rich and poor are widened and the failure to act towards the common good of humanity are thrown out of the window.

We also see the greed for profit determining sales and contracts and countries and companies are not ashamed to close deals which will prolong the suffering of others. Vaccines against HPV and medications against HIV are already written into the history of prolonged and unnecessary suffering born out of profit and greed.

Human mankind prides itself with the ability to think and reflect, to act ethically and after considerations of consequences. That is our advantage looking at all other creatures around us. We already in the process of failing this advantage in the questions of climate change and environment. Organised religion which should be guardians of such ethics and moral considerations are in current times either mostly busy with themselves or slipped into battlefields of ideologies or politics.

Covid-19 has laid bare the fault lines of societies – we should make sure that the way out of the pandemic tells a positive story of humanity standing up to the challenge in a reflective, decent and meaningful way having the global village and all its citizens in sight.

Filed under: Africa, Politics and Society, Reflection, Society and living environment, Uncategorized, , , , , , , , ,

A pleading president

If the situation would not be so dire, one could be more amazed about the pleading president, South Africans experienced yesterday evening on television. Addressing the nation he introduced more stringed measures to stop the out of control spiralling infection rate, pleading with South Africans while fighting tears to adhere to the rules.

It was a confession that the national government had lost the grip on infection and people; a bitter result of lockdown rules in the past which did not make any sense and at parts were unconstitutional mixed with a general distrust in the population witnessing the corruption levels especially in Covid-19 times of those in power and well-connected. Additional a police force riddled with corruption narratives and a police minister, whose virtue lies definitely not in honest police work or leadership. No improvement here from the failure of “Mr. Fix” as his predecessor. So enforcement levels and capabilities are at an all-time low. Understaffed and often not sufficient trained honest policemen are battling to remain on top of situations.

Add to this mix the strategy of keeping people dependent on hand-outs and an education system which often fails to produce matured thinking and one comes closer to the problems South Africa is governed by in our days.

The ban on alcohol sale and consumption in public was the right move, it highlights the fact that South African society at large has a drinking problem, maybe born out of the misery and hopelessness of people and the still not healed past. On the other hand there will be again a black market and some people, also well-connected will earn again the big bucks like in the times of the cigarette ban some months ago.

Where from here? The vaccine is for South Africa certainly the most promising fix in this situation; but all the commotions about late payments promise not a smooth sailing in this department. The promised vaccine for the first quarter 2021 has suddenly moved to the second quarter – and the indicated big announcements by the President yesterday still have to materialize before one can bank on it.

Covid-19 remains a challenge to the young democracy, and it continues to highlight all the failures and shortcomings of South African society. In this, we are not different from other countries. But we maybe have more to lose if we don’t get it right.

Filed under: Africa, Reflection, Society and living environment, South Africa, Uncategorized, , , , , , , , , ,

Snow from yesterday

Schnee von gestern” – “snow from yesterday” are yesterday’s news – so a German saying – and today we have moved on after World Aids Day. For 24 hours the pandemic which killed roughly 33 million since the beginning of the pandemic while 76 million have been infected in the same timeframe took somehow centre stage again.
In the times of Covid-19 with so far 1.5 million death such days of memento are somehow subdued, people are too busy with the current worldwide pandemic. So the day passed more quiet than normal due to restrictions – the usual suspects gave press statements and those in the field did their duty to remind the world, but even this felt half-hearted and at times decent to not get into competition with the headline creating Corona.

For me, World Aids Day was a day of reflection on how the AIDS pandemic would have played out, if not “only those gay people” would have been hit at the beginning but everybody.
What would have happened if President Ronald Reagan had put aside his misguided religious views and acted properly and in line with his duties to protect every citizen.
What would have happened if care, worry and empathy had prevailed and not the feeling by many that they called it on themselves with their appalling lifestyle.
How many lives would have been spared, how much suffering would have been avoided? Do we care to reflect and learn out of it?

Working in the field of HIV/AIDS more than 20 years I sometimes wonder how this country I live in would have evolved without the pandemic shattering the dreams and hopes of so many South Africans till this day.

Looking at Covid-19 in South Africa, there was this déjà vu – the same mechanisms kicked in – panic, fear, uncertainty in overdrive in the health sector, stigmatisation and it took time to settle down in the health sector and reason prevailed, and now, in current times, almost carelessness on the streets in the face of the second wave.
Of course, in this case, vaccines are in reach, even if we learned yesterday that the South African government is very late to secure those for the country and pay their dues in time. Being late was also the trademark of this government in times of HIV – so nothing new on this level.

And the question remains: Have we learned out of the AIDS pandemic enough to rise to the occasion?

Filed under: Africa, Politics and Society, Reflection, Society and living environment, South Africa, Uncategorized, , , , , , , ,

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