God, AIDS, Africa & HOPE

Reflections / Gedanken

03/04/2021 • 8:49 am Comments Off on A window of opportunity

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, , , , , , , , ,

02/18/2021 • 7:41 am Comments Off on A decision costing lives

A decision costing lives

While parts of South Africa celebrating the first jabs and at the same time wonder, how a president and a minister of health jump the queue and have become overnight honorary frontline health care worker, there are more questions than answers.

There are indeed questions regarding the AstraZeneca vaccinations – 1.5 million jabs arrived with great fanfare in South Africa, received and checked by the President of the country himself – only to be overnight discarded as not effective enough via a small study without peer-to-peer review and even more questions than answers, when you listen to health care professionals behind closed doors. While the headline of a news outlet in South Africa reads: “WHO gives AstraZeneca Covid-19 vaccine emergency approval, says it works against variant first found in SA” the national Minister of Health is quick to say, that the vaccine – which was paid almost double the price as European buyers – will go the African Union for distribution in other African countries.

This will cost lives – as AstraZeneca clearly prevents severe disease and death – consequently would free up hospital beds and oxygen use in the third wave which will come without doubt in the winter months. 3/4 of a million people could be spared by using the vaccine to end up in hospital or even in a crematory.

But the story does not end here. One of the national vaccine protocol chairs is also – according to newspaper reports – wearing the hat of co-principal for a stage III study. Now the gap is filled with 80 000 vaccines to complete the trial, needed by the pharmaceutical company to acquire the emergency permission and the product consequently being added to the bouquet of vaccines available around the world. Obviously there is also the promise of more vaccines for South Africa from the same company.

Transparency looks different – insiders know how tough the fight for market shares is and how much money is at stake in the run for emergency approval and being able to sell the product. As much as it is nice to see vaccinations finally happening in South Africa, connecting the dots gives at least a picture which leads to more question than answers. And with all the cheer being produced by those pulling the strings behind the proverbial curtain the fact is that giving away the AstraZeneca vaccines will cost South African lives in the future. Experts are aware that none of the vaccine delivers a 100% protection and true is also, that one vaccination might not be enough on the long run. All companies work already on boosters, including also to cover the many variants of the virus; at the end such boosters will follow for most vaccines.

For now, it should be acted on what Christian Drosten, Chef virologist of the world-famous Charite remarked some days ago: that whatever you have on vaccine, should be used because at the end, all the vaccines help to cut down on the spread of the virus one or the other way.

And so there is only one conclusion:
competition, egos, politics or similar should be on the backbench – whatever tool is available should be made available to protect people from becoming severe ill and dying. Every prevented dead is a win! The chaos around the vaccine and the questions the story raises will not help to boost the confidence of people in South Africa for the vaccine. Looking at the social media response there is no indication that jumping the queue of politicians assists in changing minds. If we really want the buy-in of those opposing the vaccine one has to avoid any appearance of non-transparency or second guessing about motivations, reasons and decision-making. In this South Africa has still to catch up heavily.

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

05/21/2020 • 10:14 am Comments Off on Scare tactics as the new transparency?

Scare tactics as the new transparency?

South Africa in the times of Covid-19:
It is amazing: feeling the heat turned up and demanding answers about all the nonsensical decisions of a constitutionally questionable National Covid-19 Command government changed tactics in the communication with “our people”.
Having realised the damage done by scientists of the medical advisory body opening up about being ignored when decisions are made and with this the presidential narrative of scientific reasoning for the lockdown in jeopardy; the Minister of Health resorted to publishing the worst case scenario of another group of academics which created the intended headlines of horror and destruction intended. The small print – that those calculations are based on weak and anyhow ever-changing data – clear to those used to see such analytics – but hidden for the majority of readers was surely mostly not realised by readers in the same way as the screaming headlines.
And obviously the death of a premature born baby with severe lung defections born by a Covid-19 mom again produced headlines of horror; the fact that the survival chance was anyhow minimal besides Covid-19 had no chance against the presumption that now even babies are prone to die quickly. Again a welcome argument spread around by all tabloids in South Africa.

Those interested in politics noted also the absence of Minister Dlamini-Zuma for a Parliamentary Committee question session: she was too busy drafting the Level 3 rules to attend to her duties towards the people’s representation. The message conveyed was how hard at work ministers are.

I have the impression, government changed tactics to convince people how serious the situation is – and I don’t know anybody personally, who would not agree to it. But what government did not factor in in this obvious change of mind is that trust has been massively lost and that changing gear from the extreme of secrecy into a pretended openness is not very convincing neither.

The uncertainty of timelines, the amount of rules not Corona connected, the plight of hungry people, the damage to the economy, the rag rug of drafts, promises, wishes and realities,  the damning Khosa judgement and the promise of splitting the country into different level areas are all fuelling the resentment of people against a national government thorn apart by internal struggles of the ruling party. This struggle is mirrored in the decision-making process.  The impotence of the ruling party of letting go of an ideology not fitting our times any more and the myth of a unified ANC speaking only with one voice  are the ingredients of the decision-making chaos South Africans witnessed the last weeks.

The virus is here to stay – the lockdown served its purpose – government had enough time to prepare.

Now is the time for lifting the lockdown and to put all emphasis of safety measures while restarting the economy and tackling the social woes of this country. And not only the social problems: The mere fact, that breaking the lockdown rules make you a criminal while stealing from the state coffers and being corrupt earns you a place in government or parliament documents what still is wrong in the country. Being part of state capture seems still to be without consequences, while walking on the beach will lock you up in a holding cell. The Covid-19 pandemic again brings also on this level into focus what is clearly not right in our country.

In the current situation, the Western Province is surely one of the best prepared provinces, statistically ahead of other provinces also when it comes to the pandemic itself. And even knowing this one can’t miss out on the efforts of political forces to use this against the people of this province by threatening to keep them more locked-down as other provinces. It is also the province where NGO’s are valued and not menaced to be brought under a strict governmental control trying to monitor and decide on food assistance in a way which will hurt those in need.

Again: now is not the time for political scores or power plays, it is not the time for scare tactics or secrecy; it is time to lift the lockdown and to put all energy into bringing the best out of the people and motivating them to keep safety measures – making it fashionable to care for each other and in doing so, uplifting our society in ways maybe not possible without the virus. Every challenge is also a chance, so they say…

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

05/17/2020 • 2:07 pm Comments Off on Don’t crack down on dissent – have a plan and show it!

Don’t crack down on dissent – have a plan and show it!

The fallout of comments made by members of the South African ministerial advisory committee MAC was to be expected – Minster Dr. Zweli Mkhize wasn’t happy and the reported heated exchange leaves the need to little fantasies about tone and emotions during the last meeting.
Obviously a government with a president claiming to follow sound and best advice of the very best academics the country has to offer cannot be happy, when the very same experts question the rationale of decisions made.
We are dealing with a health crisis – so the advice of health experts is of utmost importance – it seems that the political ploy to use this crisis for political gains and the dissatisfaction of “our people” led the academics to the conclusion that they will be blamed for the dire situation instead the politicians in charge of all the hardcore decisions; be it the ban of alcohol and tobacco sale, be it the never ending discussions about what a person is allowed to buy and what not in our times.

For me it is encouraging that those academics who are indeed known for their expertise and listened to at many conferences see finally also the need to speak out and not keep silent about the madness of regulations we are showered with – changing almost on a daily base. I guess the frankness of Trevor Manuel was one of the encouraging trigger point for them to speak out – and they said actually nothing what we did not know – they spoke common sense:

It is a health crisis – and instead of getting imprisoned in stages and rules and fine-tuning of rules there are some facts undisputable and determine the way forward:

  • Government asked and got 5 weeks to prepare for a virus, which will not stop even during lockdown to spread.
  • South Africa with the dense township population and the amount of people living in poverty or on a daily or weekly salary or allowance cannot adhere to Western measurements of e.g. physical distancing over a long period of time.
  • The impact on our economy is almost killing our system – the attempt of some in national government to change the system abusing the crisis is simply not acceptable.
  • We have to live with the virus for a longer time to come – so all public health measures should be – next to screening and testing – the focus point of all governmental efforts. Companies, NGO’s and all other in the working field should get all resources to remain on top of the pandemic and to function as safe as possible.
  • Military personnel should assist in opening field kitchen and field hospitals to assist our weak health system.
  • Parliament must regain oversight control over all the measures again – this is a time parliamentarians have to come together for the greater good of South Africa regardless of political creed.
  • Assistance must be made available to all South Africans – Covid-19 is also a chance to feel that we indeed are all in it.

A clear and transparent time table is needed to open up the economy while using all energy to bolster further our health system and get more testing and tracing done. We can’t live from President’s speech to President speech – expecting afterwards again a change in rules.
Honesty and the willingness to share all information, to explain the steps taken and the attempt to regain the trust lost in the last weeks will go a long way to beat this virus here in South Africa. We don’t need any ideology at the moment, no political grandstanding but humility and decency from those making decisions. No Cuban flag, no camouflage, no finger up in the air, no threats, no kindergarten teacher attitude but clear, sustained smart steps coming out of a common consent that we are all want to beat this little bug in a way, that makes us stronger and more resilient in the future.

 

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

03/24/2020 • 12:05 pm Comments Off on HOPE in the times of lock-down

HOPE in the times of lock-down

Since yesterday evening it is official: South Africa will go in a 21-day lock down from Thursday night and all non-essential work will cease, freedom of movement is suspended and police and military will have a watchful eye that all rules and regulations are adhered to in the weeks to come.
For an NGO like HOPE Cape Town those are difficult times on several levels:
Firstly our medical staff will continue to work and give their very best to battle the pandemic and see patients; exposing themselves to the risks of being infected. A constant worry for those responsible in the organisation which otherwise also has to shut down so-called non-essential services. Obviously our definition differs from the one the law prescribes: knowing how much people in various townships depend on assistance it is sometimes difficult to imagine how those less fortunate survive in even more dire circumstances. Believe it or not: this adds to the stress level of those who are not allowed to work in the fields as HOPE Cape Town employees.
And there is a third level of worries: the financial ones. Obviously in this crazy time many people and companies are struggling to keep themselves afloat – donating to a charity is the last on their minds which results in major income losses for NGO’s. And unfortunately, no state has yet acknowledged those financial woes, only companies for gains will receive government assistance. We will see quite some charities closing their doors because the lack of funds, we will see lots of retrenchments as a result of lock-downs and other measures, which mean to save societies from a high number of infections and mortality.

HOPE Cape Town tries to mitigate all negative factors and has till now always found a way to survive challenging times. Even in the times of Covid-19, which is unprecedented the organisation will be able not only to survive but to continue it’s much-needed work medically during the crisis and socially after the lock-down. Obviously it welcomes donations via its web page www.hopecapetown.com or any other sign of solidarity.

Codvid-19 shows us, that we are all in the same boat – that we are part of something much bigger we as humans can only master in parts. It is a strong reminder that the power of humanity has its limitation and that human mankind might have forgotten about it. Economy alone and constant economic progress is no salvation, but becomes part of a problem as shown by a small little virus shutting virtually down this world as we know it.

Covid-19 can be a game-changer of our mindsets, it can make us more aware and more humble, it can point out the faults of our societies and it can raise an awareness, many NGOs embody in their daily work. We as the human race owe each other, and we owe creation in a much deeper way we normally realize. Time to readjust our awareness – a lock-down time is not only a challenge but also an opportunity to reflect and to do better afterwards. Not because we are scared, but because we have learned something for life. And in doing so, we create hope in the times of a lock-down.

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

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