Childhood Diseases

09 November 2012

Reality check on vaccinations in SA

Despite South Africa’s status as a middle-income country spending R1.2 billion in vaccine procurement in 2010, vaccination coverage rates are surprisingly low.


Despite South Africa’s status as a middle-income country spending R1.2 billion in vaccine procurement in 2010, vaccination coverage rates are surprisingly low – lower than Malawi that has only 10% of South Africa’s per capita income.  Médecins Sans Frontières / Doctors Without Borders (MSF) rang the alarm bell at the opening of the first ever International African Vaccinology Conference, hosted in Cape Town, where delegates from 40 African countries are convening.

Discrepancies between Department of Health-issued vaccination coverage data and World Health Organisation/Unicef official estimates are stark. The Department of Health claims 96%* of South African children have been vaccinated but the international organisations are reporting 72%*; experts claim the real number is lower.

South Africa also compares poorly with other middle-income nations like Brazil that has a vaccination rate of 96%*.

“We want to see the same courage and leadership on vaccines that the Department of Health has shown on AIDS,” said Daniel Berman, General Director of MSF South Africa.

SA pays a lot for vaccines

In a plenary address, Berman said that disappointing results are not because of a lack of spending. South Africa is paying the highest prices for vaccines anywhere in the developing world.  South Africa pays R161 per dose for the new anti-pneumonia vaccine, this is three times the price paid by donors supporting most other African countries. Since this vaccine requires three doses, each child vaccinated costs R483 in South Africa.

Imported vaccine prices are inflated because they are exclusively handled by a public-private partnership that levies a 10-15% handling fee. That fee is meant to help fuel local development and production of vaccines. However, this system so far has had little impact on stimulating real vaccine development and production in South Africa.

The Department of Health has called for a stop to subsidising “local” production through high prices and urges the Ministry Trade and Industry to offer direct support for real product development instead. Direct support has been successfully used by other countries and institutions and played a large part in the development of a new affordable meningitis vaccine (MenAfriVac), that is now being rolled out in Africa at only US$0.50 per dose.

“We question if the current system in South Africa is working,” says Berman. “Children are not receiving their basic vaccines and the costs are too high. It’s time we have an honest discussion about the challenges.”

(Press Release, November 2012)


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Prof Eugene Weinberg worked in the Paediatrics Department of the Red Cross Children’s Hospital for many years. He is presently a paediatric allergist at the Allergy Diagnostic Unit of the UCT Lung Institute in Mowbray.

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