Pfizer says it can’t supply South African healthcare workers with its COVID-19 vaccine until it fulfils existing commitments to wealthier countries who pre-ordered vaccines.
South Africa could see some stocks of COVID-19 vaccines as soon as April through GAVI’s Covax initiative, South Africa’s National Health Department Deputy Director-General Anban Pillay told eNCA. Pillay says the country has approached all major COVID-19 vaccines makers in hopes of bilateral deals for more stock. Pfizer may be able to provide South Africa with a limited stock of its vaccine for healthcare workers, Pillay says, but the firm will only be able to confirm this in March after it has filled previous orders from other countries.
Read an edited transcript of Pillay’s 30 December interview with eNCA anchor Shahan Ramkissoon below or watch the full-length interview (also below):
Anban Pillay: “We participated in the Covax initiative, and that initiative allocates vaccines as they become available from the manufacturers of the vaccine. What has happened, and you may, your viewers may be particularly concerned with the fact that there are other countries that have already started rolling out the vaccine. Many of these countries didn’t participate in the Covax facility but rather got into bilateral agreements with a particular vaccine manufacturer. In this case, the Pfizer vaccine is the one that they had put their money on such, and it came through for them, and that’s why they’ve been able to roll out the vaccines first.
“Covax, on the other hand, took the approach of spreading its risk amongst a number of vaccine producers because at the time when this these trials started, there was no sense of which vaccine was going to succeed and which was going to fail. And so Covax engaged with all of the vaccine producers. Based on that, Covax will receive an allocation they’ve indicated to us expect allocation in Quarter 2, they soft allocation to us appears to be in the earlier parts of Quarter 2, so I’m hoping that sometime in April, we would be able to get the full Covax supply.
“In addition to that, I think it’s important to say that we’re pursuing the bilateral agreements, as we have been from last year, to try and get the additional supplies through the same manufacturers.
“Obviously, [pharmaceutical companies] tied up many of the production to these larger economies, where they obviously are garnering a much higher price. And so South Africa is being considered. But at this stage, we can’t confirm anything firm, as the President indicated, of exactly when we can get earlier doses before April. But we’ve certainly trying our best to persuade each company to give us a small amount, especially for our health care workers who are in the front line of this.”
Shahan Ramkissoon: So did we play our cards wrong when it comes to actually securing a vaccine? Was Covax the right move?
Answer: “…The choice we had earlier in 2020, was to say, ‘well, you could either go with putting your money into Pfizer or AstraZeneca’ — because all of these companies that were developing the vaccine require that you pay upfront — and you will be paying upfront for only one specific vaccine, so whether it was Pfizer, AstraZeneca, Johnson & Johnson or any of the others. So if we went with one single company, and that vaccine failed to succeed in the trials, we would then have basically lost our space in the queue with all the other companies.”
“All of these companies that were developing the vaccine required that you pay upfront”Anban Pillay
“So our approach was rather spread our risk across all of the companies. Covax was the facility that allowed us to do that because it basically engaged with each of those companies and got into agreements with them about the supply. Because if you went with one company, let’s assume we went with Pfizer and Pfizer’s vaccine failed, we’d be sitting today telling you, we don’t know when we’re going to get the vaccine because we’ve even missed the Covax arrangement as well. So I think it’s important to understand what we were faced with at that point in time.”
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Q: Let’s talk about AstraZeneca, which was trialled in South Africa by Wits University. They suggest now that it’s one of the best options for South Africa, given the temperature it needs to be stored in. Are you consulting with AstraZeneca?
A: “Yes, we’ve been consulting with AstraZeneca from last year as well, trying to get them to allocate to us a portion of the vaccine as early as possible.
“AstraZeneca at the time could not make any firm commitments to us around supply because they’ve taken a bit of a different route from any of the other companies in that they have multiple producers and suppliers into different regions of the world.
“We’ve been consulting with AstraZeneca…trying to get them to allocate to us a portion of the vaccine as early as possible. They said at the time they could not make any firm commitments.”Anban Pillay
“What I can say is they’ve now come back to us with some clearer sense about how supply would happen, and they’re trying to support us to get some early access to vaccines through one of the producers. This is not confirmed yet. But I think this is one of the key areas that we are pursuing to try and get early access to vaccines for healthcare.”
Q: I get the logistics around this and why South Africa went the Covax route. But the reality is we have hundreds of people dying every day from the coronavirus in this country. Why are we not pushing harder to get this vaccine here faster? April next year is a long time away.
A: “I hear what you say. But I think it’s it’s difficult for people to appreciate sitting in their homes and not having a sense of what we’re trying to do on our side to try and get access to vaccines. I think what needs to be understood that every country in the world wants to have access to these vaccines. The vaccine that was registered prior to yesterday was only the Pfizer vaccine. And now it’s the AstraZeneca vaccine, which the UK Government only registered yesterday. So there are no other vaccines and to also understand that many of the other vaccines that are not available yet, but the suppliers have not placed dossiers with our regulatory authority. So those steps have to be satisfied before we can release a vaccine that safe and effective. The worst thing we can do is say people have access to a vaccine. But we don’t know how safe or effective it is. We must be clear that this vaccine is safe and effective. So that requires time, unfortunately, the UK only registered the AstraZeneca vaccine yesterday.”
Q: Why are we not approaching Pfizer and AstraZeneca to a point where it’s with a sense of urgency, so we don’t have to wait for Covax, which is clearly going to take some time?
A: “Okay, so maybe I didn’t make myself clear before. What I’m saying is, we’ve pursued all of the vaccine manufacturers that have vaccines that are close to ready for production, including Pfizer.
“Pfizer has indicated at this stage, we do not have stock to supply to you immediately. Those countries that have had access to stock have been in bilateral agreements with Pfizer.
“Covax does have a bilateral agreement with Pfizer, but Pfizer is supplying Covax at a later stage after satisfying some of these other commitments”Anban Pillay
“As I indicated, we didn’t get into our bilateral agreement because we pursued the Covax route. Covax does have a bilateral agreement with Pfizer, but Pfizer is supplying Covax at a later stage after satisfying some of these other commitments. And that’s, that’s a decision the company takes. And like us, many other countries are also complaining to each of the companies to say we’d like to have some stock of the vaccine, and [they] say, well, we’ll see what we can do to help you. But at this stage, everybody wants vaccine, and our production capacity is fairly limited. So you would have to wait.”
Q: AstraZeneca. Let’s talk about that a bit more, right, because South Africans [participated in the trial]. Why was the deal not made there to say if it is successful, that we need some sort of preference?
A: “I don’t know. I’ve heard some of the so-called experts …on eNCA suggests that this is what government must do. That’s a very strange approach. Because when a clinical trial is done in a country, the company that’s doing the trial doesn’t seek approval from government, they seek approval from the regulator on a scientific basis…
“I agree with you that the company should consider that they did the trial in South Africa and the data from South African patients contributed to the success of their product, we have raised this with them.
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“The point I’m making is that you cannot say to a company, ‘because you did a trial in South Africa, you now have to give us a vaccine’, there is no law like that. No country has such a law. Many drugs have been trialled in South Africa, and they are not registered in the country simply because companies may choose not to do so.
“There is no known legislation anywhere in the world that I’m aware of, that you can force a company to say, if you did a trial in my country, please give us the drug doesn’t happen like that.
And I’m not sure where people get this idea from.”
Q: Pfizer said and I quote, ‘The South African government says the Pfizer vaccine won’t be suitable for South Africa because of storage requirements.’ That’s the response basically saying that you need to get your act together in securing this vaccine. So what’s the problem?
A: “The point you’re asking me about is whether the Pfizer vaccine will be used as a national rollout. So the Pfizer vaccine was presented to the Ministerial Advisory Committee at an earlier point last year, at that point, Pfizer indicated quite clearly to us, the vaccine has to be has to be stored at minus 70 degrees.
“South Africa has only two storage facilities that are able to store at minus 70 degrees in the bulk required in order to distribute the vaccine. It became clear to the Ministerial Advisory Committee and us, that if you want to have a national rollout of millions of people, you cannot operate off that. So the Pfizer vaccine will not be the best choice. So we indicated to Pfizer gonna be very difficult to do this.
Pfizer has said that it may only know in March 2021 if it can provide limited doses of its vaccine for South African healthcare workers.
“Many other countries have also done so. However, in the context of accessing vaccine for our health care workers, we went back to Pfizer to say, “Would you be able to assist us with small volumes of vaccine that we can manage through these facilities for our healthcare workers?” which is a very different vaccination programme. They’ve indicated, ‘Yes, we’ll consider that. But we can only come back to you hopefully in March but we can give you no firm commitment on that.’ So we’re still awaiting a firm commitment from them as to when exactly they will be able to get give us that stock.”
[Editor’s note: Pfizer has publically confirmed that they are working on a version of the vaccine that could be stored at more widely acceptable temperatures]
Q: Just in terms of Covax as well, we’ve missed deadlines. There is a good strong sentiment out there, that government has not adequately tried to get a vaccine to South Africa faster than April.
A: ‘Well, I don’t know why you have that view because you’re not sitting on my side in my chair. Looking every day at what we’re trying to do to access vaccines, your perception is driven by other factors, which I don’t really understand. But let me say to you that we are not actually driven by facts you miss both deadlines because you have no facts about who we met with…. and how we’ve tried to access vaccines. Are you sitting in the meetings with me with the pharma companies? You’re not so you’re speculating…
“Covax said to us, ‘we understand that South Africa will be part of Covax and you’ll be part of the initial allocation. You have not missed any deadline.’… We are also pursuing all of the vaccine manufacturers to get access to vaccines before April. I cannot tell you a date on when vaccines will be available because they have not given us a date.
“If I give you a day to day you come back to me and say, well, I misled you. So we do not want to do that. We want to make sure that a company says to us, we’re giving you x volume of the vaccine on this date, then we’ll make it public that we sure we’re going to get this delivery by the state We tend to pursue vaccines even next week if somebody can give us, but nobody has talked, so we’re not able to get it.”
Q: And the action plan in terms of rolling out that vaccine where we eventually get it, we know it’ll go to health care workers.
A: “After health care workers, we would pursue each of the vulnerable groups, the over 70/75, those with comorbidities, etc. The Ministerial Advisory Committee has come up with a priority list that is very much aligned with what the World Health Organisation has set up in terms of what priority groups are appropriate, given the morbidity and mortality that COVID presents to many patients.”