JOHANNESBURG, Jan 20 (Reuters) – South African healthcare experts are urging the government to share a detailed plan for administering COVID-19 vaccines with private sector partners who are offering their help, warning infrastructure bottlenecks will otherwise delay the rollout.

With around 1.34 million total cases and 37,449 deaths as of Monday, South Africa is by far the African nation hardest hit by the pandemic and is grappling with a second wave of infections driven by a new variant of the virus first identified in the country.

The government has said the first vaccine doses will arrive by the end of January, and South Africa will aim to vaccinate 40 million people by the end of 2021.

But with a public health system creaking even before the pandemic hit, experts say the vaccination drive will require a plan to coordinate with private health services, pharmacies, supermarkets, major employers and non-government sectors.

“South Africa needs all hands on deck,” said Glenda Gray, president of the South African Medical Research Council (SAMRC). “If we rely on the current healthcare system, then the plan is doomed.”

On Tuesday, the government released a statement saying a national committee would oversee the vaccine roll-out in both the public and private sectors.

It did not say when the roll-out would start, how distribution and storage logistics would be managed or identify private companies that would be involved. The health ministry did not reply to an email sent on Monday seeking those details.

Experts contacted by Reuters said they believed big private sector players should already be on board.

“Currently there is a single channel of procurement and no clarity on efficient and speedy delivery,” said Alex van den Heever, a professor at the Wits School of Governance in Johannesburg. “It is hugely constraining.”

SCALE OF THE CHALLENGE

South Africa immunizes around 5,000 babies daily for diseases such as measles and diphtheria as part of what is currently its biggest mass vaccination scheme.

To reach its COVID-19 vaccination target, it would need to administer some 150,000 doses every day for the next year.

A programme on that scale will need to manage reams of data on who must be vaccinated, who has received a dose of vaccine and who still needs a follow-up shot.

Tuesday’s government statement said the system would be based on a pre-vaccination registration and appointment system, but did not go into details on when and where people can get registered.

The vaccination drive will also require vast cold chain infrastructure at a time when South Africa is suffering from regular power cuts, as well as a plan to deal with unprecedented amounts of bio-medical waste, experts say.

Some private companies and industry bodies with the necessary expertise and infrastructure have already volunteered their assistance.

The Independent Community Pharmacy Association (ICPA), which represents around 1,164 pharmacies, said last week it had sent the government details of how it could assist the vaccination effort.

ICPA said it was working with the National Department of Health on vaccine roll-out, but did not say if a plan had been agreed.

Clicks Group, South Africa’s biggest pharmacy chain, told Reuters it was ready to offer the use of its vast distribution network but was awaiting clarity on how the government’s programme would work.

The Minerals Council – an industry body for mining companies – said its members were developing plans to use the sector’s healthcare infrastructure and delivery capability for the vaccine drive.

Supermarket chains and retailers are also offering to help.

“The Shoprite Group is … ideally positioned to assist with the distribution and administration of COVID-19 vaccines in South Africa once the government provides final details,” the country’s largest retailer told Reuters.

Health experts said such private sector support was encouraging, but added a detailed government blueprint was needed to avoid delays.

“It should have been developed already,” said Jeremy Nel, head of the infectious diseases division at Johannesburg’s Helen Joseph Hospital on the roll-out plan. “Slower you are to roll-out, you will have to measure the cost of failure in deaths.”

(Reporting by Promit Mukherjee and Nqobile Dludla; Editing by Joe Bavier and Alex Richardson)

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