A third wave of COVID-19 infections was perhaps inevitable. What wasn’t inevitable was the heart-breaking amount of serious illness and death it has wrought. This public-health crisis could have been averted had President Cyril Ramaphosa and his government handled the vaccine rollout effectively. 

Vaccination is everything. The spread of the new Delta variant in the UK, for example, has yielded similar infection numbers as South Africa, but with a fraction of the hospitalisations and deaths. This is because just over 65% of all UK adults have been vaccinated.

Having vaccinated only 4.7% of the population, South Africa (while having the 33rd largest national GDP in the world) ranks a disgraceful 159th out of 210 countries and territories, according to Our World in Data, a non-profit online scientific publication based at the University of Oxford. Our vaccination rate puts us behind Zimbabwe, Algeria, Cuba and Libya and barely ahead of Afghanistan, Iraq and Venezuela.

At our current rate, of an average of 70 500 per day, it will take another two years to vaccinate the government’s target of just less than 70% of the population. At this rate, we will soon see a fourth wave, which will bring yet more hospitalisations and deaths. We must act now to change this trajectory. But first we must understand what brought us here.

The vaccine rollout started late and has barely progressed. The government has offered countless excuses. None of them hold up. 

The government claims the country is a victim of ‘vaccine apartheid’ – that rich countries are hogging vaccines to the detriment of poor ones. But this hardly explains why so many other middle-income countries have done a much better job at vaccinating their people. Chile has vaccinated well over 60% of its population. Cambodia, Colombia, Cuba, Morocco and Turkey are all at over 20%. If these countries can do it, why can’t we?

The real problem is that the South African government, unlike many other governments, negligently failed to commit to buy vaccines before they were licensed. This has put the country at the back of the queue for even getting the vaccines, and the prices now are far higher. 

Even in cases where the government has obtained vaccines, the story has been dispiriting. In March, the government sold off one million doses of the AstraZeneca vaccine owing to concerns it was ineffective against the South African variant of COVID-19. Yet there was already evidence at the time that the vaccine prevented serious hospitalisation and death, so surely it would have been better to disseminate it among South Africans than to let it go. 

Amid this ineptitude, there has also been some bad luck. A contamination incident with the Johnson & Johnson vaccine forced the government to dispose of two million doses. But while this was a blow, these doses would only have pushed our vaccination rate to a still pitiful 8%, and is hardly a suitable excuse for the government’s failure to vaccinate a population of nearly 60 million.

If the government’s procurement strategy has been feeble, its rollout of the vaccine has been equally dire – underfunded, understaffed, inefficient and heavily bureaucratic. 

Chronic vaccine shortages have meant that some vaccination centres often finish an entire day’s stock within hours, while others centres often don’t have the budget and staff to operate in the evenings or on weekends. The rigid bureaucratic and controlling rules have severely hampered speedy and widespread vaccinations.

Despite the government’s negligence with the vaccine rollout, it has actively blocked efforts in the private sector to procure and distribute the vaccines. South Africa has one of the most advanced and innovative private healthcare sectors in the world. The government could have provided the international pharmaceutical companies with the required indemnities, and then mandated the private sector to procure the vaccines and distribute them nationwide at pace. Had the government merely allowed private health companies to tackle this problem, the country could have prevented the countless needless deaths and hospitalisations of the third wave. 

Government officials have argued that allowing the private sector to manage a national rollout would have distorted access in favour of those who could afford it. Yet the government could have supported private efforts on the condition of equal access for all citizens.  

A cruel irony of the government’s ostensible concerns with social justice and vaccine equality is that the government’s vaccination drive, with its heavy bureaucracy, favours the wealthy over the poor. According to Department of Health’s statistics, 65% of insured people over 60 have registered to receive a vaccine, and 48% have received at least one dose. Among the uninsured over-60 population, 45% are registered and only 26% have had one dose.

There has been talk lately about launching a government-run National Health Insurance scheme. Access to quality healthcare should indeed be a human right. But as the government’s efforts to roll out the COVID-19 vaccine make plain, it would be folly to entrust our political leaders with an enormous healthcare bureaucracy that controls every aspect of our healthcare. 

Years of corruption and cadre deployment have denuded this government of its capacity to function. Given the government’s failure with the vaccine rollout, a relatively simple and contained project, how would it fare at managing an entire healthcare system? 

Now is the time for this government to repent for the sins of its negligence in vaccination, which has caused so much suffering and death. The Talmud teaches us that true repentance comes only when we admit our wrongdoing, ask for forgiveness and change how we behave. We are truly repentant only when we resolve not to repeat our sins in the future.

It would be an act of profound integrity if President Ramaphosa and his government repented by expressing remorse and asking for forgiveness for their negligence, which have cost so many lives and created so much hardship. But it is even more crucial and urgent that the President sincerely repent by demonstrating that he has learned from the catastrophic consequences of this government’s errors, by unleashing the private sector to handle the vaccine procurement and rollout at maximum speed and efficiency. The government could then concentrate on encouraging people to get vaccinated. An effective vaccine rollout can still be salvaged from the wreckage. 

It did not have to be this way. We should not have to witness our rising death toll as citizens of other countries support local businesses and get their economies moving, gather with family and meet with friends. If the government does not make a change now, we will simply experience more suffering and death in the next wave, and the next. There is no time to be lost. Let the path to atonement and healing begin – today.