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Ensuring Equitable Covid-19 Vaccine Distribution in South Africa

Inclusive, Non-Discriminatory Approach Needed to Curb Pandemic

Volunteers wait to be checked at a vaccine trial facility set at Soweto's Chris Sani Baragwanath Hospital outside Johannesburg, South Africa, November 30, 2020.  © 2021 AP Photo/Jerome Delay)

As South Africa received its first shipment of Covid-19 vaccines this week, President Cyril Ramaphosa stated that his government aims “to make the vaccine available to all adults living in South Africa, regardless of their citizenship or residence status.” Unfortunately, his remarks stand in contrast to a recent statement by Health Minister Dr. Zwelini Mkhize that only registered South African citizens would receive the vaccine, and that the government did not have the capacity to assist undocumented foreign nationals.

South Africa, with a population of 59.62 million, is home to an estimated 4.2 million migrants, refugees and asylum seekers. Over 1.45 million cases of Covid-19  infections and 44,164 related deaths have been reported in the country as of February 1. Ramaphosa’s commitment to tacking the challenge of vaccinating all adults including undocumented migrants (who may not come forward because they are not documented and need targeted communication and awareness raising) is the right call for South Africa.

Ramaphosa’s statement that vaccination distribution will not discriminate on nationality or residence status grounds is in line with the principles of equal respect and national equity prescribed under the World Health Organizations’ SAGE Values Framework for the Allocation and Prioritization of COVID-19 Vaccination. South African authorities have an obligation to fully respect the human rights of refugees, asylum seekers, and people without legal documentation within their borders, including their right to health.

Excluding or limiting certain groups’ access to vaccination based on national origin or residency status  would undermine the public interest and public health goal of ending the pandemic. Such a discriminatory policy would also likely further inflame nationalistic sentiments in a country battling to end perennial waves of xenophobic violence.

Discrimination based on national origin or residency status would violate South Africa’s Constitution and its obligations under the Convention on the Elimination of All Forms of Racial Discrimination (CERD) and the International Covenant on Economic, Social and Cultural Rights (ICESCR). Any differential treatment based on national origin or immigration status can only be justified as nondiscriminatory if it pursues a legitimate aim and is proportionate to its achievement.

For South Africa to effectively combat the Covid-19 pandemic, authorities should fully implement President Ramaphosa’s promise of inclusion by ensuring that everyone living on its territory has equitable access to vaccines and is included in the national vaccination program, regardless of their nationality or residency status. The authorities should embark on awareness raising, information campaigns, and ensure those without documentation can travel safely to vaccination centers.

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