Since the first case was reported in March, the country’s total coronavirus infections have spiked to 1 million, reported the South African Department of Health on Sunday evening.&nbsp;



<figure class="wp-block-embed is-type-rich is-provider-twitter wp-block-embed-twitter"><div class="wp-block-embed__wrapper">
<blockquote class="twitter-tweet" data-width="500" data-dnt="true">Today, we have breached one million cumulative cases of <a href="https://twitter.com/hashtag/COVID%E3%83%BC19?src=hash&amp;ref_src=twsrc%5Etfw">#COVIDー19</a> in South Africa, with a cumulative total of 1 004 413 cases reported. <a href="https://t.co/p00BWXcX8J">pic.twitter.com/p00BWXcX8J</a>&mdash; Department of Health: COVID-19 (@COVID_19_ZA) <a href="https://twitter.com/COVID_19_ZA/status/1343253366420500481?ref_src=twsrc%5Etfw">December 27, 2020</a></blockquote><script async src="https://platform.twitter.com/widgets.js" charset="utf-8"></script>
</div></figure>



“Anyone who says COVID-19 is not a serious issue, are those who have not come into contact with someone who has had the virus,” South African Health Minister, Dr. Zweli Mkhize stated on Twitter this morning.&nbsp;



This puts further strain on the country as recently the South African President, Cyril Ramaphosa, addressed the nation placing stricter restrictions “with immediate effect” on<a href="https://www.forbesafrica.com/current-affairs/2020/12/14/more-grave-second-wave-in-south-africa-country-to-receive-vaccines-early-2021/"> December 14.&nbsp;</a>



“If we don’t do things differently, this will be the last Christmas for many South Africans,” said Ramaphosa. 



Some of the restrictions included the closure of beaches and public parks in the Eastern Cape and the Garden Route in the Western Cape for the duration of the festive season from December 16 to January 3. The curfew now starts at 11 PM and end at 4 AM. Restaurants and bars have to close at 10PM so that staff and patrons can get home before the enforcement of the curfew. Alcohol sales have also been restricted. Retail outlets are only permitted to sell alcohol between 10AM and 6PM from Monday to Thursday.



However, Dr. Zweli Mkhize further said that “One cannot speculate on the restrictions that will now be. ”&nbsp;



<figure class="wp-block-embed is-type-rich is-provider-twitter wp-block-embed-twitter"><div class="wp-block-embed__wrapper">
<blockquote class="twitter-tweet" data-width="500" data-dnt="true">One cannot speculate on the restrictions that will now be put in place. <a href="https://twitter.com/MorningLiveSABC?ref_src=twsrc%5Etfw">@MorningLiveSABC</a>&mdash; Zweli Mkhize (@DrZweliMkhize) <a href="https://twitter.com/DrZweliMkhize/status/1343427112217272321?ref_src=twsrc%5Etfw">December 28, 2020</a></blockquote><script async src="https://platform.twitter.com/widgets.js" charset="utf-8"></script>
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This is a developing story.&nbsp;

SAFRICA-HEALTH-VIRUS

South Africa Surpasses 1 Million Reported Cases But No Sign Of Further Restrictions Yet

What a year it has been! In this mid-November interview with South Africa’s health minister Dr.Zweli Mkhize, he dwells on the early days of the pandemic and the country’s response, and the opportunities that have arisen.



Q. What do you think are some of the contributing factors to Africa having a relatively low caseload in comparison with other parts of the world?



A. While there are no definitive answers for this yet, there are several hypotheses I have with regards to this. Firstly, Africa had most of its initial cases come from various parts of the world, in particular Europe. As soon as the initial onset of the virus was identified correctly, international borders were closed. This meant that there was a significant decrease in imported cases and the focus could be shifted to cases being transmitted internally. This issue then in turn affected the number of cases. South Africa, for example, has an estimate of around 21 million international flyers per annum, however once this number was decreased; it played a significant role in decreasing the rate of spread. This also happened in Ethiopia and Kenya and had the same effect in reducing the rate of spread in their respective countries.&nbsp;



The second hypotheses I have relates to the intrinsic social systems that exist within the continent. The difference we have to more developed countries is that we have grassroot workers who go around and inform communities. This is the system we have used when dealing with other crises such as HIV, malaria and so on. The utilization of this system has proven itself to be consistently beneficial, especially given that universal health is not our strength.



Another theory, which has scientific grounding, is the presence of sunshine and the time it takes for the decomposition of the virus and given the theories around this, sunshine may well be a factor which impacts on the survival or life-span of the virus.&nbsp;



The demographics of the continent have also played a role as Africa has a significantly skewed younger population. This group is affected less by the virus and rarely show symptoms or they experience very mild symptoms which could have also been a factor.



Lastly, testing could also prove to be a factor and as with other parts of the world, provides an estimation of the positive cases which may well be bigger than the figures show due to people within the population being asymptomatic and therefore not realizing that they need to be tested. For example, antibody tests carried out in certain regions indicated that antibodies were present but they had not tested positive for the virus or had not gone in to be tested due to little or no display of symptoms.



All of this however does require more research, as the points I’ve raised are anecdotal and still require more evidence from the science community.&nbsp;



Q. According to CDC Africa, the southern parts of Africa currently have over 800,000 Covid-19 cases [as of mid-November], higher than any other region within Africa. What do you think are some of the possible reasons for this?



A. Within the southern region, South Africa is responsible for around 90% of these positive cases. I think the social dynamics and metropolitan social life in South Africa would probably be a significant contributor.&nbsp;



The increasing numbers of cases, which were mainly imported, means that South Africa has quite a noticeable relation to the Western capitals that have been hard hit and because of the mode in which the virus reached our shores, we ended up with a high number of imported cases and at the same time, because of a more metropolitan lifestyle, we as a country, ended up with a much higher increase.



That then explains why South Africa has got higher numbers because as soon as we closed our borders to international travelers and our numbers began to be driven by internal transmission, we saw the rate of infection begin to slow, much like it did for other countries within Africa.



Q. South Africa is also renowned for its spirit of Ubuntu; do you think this has played a role in how the nation has approached overcoming this pandemic?



A. I think the element of Ubuntu probably works in the context of our community networks as people go out and use their existing social networks and understanding to try and prevent infection in others. It does tend to be a mixed bag as these social networks can also be used as a means to spread infection when not taking the proper precautions but it’s a factor you can’t completely rule out and needs more research.



Q. One thing that has come through is how efficiently the clinical trial process of vaccines can be expedited… Do you think these enhanced methods of management could be applied to other clinical trial processes such as HIV vaccine trials?



A. I think the innovations are very encouraging if you take into account their ability to carry out some phases in parallel to each other. This means that they were able to cover more ground with their research at a quicker pace and it is being done more efficiently than it has been done in the past. I think the lessons that have come through for the larger scientific community is that it is possible to expedite certain processes within the phases of trial research.&nbsp;



Concern for safety has arisen as a result of how quickly these trials have happened but should these vaccines prove their success in their final phases, then these new methods are a breakthrough as it has provided methods for safe and efficient clinical trials and definitely has applications to other vaccine trials within other fields of virology.



Q. South Africa is currently the only African country to be conducting clinical trials with Kenya awaiting final approval from internal processes and Uganda’s Virus Research Institute looking to collaborate with the Imperial College of London. What do you think needs to be done for Africa to become more of a clinical trial hub?&nbsp;



A. I think that the Africa CDC has the potential to play a vital role in this sphere as there is the potential to create a strong network of biomedical and biotechnological experts wherein various levels of expertise in different fields are able to collaborate on a single platform. This is so the level of knowledge and information sharing is more or less equal across various countries.&nbsp;



This will assist in creating a clinical trial hub within Africa. If you have specialists and experts within a specific field and have them in communication with each other, it creates collaboration which brings about new ideas on what needs to be done within clinical trials. If this then forms part of a network coordinated through the Africa CDC, you can then have the African CDC assist this process by acting as a base of support for countries willing to participate in these clinical trials and it allows for this to be done without needing to reinvent the wheel.



This means utilizing what’s available and getting the necessary support so you could, for example, have collaboration between the African CDC and all the current Covid-19 vaccine research institutions and this could provide a platform for trials to occur. Early discussions could look at the strengths of each research institute in each African country and evaluate who can rise to the occasion and who cannot, who could carry out a portion of the study and then be partnered with another country to carry out the other portions.&nbsp;



Once this platform is established, it provides the possibility for these African research institutes within various countries to apply and allows for assistance from African CDC in the form of resources and expertise, should any of these institutes be allowed to conduct a clinical trial. This should be the direction that the future takes.



The Covid-19 pandemic has proven this is possible as a pool of experts in various fields was created and was shared with the African CDC, so the teams within the CDC who are working on the Covid-19 pandemic consists of specialists who have all come from different countries and are from different disciplines. This is a good start to increasing clinical trials, as should these teams be enhanced and efforts towards collaboration are intensified, particularly across disciplines. This will then allow for them to communicate with other specialists and experts within various institutions across the globe.&nbsp;



Q. With organizations such as COVAX attempting to ensure vaccines reach every part of the globe, when do you foresee the vaccine reaching Africa and how do you think distribution of the vaccine should work?



A. This is an interesting topic and I can only speculate here as Pfizer foresees the progress with their vaccine reaching approval by the end of this year and getting a license to begin production. South Africa as a country would like to be a part of this success and therefore distribution can occur through initiatives such as COVAX, which in itself will look to utilize these vaccines as they become available.



Johnson &amp; Johnson is looking at completing at the end of this year and possibly starting production of their vaccine around May. Now again, the need is to ensure that platforms such as COVAX also receive this vaccine as it becomes available.



The key challenges here are availability of financial resources to ensure that these vaccines are paid for; this is unaffordable to some countries, especially in Africa. Therefore, some countries on the continent will have no choice but to wait for humanitarian efforts from the likes of COVAX and CEPI.



There is also the collaboration of financial institutions such as the World Bank who are willing to provide support to some countries to ensure that they also have access. This will be a continuous effort to ensure that no country gets left behind and everyone is effectively immunized against Covid-19.



Q. Do you think there are protocols within the NHI that could have assisted with the free and fair distribution of vaccines within South Africa?



A. If NHI was currently an active entity within South Africa, this would have ensured that the total availability of these vaccines would have been secured through NHI protocols for funding, however given the current circumstances; everyone will now receive the vaccine according to their need and the criteria that has been set out by the country.



Certainly, the NHI would have assisted with the distribution of a vaccine. This, however, does not mean that we are unable to obtain access to a vaccine as government is still involved in procurement. We [government] are currently examining possible ways to ensure that the vaccine reaches everyone who truly needs it first.



Q: What applications does the NHI have to a pandemic such as Covid-19?



A: The fundamental point here is resilience and sustainability of the South African health system and that there is a strong foundation. If the foundation is strong, a pandemic such as this [Covid-19] becomes easier to manage. All of these points ensure the delivery of quality healthcare for all South Africans and the NHI becomes the platform from which a crisis response is formulated.&nbsp;



This system also ensures that the healthcare being received is the same in both rural and urban areas and should medical assistance be required, it is given without any compromises on the quality and speed at which these services are received. In a pandemic, this quality of care is essential in making sure it is properly treated no matter what the environment.



The key issue is ensuring that the NHI allows us to build an unshakeable foundation for the South African health service with good infrastructure and an abundance of human resources, adequate supplies of medical and technological devices and sufficient health information and promotion systems. All of which should be able to service all South Africans.



When a crisis such as the coronavirus occurs, we should then be able to utilize this system to allow a quick and efficient response and therefore ensure that those who require urgent attention have received it. We can also use the functions within this system to ensure the rest of the population has been adequately informed to ensure their safety.



Q: Do you think with resources being directed to the pandemic that it then forestalls on when the NHI becomes a viable option to the South Africa public?



A: I think the approach we take to a pandemic should not be a matter of ‘an either, or’ situation, the approach should focus simultaneously on our response to a pandemic like Covid-19, and the approach that allows us to move closer to using a universal health cover approach.



It then becomes a question of infrastructure systems used to manage the Covid-19 pandemic and that these additions to existing infrastructure not being dismantled after it has served its purpose. It should instead, be absorbed into existing infrastructure for future use.



Therefore what this pandemic has done is accelerate the creation of some infrastructure that will bring us closer to implementing the NHI. The second area it has impacted on is human resources; we will use this time to further expand on our pre-existing human resource pool which is part of securing South Africa in the future against crises such as the Covid-19 pandemic.



It has also moved forward collaborations and partnerships between the public and private health sector and basic agreements have begun to be reached on how to approach health-related issues going forward. Access to some private hospitals by public sectors was also given based on the needs of the public sector which included accommodations for costs, the quality of care that was received and so on.&nbsp;



So there have been opportunities that have arisen from the pandemic and the need for investment into the future of NHI has become apparent.&nbsp;



Q. With unified healthcare being a success in countries such as Brazil and Canada, do you think there are any lessons South Africa could take from them?



A. I think there’s only lessons to be learned from countries with a universal healthcare system; that we cannot wait any longer for the implementation of NHI as it provides healthcare to the areas where it is needed most.



Q. Lastly, do you have any concerns around the implementation of NHI?



A. I think this pandemic has shown us that circumstances don’t matter and shouldn’t forestall something this important. The pressure put on health resources by the Covid-19 pandemic and the impact it has had on the economy has slowed down the speed with which the NHI could have been implemented.



However, this does not mean that it should not still proceed, it means understanding that the current situation that we are in has placed constraints on certain aspects of the economy and this in turn has had an impact on the implementation of the NHI.



However, other countries have never looked at their wealth or state of economy when implementing a universal health system, this time with all these constraints is when implementing NHI is most essential and part of this is building on the infrastructure and systems that were successful.&nbsp;



So what NHI is now and what it can be in the future has to be taken into account as this is dependent on the available resources and look at how we can maximize the resources that are available.

South African  Minister Dr Zweli Mkhize visits Clairwood Hospital in Durban ahead of the expected peak in the Province

The Collaborative Direction The Future Can Take In Vaccine Research And Distribution

2020. Unexpected. Unprecedented. The year a virus tore through the core of our being and assailed our health systems and the wellbeing of our economies. Its effects ricocheted through every street, every alley of South Africa. FORBES AFRICA trained its lens on the new reality the year is leaving behind.



Photographs and Words by Motlabana Monnakgotla &amp; Chanel Retief 



<h2 class="has-text-align-center wp-block-heading" id="h-the-last-mile">The Last Mile</h2>



<div class="wp-block-image is-style-default"><figure class="aligncenter size-large"><img loading="lazy" decoding="async" width="1024" height="591" src="https://www.forbesafrica.com/wp-content/uploads/2020/12/The-Last-Mile-1024x591.jpg" alt="" class="wp-image-49381" srcset="https://cms.forbesafrica.com/wp-content/uploads/2020/12/The-Last-Mile-1024x591.jpg 1024w, https://cms.forbesafrica.com/wp-content/uploads/2020/12/The-Last-Mile-300x173.jpg 300w, https://cms.forbesafrica.com/wp-content/uploads/2020/12/The-Last-Mile-768x443.jpg 768w, https://cms.forbesafrica.com/wp-content/uploads/2020/12/The-Last-Mile-1536x886.jpg 1536w, https://cms.forbesafrica.com/wp-content/uploads/2020/12/The-Last-Mile-2048x1182.jpg 2048w, https://cms.forbesafrica.com/wp-content/uploads/2020/12/The-Last-Mile-600x346.jpg 600w" sizes="auto, (max-width: 1024px) 100vw, 1024px" /></figure></div>



When Kagiso Ramphela (above) started Ramphela Funerals, a funeral parlor, just before Covid-19 struck South Africa, he never anticipated what was in store. Deemed essential services during the pandemic, his business, in a bizarre twist of fate, picked up.



“I don’t want to say business is booming, because it sounds like I am saying for business to boom, people must die. But what I will say is I think things have been fair to us,” Ramphela says, scratching his head, when we meet him at his office in Soweto, Johannesburg.



In this business, he always expects the unexpected, and this could mean calls in the middle of the night, from harried relatives requesting caskets for their loved ones. Ramphela needs to also ensure his staff is protected and safe from the virus at all times, whilst providing support to grieving families.



<h2 class="has-text-align-center wp-block-heading" id="h-coping-with-loss">Coping With Loss</h2>



<div class="wp-block-image is-style-default"><figure class="aligncenter size-large"><img loading="lazy" decoding="async" width="1024" height="732" src="https://www.forbesafrica.com/wp-content/uploads/2020/12/Coping-With-Loss-1024x732.jpg" alt="" class="wp-image-49377" srcset="https://cms.forbesafrica.com/wp-content/uploads/2020/12/Coping-With-Loss-1024x732.jpg 1024w, https://cms.forbesafrica.com/wp-content/uploads/2020/12/Coping-With-Loss-300x215.jpg 300w, https://cms.forbesafrica.com/wp-content/uploads/2020/12/Coping-With-Loss-768x549.jpg 768w, https://cms.forbesafrica.com/wp-content/uploads/2020/12/Coping-With-Loss-1536x1099.jpg 1536w, https://cms.forbesafrica.com/wp-content/uploads/2020/12/Coping-With-Loss-2048x1465.jpg 2048w, https://cms.forbesafrica.com/wp-content/uploads/2020/12/Coping-With-Loss-600x429.jpg 600w" sizes="auto, (max-width: 1024px) 100vw, 1024px" /></figure></div>



“There’s no closure,” says Charlie Mpogeng (above) standing by his brother&#8217;s grave at Westpark Cemetery in Emmarentia, west of Johannesburg. On the morning of July 17, he lost his 37-year-old brother, Herman Motlhabane, to Covid-19. “Everyone loved and respected him,” remembers Mpogeng.



“We were dressed in PPE gear to go see his body at the funeral home. We had to come out, take off the PPE, and get sanitized. And then immediately I had to get on to a call with the undertaker. There was no time to sit down and be like, ‘oh, snap I just lost my brother’.”



At the funeral, those in attendance had to observe social distancing and the ceremony only lasted a little over an hour. This is a familiar story for most who have lost a loved one to the pandemic this year. As of mid-November, South Africa recorded over 20,000 Covid- related deaths.



<h2 class="has-text-align-center wp-block-heading" id="h-a-brake-on-business">A Brake On Business</h2>



<div class="wp-block-image is-style-default"><figure class="aligncenter size-large"><img loading="lazy" decoding="async" width="1024" height="649" src="https://www.forbesafrica.com/wp-content/uploads/2020/12/A-Brake-On-business-1024x649.png" alt="" class="wp-image-49376" srcset="https://cms.forbesafrica.com/wp-content/uploads/2020/12/A-Brake-On-business-1024x649.png 1024w, https://cms.forbesafrica.com/wp-content/uploads/2020/12/A-Brake-On-business-300x190.png 300w, https://cms.forbesafrica.com/wp-content/uploads/2020/12/A-Brake-On-business-768x487.png 768w, https://cms.forbesafrica.com/wp-content/uploads/2020/12/A-Brake-On-business-1536x973.png 1536w, https://cms.forbesafrica.com/wp-content/uploads/2020/12/A-Brake-On-business-2048x1298.png 2048w, https://cms.forbesafrica.com/wp-content/uploads/2020/12/A-Brake-On-business-600x380.png 600w" sizes="auto, (max-width: 1024px) 100vw, 1024px" /></figure></div>



With most of the country reverting to a new Work-From- Home reality in the wake of Covid-19, South Africa’s taxi industry took a hard knock. In June, taxi associations across Johannesburg announced that they would be increasing their fares from a minimum of R11 to R30 ($1) a trip, also lamenting the lack of adequate government relief. 



New regulations stipulate that public vehicles are only allowed to carry 70% of their maximum capacity and to mandatorily practice social distancing, mask-wearing, and hand sanitizing. 



Public taxis are a popular mode of transport for daily wage earners and office commuters, especially in South Africa’s sprawling townships. Another business that braked to a screeching stop? The neighborhood car-wash facility.



<h2 class="has-text-align-center wp-block-heading" id="h-unemployment-woes">Unemployment Woes</h2>



<div class="wp-block-image is-style-default"><figure class="aligncenter size-large"><img loading="lazy" decoding="async" width="1024" height="683" src="https://www.forbesafrica.com/wp-content/uploads/2020/12/Unemployment-Woes-1024x683.jpg" alt="" class="wp-image-49382" srcset="https://cms.forbesafrica.com/wp-content/uploads/2020/12/Unemployment-Woes-1024x683.jpg 1024w, https://cms.forbesafrica.com/wp-content/uploads/2020/12/Unemployment-Woes-300x200.jpg 300w, https://cms.forbesafrica.com/wp-content/uploads/2020/12/Unemployment-Woes-768x512.jpg 768w, https://cms.forbesafrica.com/wp-content/uploads/2020/12/Unemployment-Woes-1536x1024.jpg 1536w, https://cms.forbesafrica.com/wp-content/uploads/2020/12/Unemployment-Woes-2048x1365.jpg 2048w, https://cms.forbesafrica.com/wp-content/uploads/2020/12/Unemployment-Woes-600x400.jpg 600w" sizes="auto, (max-width: 1024px) 100vw, 1024px" /></figure></div>



According to the National Income Dynamics Study-Coronavirus Rapid Mobile Survey, approximately three million South Africans have lost their jobs due to covid-19. Disgruntled unions came together in a nationwide protest (as in this image taken in the central business district of Johannesburg) on October 7 against unemployment, wage disputes, and job losses. Some demands were related to Covid-19 corruption, the failing economy, and the fact that due to a setback in the government’s wage agreement, workers may not receive salary increases in the next financial year. 



<h2 class="has-text-align-center wp-block-heading" id="h-off-track">Off-Track</h2>



<div class="wp-block-image is-style-default"><figure class="aligncenter size-large"><img loading="lazy" decoding="async" width="1024" height="683" src="https://www.forbesafrica.com/wp-content/uploads/2020/12/Off-Track-1024x683.jpg" alt="" class="wp-image-49378" srcset="https://cms.forbesafrica.com/wp-content/uploads/2020/12/Off-Track-1024x683.jpg 1024w, https://cms.forbesafrica.com/wp-content/uploads/2020/12/Off-Track-300x200.jpg 300w, https://cms.forbesafrica.com/wp-content/uploads/2020/12/Off-Track-768x512.jpg 768w, https://cms.forbesafrica.com/wp-content/uploads/2020/12/Off-Track-1536x1024.jpg 1536w, https://cms.forbesafrica.com/wp-content/uploads/2020/12/Off-Track-2048x1365.jpg 2048w, https://cms.forbesafrica.com/wp-content/uploads/2020/12/Off-Track-600x400.jpg 600w" sizes="auto, (max-width: 1024px) 100vw, 1024px" /></figure></div>



The pandemic also derailed the rail industry, with a reported surge in cable theft at railway stations. Reuters reported that during the lockdown – implemented in various stages in South Africa since march – organized, sometimes armed, criminal gangs stole valuable copper from the railway lines. As part of his economic recovery plan, President Cyril Ramaphosa has proposed the privatization of some of South Africa’s key train routes in a bid to improve transport access to millions of South Africans.



<h2 class="has-text-align-center wp-block-heading" id="h-butt-seriously">Butt Seriously </h2>



<div class="wp-block-image is-style-default"><figure class="aligncenter size-large"><img loading="lazy" decoding="async" width="1024" height="683" src="https://www.forbesafrica.com/wp-content/uploads/2020/12/Butt-Seriously-1024x683.jpg" alt="" class="wp-image-49374" srcset="https://cms.forbesafrica.com/wp-content/uploads/2020/12/Butt-Seriously-1024x683.jpg 1024w, https://cms.forbesafrica.com/wp-content/uploads/2020/12/Butt-Seriously-300x200.jpg 300w, https://cms.forbesafrica.com/wp-content/uploads/2020/12/Butt-Seriously-768x512.jpg 768w, https://cms.forbesafrica.com/wp-content/uploads/2020/12/Butt-Seriously-1536x1024.jpg 1536w, https://cms.forbesafrica.com/wp-content/uploads/2020/12/Butt-Seriously-2048x1365.jpg 2048w, https://cms.forbesafrica.com/wp-content/uploads/2020/12/Butt-Seriously-600x400.jpg 600w" sizes="auto, (max-width: 1024px) 100vw, 1024px" /></figure></div>



One of the most controversial lockdown regulations in South Africa was the banning of the sale of cigarettes. This forced many to either resort to more expensive, often ‘illegal ways’ to source their smoking stock, or quit altogether.



The Research Unit on the Economics of Excisable Products, based at the University of Cape Town, and the South African Medical Research Council&#8217;s Dr Catherine Egbe, found that nearly a million people quit smoking during the lockdown.



On the other hand, British American Tobacco South Africa (BATSA) released a media statement in July saying that research shows 11 million smokers in South Africa are still able to purchase cigarettes from illicit suppliers. “These illicit suppliers are not suddenly going to become compliant and start obeying the law and paying taxes when the ban is eventually lifted. They evaded taxes before the lockdown, they’ve made billions tax-free during the ban and they will evade taxes after the ban,” said BATSA’s Head of External Affairs Johnny Moloto in July.



<h2 class="has-text-align-center wp-block-heading" id="h-something-to-wine-about">Something to Wine About</h2>



<div class="wp-block-image is-style-default"><figure class="aligncenter size-large"><img loading="lazy" decoding="async" width="1024" height="683" src="https://www.forbesafrica.com/wp-content/uploads/2020/12/Something-To-Wine-About-1024x683.png" alt="" class="wp-image-49380" srcset="https://cms.forbesafrica.com/wp-content/uploads/2020/12/Something-To-Wine-About-1024x683.png 1024w, https://cms.forbesafrica.com/wp-content/uploads/2020/12/Something-To-Wine-About-300x200.png 300w, https://cms.forbesafrica.com/wp-content/uploads/2020/12/Something-To-Wine-About-768x512.png 768w, https://cms.forbesafrica.com/wp-content/uploads/2020/12/Something-To-Wine-About-1536x1024.png 1536w, https://cms.forbesafrica.com/wp-content/uploads/2020/12/Something-To-Wine-About-2048x1365.png 2048w, https://cms.forbesafrica.com/wp-content/uploads/2020/12/Something-To-Wine-About-600x400.png 600w" sizes="auto, (max-width: 1024px) 100vw, 1024px" /></figure></div>



Another point of contention was the back and forth regarding the ban on alcohol during the lockdown. This impasse specifically had a negative impact on the country’s bars and restaurant businesses.



The Restaurant Association of South Africa (RASA) CEO Wendy Alberts says the hard lockdown put a strain on several restaurants that have had to permanently close their doors.



RASA ran a survey in which 23,000 restaurants across South Africa participated (during alert level two of the lockdown). Of that, 30% stated they have shut down while 50% said they do not know if they will be able to reopen due to massive overheads and debt.



“I am very heartsore for those restaurants that have lost their businesses and staff that have lost their jobs. So although this appears to be a win, there is no win in this space because people have lost, and people have been hurt,” says Alberts.



With lockdown restrictions now eased, the restaurants and bars are slowly returning to life. In this image, taken at SOD in Soweto, the South African summer seems to have revived conviviality in outdoor spaces.



<h2 class="has-text-align-center wp-block-heading" id="h-art-of-the-matter">Art Of The Matter </h2>



<div class="wp-block-image is-style-default"><figure class="aligncenter size-large"><img loading="lazy" decoding="async" width="1024" height="618" src="https://www.forbesafrica.com/wp-content/uploads/2020/12/Art-Of-The-Matter-1024x618.jpg" alt="" class="wp-image-49375" srcset="https://cms.forbesafrica.com/wp-content/uploads/2020/12/Art-Of-The-Matter-1024x618.jpg 1024w, https://cms.forbesafrica.com/wp-content/uploads/2020/12/Art-Of-The-Matter-300x181.jpg 300w, https://cms.forbesafrica.com/wp-content/uploads/2020/12/Art-Of-The-Matter-768x463.jpg 768w, https://cms.forbesafrica.com/wp-content/uploads/2020/12/Art-Of-The-Matter-1536x927.jpg 1536w, https://cms.forbesafrica.com/wp-content/uploads/2020/12/Art-Of-The-Matter-2048x1236.jpg 2048w, https://cms.forbesafrica.com/wp-content/uploads/2020/12/Art-Of-The-Matter-400x240.jpg 400w, https://cms.forbesafrica.com/wp-content/uploads/2020/12/Art-Of-The-Matter-600x362.jpg 600w" sizes="auto, (max-width: 1024px) 100vw, 1024px" /></figure></div>



A child rides past a mural painted in August by South African artist Graham Mckuur, known as ‘Dimms’, on Kremetart Street in Eldorado Park Ext 3. The work is in tribute to Nathaniel Julius, a 16-year- old allegedly shot and killed by police in Johannesburg&#8217;s Eldorado Park. 



The teenager had Down Syndrome, which sent shockwaves on social media. According to BBC Africa, the family said Julius was shot for not answering police officers’ questions. News reports say that three officers have been arrested on charges of murder.



<h2 class="has-text-align-center wp-block-heading" id="h-room-for-change">Room For Change</h2>



<div class="wp-block-image is-style-default"><figure class="aligncenter size-large"><img loading="lazy" decoding="async" width="1024" height="683" src="https://www.forbesafrica.com/wp-content/uploads/2020/12/room-for-change-1024x683.jpg" alt="" class="wp-image-49379" srcset="https://cms.forbesafrica.com/wp-content/uploads/2020/12/room-for-change-1024x683.jpg 1024w, https://cms.forbesafrica.com/wp-content/uploads/2020/12/room-for-change-300x200.jpg 300w, https://cms.forbesafrica.com/wp-content/uploads/2020/12/room-for-change-768x512.jpg 768w, https://cms.forbesafrica.com/wp-content/uploads/2020/12/room-for-change-1536x1024.jpg 1536w, https://cms.forbesafrica.com/wp-content/uploads/2020/12/room-for-change-2048x1365.jpg 2048w, https://cms.forbesafrica.com/wp-content/uploads/2020/12/room-for-change-600x400.jpg 600w" sizes="auto, (max-width: 1024px) 100vw, 1024px" /></figure></div>



2020 definitely changed the way we work. the hard lockdown in level one of the pandemic saw emptying office spaces, until around alert level three when most companies gradually had staff trickling in to work. But with Covid-19 still a sore reality, most office-goers have slipped into the work-from-home mode for longer, or indefinitely. 



This has also amplified digitalization and the need for companies to quickly streamline technology to enable better workflow processes. The International Labour organization has also been reporting on the rise of the flexible workforce’. The final word on the future workplace is still being scripted.

00 Opening

The Year That Changed Everything

There has been enough debate and deliberation around South Africa’s proposed National Health Insurance Bill for unified health coverage. Covid-19 has turned the spotlight on it again, and there’s more news expected in February 2021.



I FEEL GOOD,” WERE THE LAST WORDS 33-YEAR-OLD Charlie Mpogeng remembers his brother, Herman Motlhabane, saying to him before his untimely passing on the morning of July 17.



Motlhabane died, his relatives not knowing it was because of Covid-19 as his test results were only made available two weeks after his passing.



He had complained of a flu before being hospitalized.



“It was during that time of mass hysteria when everyone was like ‘if you have the flu, have it checked out’,” Mpogeng remembers as he walks to his brother’s grave at Westpark Cemetery in Emmarentia, west of Johannesburg. Even as he speaks, a tractor is digging up more graves around him, for other hapless victims who have succumbed to Covid-19.



By the end of July, 1,932 people had died of the pandemic in South Africa’s Gauteng Province, Motlhabane one of them.



With a disruptive virus still on the prowl to claim more unsuspecting lives, political establishments everywhere are sitting up and revisiting their healthcare systems – or the lack of it.



In South Africa, the focus has returned to the National Health Insurance (NHI) Bill, proposed to improve and strengthen the health financing system and provide quality, affordable medical care to all.



“The pandemic also showed the need for the public and private healthcare sectors to work together,” Dr Zweli Mkhize, the country’s health minister, said at a press briefing in October. “This is one of the core principles of the NHI.”



To further enable this, the National Health Laboratory Service (NHLS) and The National Institute For Communicable Diseases Of South Africa (NCID) have fallen under one umbrella, to ensure tests are adequately and accurately captured, but also to ensure labs can exchange skills, information and resources as and when the need arises.



“At the start of the pandemic, there was a critical shortage of test kits. At that time, the labs 



would count all the kits that were available in the country and then distribute them equitably amongst each other, regardless of whether the lab was private or public and it’s important



to point out that both public and private labs co-sponsored each other in ensuring equitable distribution,” Popo Maja, the spokesperson for the national Department of Health in South Africa, tells FORBES AFRICA.



Healthcare workers were counted as “one workforce” during these dire times, working freely between public and private sectors and some moving to work at field hospitals. Due to the high demand for hospital beds for Covid-19 patients, the government agreed with private hospital groups about pricing and acceptance of state patients. According to Maja, such negotiations have previously taken years 



and were often facilitated by lawyers and courts, at times without resolution.



“Covid-19 reminded us that we depend on each other. We have been able to forge cooperation between private and public,” Mkhize further stated in a one-on-one interview at the fifth annual FORBES AFRICA Philips Future of Health Summit in November. “We need a system that will ensure equitable access to quality healthcare irrespective of class and status or financial standing. Universal health coverage is now a global aspiration.”



The NHI Bill has been deliberated for years and the next development is expected to happen in February 2021. The Parliament’s portfolio committee on health dealing with the bill said that it plans to submit a report on the comments by then. According to ‘BusinessTech’, the pandemic had an impact on the process regarding the NHI and parliament which had to go through a mountain of submissions on the bill.



And though the Department of Health is confident that the pandemic has proven that the NHI is necessary, others believe differently, in consonance with the fact that the bill has sparked much debate from various quarters over the years.



“Our economic situation has deteriorated so drastically, that if it was unaffordable before, it’s even more unaffordable now. I mean the estimates of costs are hundreds of billions of rands,” says Jack Bloom, Democratic Alliance Gauteng Shadow Health MEC, to FORBES AFRICA.



Bloom goes on to explain that right now, the state should be focusing on fixing the administration issues in the health sector, including those around poor hospital infrastructure, frustrated medical personnel, and delayed surgeries and treatments.



However, Dr Nicolas Crisp, public health specialist and NHI advisor to Mkhize, remains optimistic that the NHI can alleviate some of the problems. He believes that by having the NHI, some of the strain on the private sector can be alleviated.



“This is an ethical matter that needs to be debated between clinicians. It’s not a political matter. And it’s not a purely budget matter. It’s an ethical clinical discussion around what can you give to a patient and it’s about what the evidence shows to be the best outcomes for the inputs,” Crisp says.



He believes that countries with a single health system have tended to do better than those with more than one. Decisions and actions can be taken swiftly with one system as instructions don’t need to be directed to multiple networks. Countries like the United Kingdom and Vietnam already boast such systems.



“So it doesn’t matter who’s actually delivering the services, it’s that there’s a coherent mechanism of making decisions and disseminating those decisions. And there’s a coherent mechanism of collecting data to one central point,” Crisp offers.



He has been a medical practitioner in the public sector from the 90s, consulting not only in South Africa but in other parts of Africa including Nigeria, Ghana, Tanzania, Botswana, Namibia, and Lesotho. Crisp became the advisor in July this year to assist with the design and development of the administrative and operational capacity to implement the NHI. For just over a year, Crisp has been working with the Department of Health in South Africa looking at the practical implications and requirements to support the NHI fund.



“It is extremely complicated. Let’s take just the public sector. At the moment, the money to run the public health services comes from the national fiscus; it is distributed to the provincial governments, the government, and then they are the ones who decide what percentage of that equitable share will go to health, then they inform the National Treasury and the National Department of Health that this is the amount of money they set aside for health,” Crisp explains, adding that the private sector is not any better. 



There are two ways to pay for healthcare in the private sector. One is where if you are fortunate enough that you can afford it, and you insure yourself through a medical scheme. However, the terms and conditions of this are that you only manage to cover what you can afford, and when it runs out, some are required to use public services.



“The second way that we pay for healthcare in the private sector is that when the need arises, we scramble and raise money,” Crisp explains, “And for people who are middle income and relatively poor, the only way they can raise money is to sell assets or to scrounge from their neighbors, friends, and family, and to basically blow their cash reserves to pay for their healthcare. So it’s very tenuous, and it’s insecure.”



But what do the healthcare workers feel about the NHI in South Africa in these pressing times?



It’s all good and well to consider the patient but what of those who are in the frontline, tending to them?



Solidarity, a trade union, tells FORBES AFRICA that it believes the NHI can and will destabilize the healthcare sector.



The primary research they did in 2019 amongst medical practitioners in both the private and public sectors threw up a negative response towards it.



Morné Malan, the union’s strategic specialist for research and communication, says the report indicated that 83% of medical professionals believe that should NHI be implemented, it will lead to a drastic increase in immigration to other countries; 41% said they would personally consider taking steps to immigrate if 



it is implemented and 21% of healthcare professionals indicated that they have already started taking steps towards immigration.



“The feedback that we’re getting from the industry itself is that there’s very little confidence in government, and there’s very little confidence in the system itself. And you know, this is a crucial factor. Because these are the professionals who are going to be at the frontline,” Malan says.



Other than the practical implications around NHI, is the financial and fiscal aspect that it will cost billions. And the concern from the trade unions is who will have to pay for the NHI.



“Only around 12% of South Africa’s population pays taxes. Most countries, which do have universal healthcare systems, or I should say, which do have nationalized or socialized medicine, the figure is closer to around 30% plus,” Malan says.



“It is the current system that is unstable,” Maja says. “The government currently uses the same amount of money to fund 16% of the population that uses private healthcare as it uses to fund 84% of the population that uses public facilities. The public healthcare system is under enormous pressure due to a growing population and rise of non-communicable diseases amongst other issues.”



However, the National Education, Health and Allied Workers’ Union (Nehawu) say they have always supported NHI as it provides universal healthcare to everyone, and healthcare should not be divided into the “haves and have-nots”.



Nehawu spokesperson Khaya Xaba explains that the coronavirus has proven the need for one healthcare system, and not two.



According to Nehawu, the need is urgent, as currently, the private sector only treats 14% of South Africans, who have medical aid; while 86% of South Africans are treated by the public sector.



“I believe that the outbreak of the coronavirus in the country has proven beyond reasonable doubt that we need the urgent implementation of the NHI,” Xaba says.



“Through the NHI, we believe that working together between the two sectors and collapsing them into one will be able to deal with the needs of the country. We will be able to attend to everyone who’s sick, even if they don’t have money.”



Covid-19 may be a stark reminder of the urgent need for a unified healthcare system, but is all of South Africa ready for it yet?



Only time – and perhaps another treacherous jolt from nature – will tell.

FRANCE-HEALTH-VIRUS-TEST

What Next For The NHI?

TOPLINE As top Congressional leaders race to finalize a $900 billion federal aid bill before the holidays, progressive lawmakers are already voicing their discontent with a package they say is insufficient to meet the needs of the country during the pandemic. 



<h4 class="wp-block-heading" id="h-key-facts">KEY FACTS</h4>



Sen. Bernie Sanders (I-Vt.) expressed his disappointment on MSNBC Wednesday that the bill under discussion includes very little newly appropriated money (with the rest repurposed from the CARES Act that passed Congress in March) and added that more aid will be needed under President-elect Joe Biden.



Speaking on the Senate floor hours later, Sanders decried what he said was just $348 billion in new spending as a mere 10% of the $3.4 trillion Heroes Act, which the House passed in May as a follow-up to the CARES Act and the Senate ignored.



Sen. Elizabeth Warren (D-Mass.) also told reporters Wednesday that the plan is “not enough,”&nbsp;<a href="https://twitter.com/JulieNBCNews/status/1339258075690250242" target="_blank" rel="noreferrer noopener">according to</a>&nbsp;NBC’s Julie Tsirkin, adding that she intends to “keep pushing for more.”&nbsp;



Members of the Congressional Progressive Caucus including Rep. Ro Khanna (D-Calif.), Rep. Pramila Jayapal (D-Wash.) and Rep. Katie Porter (D-Calif.) released a&nbsp;<a href="https://khanna.house.gov/sites/khanna.house.gov/files/2020.12.12_Jayapal_Khanna_Porter_COVIDpackage.pdf" target="_blank" rel="noreferrer noopener">letter</a>&nbsp;Tuesday calling for the next aid bill to include direct payments of $2,000 for individuals (the deal under discussion will reportedly include payments of roughly $600 per person) and extended unemployment benefits for a minimum of six months.&nbsp;&nbsp;&nbsp;



Rep. Gerry Connolly (D-Va.) also weighed in on Twitter Wednesday afternoon, describing the bill under discussion as a “Faustian bargain” because of the way Republicans linked two contentious proposals—state and local aid, a major Democratic priority, and protecting businesses from coronavirus lawsuits, a major Republican concern—which were both ultimately excluded.  



<figure class="wp-block-embed-twitter wp-block-embed is-type-rich is-provider-twitter"><div class="wp-block-embed__wrapper">
<blockquote class="twitter-tweet" data-width="500" data-dnt="true">Republicans managed to pair corporate liability protection with state and local government support. An invidious pairing. And sadly we’re about to buy into that and sacrifice all the life saving services local government provides our constituents. This is a Faustian bargain.&mdash; Rep. Gerry Connolly (@GerryConnolly) <a href="https://twitter.com/GerryConnolly/status/1339275165037973506?ref_src=twsrc%5Etfw">December 16, 2020</a></blockquote><script async src="https://platform.twitter.com/widgets.js" charset="utf-8"></script>
</div></figure>



<h4 class="wp-block-heading">CHIEF CRITIC</h4>



“If you’re asking me if I think this bill was well negotiated, I don’t,” Sanders told MSNBC Wednesday. “There should have been a lot more money than there currently is.” The independent from Vermont added that while he was glad to see direct payments of roughly $600 per person included in the package (albeit at a lower level than the second round of $1,200 payments he’s been&nbsp;<a href="https://www.forbes.com/sites/andrewsolender/2020/12/10/sanders-hawley-mount-rare-bipartisan-push-for-1200-stimulus-checks/?sh=6c377463250e">pushing for</a>), “we have got to do more.”



<h4 class="wp-block-heading">BIG NUMBER</h4>



7.8 million. That’s how many Americans have fallen into poverty since June as critical CARES Act benefits expired, according to&nbsp;<a href="https://harris.uchicago.edu/files/monthly_poverty_rates_updated_thru_november_2020_final.pdf" target="_blank" rel="noreferrer noopener">new research</a>&nbsp;from the University of Chicago and the University of Notre Dame. That translates to the&nbsp;<a href="https://www.forbes.com/sites/tommybeer/2020/12/16/largest-increase-in-us-poverty-recorded-in-2020/?sh=3b405c4d32bd">largest single-year increase</a>&nbsp;in the poverty rate since the government began tracking poverty data 80 years ago.&nbsp;



<h4 class="wp-block-heading">KEY BACKGROUND</h4>



In May, the Democratic-led House of Representatives passed the $3.4 trillion Heroes Act as a sweeping follow-up to the historic CARES Act signed in March. The Senate never took up the bill because the Republicans who control the chamber questioned not only the size of the package, but whether any new spending would be needed. Months later, the House passed a $2.2 trillion version of the Heroes Act (with a shortened timeline to bring down costs), but that bill never made it past the Senate’s GOP gatekeepers either. Until this month, Democratic leaders had not been willing to support any package worth less than about $2 trillion.



<h4 class="wp-block-heading">CRUCIAL QUOTE</h4>



During his remarks on Wednesday, President-elect Biden said he was “encouraged” by the progress towards a bill on Capitol Hill but emphasized his view of the deal on the table as a “down payment” ahead of more relief legislation after he takes office next year.&nbsp;



<h4 class="wp-block-heading">FURTHER READING</h4>



<a href="https://www.forbes.com/sites/sarahhansen/2020/12/16/report-relief-deal-will-include-stimulus-checks-exclude-state-aid-and-liability-protections/">Report: Relief Deal Will Include Stimulus Checks, Exclude State Aid And Liability Protections</a>&nbsp;(Forbes)



<a href="https://www.forbes.com/sites/sarahhansen/2020/12/15/senate-leader-mcconnell-vows-were-not-leaving-without-covid-19-relief-as-rank-and-file-stews-over-lack-of-stimulus-checks/">Senate Leader McConnell Vows ‘We’re Not Leaving’ Without Covid-19 Relief As Rank And File Stews Over Lack Of Stimulus Checks</a>&nbsp;(Forbes)



<a href="https://www.forbes.com/sites/sarahhansen/2020/12/15/pelosi-mcconnell-schumer-and-mccarthy-set-for-pivotal-stimulus-meeting-ahead-of-friday-shutdown-deadline/">Pelosi, McConnell, Schumer, And McCarthy Set For Pivotal Stimulus Meeting Ahead Of Friday Shutdown Deadline</a>&nbsp;(Forbes)



<a href="https://www.forbes.com/sites/sarahhansen/2020/12/15/warren-buffett-on-stimulus-gridlock-just-renew-the-ppp-and-get-us-to-the-end-of-the-tunnel/">Warren Buffett On Stimulus Gridlock: ‘Just Renew The PPP And Get Us To The End Of The Tunnel’</a> (Forbes)



-By Sarah Hansen, Forbes Staff

BERNIE SANDERS

A $900 Billion Covid-19 Aid Compromise Is Coming Together And Some Progressives Aren’t Happy

To improve Africa’s chances and ensure the safe storage of Covid-19 vaccines, Zeynep Harezi, and Karpowership based in Istanbul are working on innovative power generation solutions.



There is still a strong debate about Africa’s chances of receiving the Covid-19 vaccines when they become available in 2021: how will the continent store it?



Although organizations like GAVI, the Vaccine Alliance, are closely working with global pharmaceutical giants like Pfizer and AstraZeneca to ensure that Africa does not get left behind, there are other important considerations the continent needs to consider when it comes to receiving inoculation.



One such factor is the availability of consistent power to keep the vaccines refrigerated in order to remain potent and safe. According to a Reuters report, most vaccines require cooling of between two and eight degrees Celsius with the Phase 1 trials of the Covid-19 vaccine requiring storage in an environment as low as -80 degrees Celsius.



According to the World Health Organization (WHO), an estimated 50% of all vaccines are destroyed due to issues like temperature control. To improve Africa’s chances and ensure the safe storage and implementation of the vaccines, Zeynep Harezi and her Karpowership organization is hoping to introduce innovative power generation solutions that will enable Africa to succeed in not only the fight against Covid-19 but also power infrastructure development.



The 32-year-old Turkish-born managing director of Karpowership has a background in philosophy and economics, having graduated with a master’s degree from the London School of Economics. Harezi once dreamed of becoming the president of Turkey when she was a child, a choice that was greatly influenced by the country’s first female prime minister at the time. But it was her uncle who would set her sights on helping Africa improve its power infrastructure.



“When I was six years old, my uncle would tell me that he was going to build power plants inside ships and send them to countries all over the world. But he would also tell me about the mermaids in Atlantis so I was never sure where the line of reality was and where it was just story-telling,” recalls Harezi.



But her uncle’s stories were not tall tales after all. In 1996, the family-owned business entered the energy sector in Turkey when there was privatization of it. At the time, Karpowership was the first company to have an export licence and began exporting electricity from Turkey to Iraq.



“Then, many mining companies in Africa approached us and said ‘can we please build land-based power plants for them’ because they could not get reliable electricity and we told them instead of building land-based power plants in remote locations, we could build them inside ships or on barges much faster and with a better design to have increased efficiency and we can deliver them much faster than land-based power plants,” avers Harezi.



<div class="wp-block-media-text alignwide is-stacked-on-mobile" style="grid-template-columns:36% auto"><figure class="wp-block-media-text__media"><img loading="lazy" decoding="async" width="683" height="1024" src="https://www.forbesafrica.com/wp-content/uploads/2020/12/ZH-2020-New-Fave-1-683x1024.jpg" alt="" class="wp-image-49312" srcset="https://cms.forbesafrica.com/wp-content/uploads/2020/12/ZH-2020-New-Fave-1-683x1024.jpg 683w, https://cms.forbesafrica.com/wp-content/uploads/2020/12/ZH-2020-New-Fave-1-200x300.jpg 200w, https://cms.forbesafrica.com/wp-content/uploads/2020/12/ZH-2020-New-Fave-1-768x1152.jpg 768w, https://cms.forbesafrica.com/wp-content/uploads/2020/12/ZH-2020-New-Fave-1-1024x1536.jpg 1024w, https://cms.forbesafrica.com/wp-content/uploads/2020/12/ZH-2020-New-Fave-1-1365x2048.jpg 1365w, https://cms.forbesafrica.com/wp-content/uploads/2020/12/ZH-2020-New-Fave-1-300x450.jpg 300w, https://cms.forbesafrica.com/wp-content/uploads/2020/12/ZH-2020-New-Fave-1-600x900.jpg 600w, https://cms.forbesafrica.com/wp-content/uploads/2020/12/ZH-2020-New-Fave-1-scaled.jpg 1707w" sizes="auto, (max-width: 683px) 100vw, 683px" /></figure><div class="wp-block-media-text__content">
<blockquote class="wp-block-quote is-layout-flow wp-block-quote-is-layout-flow">“The long-term vision is to eradicate non-access to electricity. Everyone in the world should have access to electricity; it is a basic human right and we have the technology to deliver it.”</blockquote>
</div></div>



So, the organization began building floating power plants for mining projects in Africa. But before they could sell them to the continent, the Iraqi minister of energy requested an energy power plant for their southern city that had access to the sea. Harezi had just the right floating power ship to send. The next two power ships were subsequently supplied to Lebanon before finally their first supply was delivered to Ghana in 2014.



“The long-term vision is to eradicate non-access to electricity. Everyone in the world should have access to electricity; it is a basic human right and we have the technology to deliver it. As Karpowership, we can deliver baseload utility scale floating power plants to the remotest countries in the world with the highest risk of execution and construction, and we can deliver in less than 30 days. So, there is no excuse for anyone in the world to have no access to electricity and we can do it at a very low cost,” says Harezi.



Africa’s population growth is higher than other regions, hence the demand for electricity surpasses the planned increase of power supply. This means there is always a gap between supply and demand. This is a natural fit for Karpowership. Harezi says it can deliver between 25% to 80% of a country’s total electricity on one ship in less than 30 days. And there are “other advantages too” of this model.



“The regular infrastructure-related challenges of Africa are usually to do with project finance, construction risks, execution risks and the timeline. So, a project is usually promised to be operational in three years where as the project finance only lasts for two years and the actual construction takes another three to five years. So, the project that was promised for three years ends up not being finished for another eight years,” says Harezi.



Such solutions could give Africa a fighting chance in the Covid-19 vaccine race. With the company currently providing most of the national electricity in Gambia, Guinea-Bissau, Sierra Leone, Mozambique and Senegal, it seems poised to disrupt the African energy sector in a pandemic era.

image0 (2)

Floating Power: ‘No Excuse To Not Have Electricity’

Topline: “If we don’t do things differently, this will be the last Christmas for many South Africans,” said South African President Cyril Ramaphosa, addressing the nation on Monday evening, as he announced more restrictions, some “with immediate effect”.



<h4 class="wp-block-heading" id="h-key-facts">Key Facts</h4>



● South Africa is officially in its second wave, said president Ramaphosa during a live broadcast. On December 3, the country recorded over 4,400 new cases. Ten days later, South Africa recorded nearly 8,000 new cases. The cumulative number of confirmed Covid-19 cases in South Africa now stands at over 860,000.



● Ramaphosa said this figure is of “great concern” for the country.



● “Given the rate at which new cases have grown over the last two weeks, there is every possibility that if we do not act urgently and if we do not act together, the second wave will be more severe than the first wave,” he said.



● Furthermore, in a short amount of time, the daily average of coronavirus deaths has increased by nearly 50%. A figure that previously sat at 100 deaths a day is now over 150 deaths.



● The four provinces in South Africa that are leading the second wave are the Eastern Cape, Western Cape, KwaZulu-Natal (KZN) and Gauteng.



● The reasons behind the increase vary from health protocols (no social distancing or masks being worn) not being followed to super-spreader events like large gatherings being held.



● “We have gotten into the Christmas spirit early and are inviting friends and family over for get-togethers,” Ramaphosa said. “Yet, it is our failure to closely adhere to all these basic precautions at all times that has brought us to this second wave.”



<h4 class="wp-block-heading" id="h-key-changes-made-by-the-south-african-government-to-contain-the-spread-of-the-virus">Key changes made by the South African government to contain the spread of the virus.</h4>



● Beaches and public parks in the Eastern Cape and the Garden Route in the Western Cape will be closed for the duration of the festive season from December 16 to January 3. In KZN, beaches and public parks will be closed for what are traditionally the busiest days of the holiday season.



● The curfew will start at 11PM and end at 4AM. Restaurants and bars will have to close at 10PM so that staff and patrons can get home before the enforcement of the curfew.



● Alcohol sales will also be restricted. Retail outlets are only permitted to sell alcohol between 10AM and 6PM from Monday to Thursday. However, registered wineries and wine farms may continue to offer tastings and wine sales to the public for off-site consumption over weekends. Alcohol consumption in all public spaces, such as beaches and parks, is strictly forbidden.



<h4 class="wp-block-heading" id="h-crucial-quote">Crucial Quote</h4>



“If we do not do things differently this festive season, we will greet the new year not with joy, but with sorrow. Many of our friends, relatives, and co-workers will be infected, some will get severely ill and some, tragically, will die&#8230; It is therefore essential that we take extraordinary measures to contain the second wave and save lives while working to protect livelihoods,” Ramaphosa said.



<h4 class="wp-block-heading" id="h-vaccine-update">Vaccine Update</h4>



In addition to enforcing stricter nationwide enforcement of existing lockdown alert level 1 restrictions, the president also announced that South Africa had concluded all the necessary processes to participate in the World Health Organization’s Covid-19 Global Vaccine Access Facility (COVAX).



“As part of this facility, it is expected that South Africa will receive initial vaccines to cover 10% of our population in the early part of next year,” Ramaphosa said.

South African President Ramaphosa visits the Mashatile family home to offer condolences

More Grave Second Wave In South Africa/Country To Receive Vaccines Early 2021

Although the world was struck by the Covid-19 Pandemic, other issues were also brought to the forefront in 2020. Here are the hashtags from Africa that caught the globe’s attention this year.



#ENDSars: Just as the country celebrated its diamond jubilee, police brutality protests started on October 7 in Nigeria calling for the disbanding of the infamous police unit, the Special Anti-Robbery Squad (SARS), which had long been accused of extortion, torture, and extra-judicial killings.



<div class="wp-block-image is-style-default"><figure class="aligncenter size-large is-resized"><img loading="lazy" decoding="async" src="https://www.forbesafrica.com/wp-content/uploads/2020/12/GettyImages-1229378322-1024x682.jpg" alt="" class="wp-image-49261" width="432" height="288" srcset="https://cms.forbesafrica.com/wp-content/uploads/2020/12/GettyImages-1229378322-1024x682.jpg 1024w, https://cms.forbesafrica.com/wp-content/uploads/2020/12/GettyImages-1229378322-300x200.jpg 300w, https://cms.forbesafrica.com/wp-content/uploads/2020/12/GettyImages-1229378322-768x511.jpg 768w, https://cms.forbesafrica.com/wp-content/uploads/2020/12/GettyImages-1229378322-1536x1022.jpg 1536w, https://cms.forbesafrica.com/wp-content/uploads/2020/12/GettyImages-1229378322-2048x1363.jpg 2048w, https://cms.forbesafrica.com/wp-content/uploads/2020/12/GettyImages-1229378322-600x399.jpg 600w" sizes="auto, (max-width: 432px) 100vw, 432px" /><figcaption> (Photo by Maciek Musialek/NurPhoto via Getty Images)</figcaption></figure></div>



#CongoIsBleeding: Exploitation in the mines of the Democratic Republic of the Congo (DRC) received attention in October to highlight child slavery, deadly conflicts, and corruption spawned by the quest to feed mega-companies with minerals.



#ShutItAllDown: This was a wave of ongoing gender-based violence protests across Namibia aimed at stopping the spread of rape and the killing of women. According to CNN, the protests were in response to news of another attack, in turn, those protestors threatened to leave everything at a standstill for four days earlier in October.



<div class="wp-block-image is-style-default"><figure class="aligncenter size-large is-resized"><img loading="lazy" decoding="async" src="https://www.forbesafrica.com/wp-content/uploads/2020/12/GettyImages-1228977823-1024x683.jpg" alt="" class="wp-image-49263" width="388" height="259" srcset="https://cms.forbesafrica.com/wp-content/uploads/2020/12/GettyImages-1228977823-1024x683.jpg 1024w, https://cms.forbesafrica.com/wp-content/uploads/2020/12/GettyImages-1228977823-300x200.jpg 300w, https://cms.forbesafrica.com/wp-content/uploads/2020/12/GettyImages-1228977823-768x512.jpg 768w, https://cms.forbesafrica.com/wp-content/uploads/2020/12/GettyImages-1228977823-1536x1024.jpg 1536w, https://cms.forbesafrica.com/wp-content/uploads/2020/12/GettyImages-1228977823-2048x1365.jpg 2048w, https://cms.forbesafrica.com/wp-content/uploads/2020/12/GettyImages-1228977823-600x400.jpg 600w" sizes="auto, (max-width: 388px) 100vw, 388px" /><figcaption> (Photo by HILDEGARD TITUS/AFP via Getty Images)</figcaption></figure></div>



#ZimbabweanLivesMatter: A predominantly online demonstration to address the human rights abuses in Zimbabwe in August. According to The Guardian, the hashtag was ‘fashioned’ after the Black Lives Matter global protests staged since the killing of George Floyd by a US police officer in May. Furthermore, the incarceration of journalist Hopewell Chin’ono and the Booker Prize long-listed author Tsitsi Dangarembga has angered more people across Africa.



<div class="wp-block-image is-style-default"><figure class="aligncenter size-large is-resized"><img loading="lazy" decoding="async" src="https://www.forbesafrica.com/wp-content/uploads/2020/12/GettyImages-1227856557-1024x683.jpg" alt="" class="wp-image-49265" width="433" height="289" srcset="https://cms.forbesafrica.com/wp-content/uploads/2020/12/GettyImages-1227856557-1024x683.jpg 1024w, https://cms.forbesafrica.com/wp-content/uploads/2020/12/GettyImages-1227856557-300x200.jpg 300w, https://cms.forbesafrica.com/wp-content/uploads/2020/12/GettyImages-1227856557-768x512.jpg 768w, https://cms.forbesafrica.com/wp-content/uploads/2020/12/GettyImages-1227856557-600x400.jpg 600w" sizes="auto, (max-width: 433px) 100vw, 433px" /><figcaption>Julie Barnes holds a placard during an anti-corruption protest march along Borrowdale road, on July 31, 2020 in Harare. (Photo by ZINYANGE AUNTONY/AFP via Getty Images)</figcaption></figure></div>



#RapeNationalEmergancy: On September 11, Liberian President George Weah declared rape a national emergency in the country. According to Al Jazeera, Weah introduced measures in place to address the increase in violence against women. Measures include a special prosecutor for rape in the country, as well as the set-up of a national sex offender registry and the establishment of a “national security task force” on sexual and gender-based violence.



#ChildTrafficking: This has been highlighted as a severe problem on cocoa farms in Ghana and Ivory Coast. According to a US study, the prevalence of children doing hazardous work, including using sharp tools, has also gone up in the world’s top two cocoa producers, reported Al Jazeera in October.



<div class="wp-block-image is-style-default"><figure class="aligncenter size-large is-resized"><img loading="lazy" decoding="async" src="https://www.forbesafrica.com/wp-content/uploads/2020/12/GettyImages-1227845071-1024x678.jpg" alt="" class="wp-image-49266" width="444" height="294" srcset="https://cms.forbesafrica.com/wp-content/uploads/2020/12/GettyImages-1227845071-1024x678.jpg 1024w, https://cms.forbesafrica.com/wp-content/uploads/2020/12/GettyImages-1227845071-300x199.jpg 300w, https://cms.forbesafrica.com/wp-content/uploads/2020/12/GettyImages-1227845071-768x509.jpg 768w, https://cms.forbesafrica.com/wp-content/uploads/2020/12/GettyImages-1227845071-1536x1017.jpg 1536w, https://cms.forbesafrica.com/wp-content/uploads/2020/12/GettyImages-1227845071-2048x1356.jpg 2048w, https://cms.forbesafrica.com/wp-content/uploads/2020/12/GettyImages-1227845071-600x397.jpg 600w" sizes="auto, (max-width: 444px) 100vw, 444px" /><figcaption>(Photo by Olukayode Jaiyeola/NurPhoto via Getty Images)</figcaption></figure></div>



#Guinea: Guinea’s president, Alpha Condé, has won a “controversial third term” with 59.49% of the vote, the National Independent Electoral Commission declared on October 24. According to the Guardian, his victory came at the same time as widespread protests “violently suppressed by security forces”.



<div class="wp-block-image is-style-default"><figure class="aligncenter size-large is-resized"><img loading="lazy" decoding="async" src="https://www.forbesafrica.com/wp-content/uploads/2020/12/GettyImages-1229107728-1024x683.jpg" alt="" class="wp-image-49262" width="395" height="263" srcset="https://cms.forbesafrica.com/wp-content/uploads/2020/12/GettyImages-1229107728-1024x683.jpg 1024w, https://cms.forbesafrica.com/wp-content/uploads/2020/12/GettyImages-1229107728-300x200.jpg 300w, https://cms.forbesafrica.com/wp-content/uploads/2020/12/GettyImages-1229107728-768x512.jpg 768w, https://cms.forbesafrica.com/wp-content/uploads/2020/12/GettyImages-1229107728-1536x1024.jpg 1536w, https://cms.forbesafrica.com/wp-content/uploads/2020/12/GettyImages-1229107728-2048x1365.jpg 2048w, https://cms.forbesafrica.com/wp-content/uploads/2020/12/GettyImages-1229107728-600x400.jpg 600w" sizes="auto, (max-width: 395px) 100vw, 395px" /><figcaption> Alpha Conde addresses his supporters at a campaign rally in Conakry on October 16, 2020. (Photo by JOHN WESSELS/AFP via Getty Images)</figcaption></figure></div>



#AnglophoneCrisis: Since October 2016, Cameroon’s Anglophone minority have been protesting due to sectoral grievances that morphed into political demands. On October 24 this year, the United Nations reported that eight children were killed and dozens wounded by a group of armed men at the Mother Francisca International Bilingual Academy Kumba in the southwest region of Cameroon. Although the southwest region is one of two Anglophone regions, it was not clear if the attack was linked to a continuing struggle between government forces and armed groups in the English-speaking west seeking to form a breakaway state.



<div class="wp-block-image is-style-default"><figure class="aligncenter size-large is-resized"><img loading="lazy" decoding="async" src="https://www.forbesafrica.com/wp-content/uploads/2020/12/GettyImages-1154062693-1024x682.jpg" alt="" class="wp-image-49268" width="418" height="278" srcset="https://cms.forbesafrica.com/wp-content/uploads/2020/12/GettyImages-1154062693-1024x682.jpg 1024w, https://cms.forbesafrica.com/wp-content/uploads/2020/12/GettyImages-1154062693-300x200.jpg 300w, https://cms.forbesafrica.com/wp-content/uploads/2020/12/GettyImages-1154062693-768x512.jpg 768w, https://cms.forbesafrica.com/wp-content/uploads/2020/12/GettyImages-1154062693-1536x1023.jpg 1536w, https://cms.forbesafrica.com/wp-content/uploads/2020/12/GettyImages-1154062693-2048x1365.jpg 2048w, https://cms.forbesafrica.com/wp-content/uploads/2020/12/GettyImages-1154062693-600x400.jpg 600w" sizes="auto, (max-width: 418px) 100vw, 418px" /><figcaption> Anglophone village women pray in a church located in a hill village on May 12, 2019 a few miles outside Buea in SW Cameroon. (Photo by Giles Clarke/UNOCHA via Getty Images)</figcaption></figure></div>



#PrayForEthiopia: CNN reported on November 7 that a military conflict, which has raised fears of civil war, broke out due to Tigray&#8217;s Peoples Liberation Front’s (TPLF) unilateral decision to elect a regional administration against Prime Minister Abiy Ahmed’s wishes. “Our operation aims to end the impunity that has prevailed for far too long and hold accountable individuals and groups under the laws of the land,” Abiy said on Twitter. According to the Herald Malaysia, this resulted in heavy casualties and thousands of civilians fleeing the region.



<div class="wp-block-image is-style-default"><figure class="aligncenter size-large is-resized"><img loading="lazy" decoding="async" src="https://www.forbesafrica.com/wp-content/uploads/2020/12/GettyImages-1229977140-1024x683.jpg" alt="" class="wp-image-49259" width="431" height="287" srcset="https://cms.forbesafrica.com/wp-content/uploads/2020/12/GettyImages-1229977140-1024x683.jpg 1024w, https://cms.forbesafrica.com/wp-content/uploads/2020/12/GettyImages-1229977140-300x200.jpg 300w, https://cms.forbesafrica.com/wp-content/uploads/2020/12/GettyImages-1229977140-768x512.jpg 768w, https://cms.forbesafrica.com/wp-content/uploads/2020/12/GettyImages-1229977140-1536x1024.jpg 1536w, https://cms.forbesafrica.com/wp-content/uploads/2020/12/GettyImages-1229977140-2048x1365.jpg 2048w, https://cms.forbesafrica.com/wp-content/uploads/2020/12/GettyImages-1229977140-600x400.jpg 600w" sizes="auto, (max-width: 431px) 100vw, 431px" /><figcaption>TOPSHOT &#8211; An Ethiopian refugee who fled the Tigray conflict prays during Sunday Mass at an Ethiopian Orthodox church building built by former Ethiopian refugees, at the village next to Um Raquba refugee camp in Gedaref, eastern Sudan, on December 6, 2020. (Photo by YASUYOSHI CHIBA/AFP via Getty Images)</figcaption></figure></div>



#StopGBV: During the lockdown, gender-based violence and femicide in South Africa has become a second pandemic for the country. According to the Commission of Gender Equality, South Africa is ranked amongst the highest in Africa for domestic violence. At the end of July, Police Minister Bheki Cele released crime stats showing that sexual crimes in the country increased by 1.7%, with 53,293 cases reported. This is 873 cases more than in 2019.



<div class="wp-block-image is-style-default"><figure class="aligncenter size-large is-resized"><img loading="lazy" decoding="async" src="https://www.forbesafrica.com/wp-content/uploads/2020/12/GettyImages-1222580728-1024x710.jpg" alt="" class="wp-image-49267" width="389" height="270" srcset="https://cms.forbesafrica.com/wp-content/uploads/2020/12/GettyImages-1222580728-1024x710.jpg 1024w, https://cms.forbesafrica.com/wp-content/uploads/2020/12/GettyImages-1222580728-300x208.jpg 300w, https://cms.forbesafrica.com/wp-content/uploads/2020/12/GettyImages-1222580728-768x533.jpg 768w, https://cms.forbesafrica.com/wp-content/uploads/2020/12/GettyImages-1222580728-1536x1065.jpg 1536w, https://cms.forbesafrica.com/wp-content/uploads/2020/12/GettyImages-1222580728-2048x1421.jpg 2048w, https://cms.forbesafrica.com/wp-content/uploads/2020/12/GettyImages-1222580728-600x416.jpg 600w" sizes="auto, (max-width: 389px) 100vw, 389px" /><figcaption>Students protest against gender based violence (GBV) at parliament on June 24, 2020 in Cape Town, South Africa. (Photo by Nardus Engelbrecht/Gallo Images via Getty Images)</figcaption></figure></div>

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What Was Trending In Africa In 2020?

Professor Barry Schoub, a world-renowned virologist, details the Covid-19 vaccine process and the innovations being made in the field as well as the involvement of Africa in these trials.



 



Q. Given how each phase within a clinical trial has been expedited to find a Covid-19 vaccine, do you think it will have the same effectiveness or efficacy as other vaccines used to combat infectious diseases similar in nature?



A. I think up to the Pfizer release, scientists, virologists, vaccinologists thought it would be a vaccine with a 60% efficacy. So these results are in the same ballpark as the influenza vaccine because it’s got a similar kind of disease process. It is only an interim analysis of course, but it certainly has very good connotations attached to it. It is also a possibility that the corona vaccines will have a higher protection rate than the influenza vaccine for example. However, it will not have the same efficacy rate as more successful vaccines such as the measles vaccine which has an efficacy of about 95% and therefore we do need to have some reservation.



Q. There are a number of vaccine types currently in trials. Pfizer and BioNTech are developing a genetic vaccine while Johnson &amp; Johnson are trialing a viral vector vaccine model they have used for finding an Ebola vaccine previously. Do you think the type of vaccine influences the efficacy rate?



A. These vaccines are all new, this has never been done on humans, so there is no definitive way to say. We’ve never had an RNA or DNA vaccine going into human beings and we’ve never had a virus vector going into human beings. Previous use of a viral vector for HIV vaccine trials didn’t go well because of pre-existing immunity to the adenovirus being used as the vessel. All of this is new territory and really in a way, unpredictable.



Q. What do you think of the innovations then made with these vaccines?



A. It’s very exciting and just the speed with which these vaccines have come out as well. This disease has only been with us from the beginning of the year, so it’s amazing as vaccines usually take years to develop.&nbsp;



Q. These trials are also being tested throughout the world, and given that South Africa is the only site in Africa with any of these trials happening, do you think there should be more testing sites in Africa?



A. I don’t think all of Africa needs involvement in trials per se… It would just be where there is prevalence of disease, for example, endemic diseases such as HIV and TB in southern Africa and more tropical diseases so these are scenarios that do need to be looked at.



Q. Do you think these trials have accounted for all necessary factors that could play a role in how successful the vaccines could be?



A. In European and American trials, there are still key populations missing in the evaluation of these vaccinations like the elderly or people with co-morbidities, so all of these factors do need to be evaluated. All the vaccines currently in Phase III lack the optimal populations, so they all have a set age parameter and these vaccines still need testing in high-risk populations.



Q. Do you see any potential barriers that could decrease the uptake of the vaccine?



A. Well… there’s always suspicion, and polls here and abroad have shown hesitance and reluctance. First of all, things have been done at such fast speeds so there are concerns about safety and also the novelty of these vaccines and that they haven’t been used on humans before. So these factors can lead to suspicion.&nbsp;



Q. Do you think there any possible solutions to this?



A. They need to be reassured that these do undergo very rigorous safety testing and this will prove to be an educational exercise.



Q. What are your thoughts on the eventual accessibility of the vaccine within Africa?



A. In the beginning, we could possibly get a relatively small proportion of vaccines for the population, so the initial batches will have to go to priority groups. This includes frontline workers as an example, people in elderly homes and other high-risk populations.



Q. Do you think initiatives such as CEPI could also see Africa receiving the vaccine sooner than anticipated?



A. Initiatives such as CEPI and COVAX are pooled procurement mechanisms, so these aim to provide both middle and low income countries with their initial supply of the vaccine when it becomes available. So the vaccination process will need to happen in two steps; first step would be to protect vulnerable groups and then only later try to achieve herd immunity.



<div class="wp-block-group"><div class="wp-block-group__inner-container is-layout-flow wp-block-group-is-layout-flow">
[IN NUMBERS] 



<h2 class="has-text-align-center wp-block-heading" id="h-12-billion">$12 BILLION</h2>



In an African Union (AU) meeting in November to discuss Africa’s strategy for financing Covid-19 vaccines, AU Chairperson and South African President Cyril Ramaphosa noted that about $12 billion was required, and this was expected to come from three sources: the COVAX Donor Initiative, The World Bank, direct donors, and the African Import-Export Bank, which has committed to raising up to $5 billion.
</div></div>



<h4 class="wp-block-heading" id="h-further-reading">Further Reading</h4>



PLEASE NOTE:&nbsp;More stories regarding the Covid-19 vaccine will be published. However, if you would like to read the full Focus piece by Simone Sribrath, click&nbsp;<a href="https://www.forbesafrica.com/product/single-digital-issue-dec-jan-2020/">here to download the digital copy of FORBES AFRICA.</a>



<a href="https://www.forbesafrica.com/focus/2020/12/07/what-goes-into-a-clinical-trial/">What Goes Into A Clinical Trial?&nbsp;(Forbes Africa)</a>



<a href="https://www.forbesafrica.com/focus/2020/12/07/all-you-need-to-know-about-the-vaccine/">All You Need To Know About The Vaccine (Forbes Africa)</a>



<a href="https://www.forbesafrica.com/focus/2020/12/10/qa-endemic-diseases-like-hiv-are-still-an-emergency/">Q&amp;A: ‘ENDEMIC DISEASES LIKE HIV ARE STILL AN EMERGENCY’ (Forbes Africa)</a>

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‘ALL OF THIS IS NEW TERRITORY AND REALLY IN A WAY, UNPREDICTABLE’

Dr. Sinead Delany-Moretlwe, Director of Research at the Wits Reproductive Health and HIV Institute in Johannesburg, South Africa:



Q. Currently, clinical trials can take years to reach Phase IV. The Covid-19 pandemic has shown us how much quicker it can go. Do you think there are lessons that can be taken from this?



A: We have learned a lot during the Covid-19 pandemic about how we can potentially expedite processes and get products to the people that need them rapidly and I think it’s important to remember that in our region, endemic diseases like HIV are still an emergency. While we don’t want to cut corners and while we want to ensure that we have safe and effective products for people, something that Covid-19 vaccine trials may need to grapple with is no longer using placebo-control trials as it is harder to justify from an ethical perspective, especially as more vaccines begin to hit the market.



Q. What does this then mean from a design perspective for trials going forward?



A. Trial design is going to be very interesting to see going forward. In terms of just the processes, there have been discussions about how to diminish the transition time from Phase II to Phase III and these large gaps that affect when results are being received.&nbsp;



Q. What lessons are there for clinical trials running during a pandemic such as the current one?&nbsp;



A. Future trials are going to have to Covid-proof themselves. We learned during conducting our trial, sibling trials during a pandemic are challenging and we’re going to have to think about how we do these studies so that we are managing staff and participant safety. 



<h4 class="wp-block-heading" id="h-further-reading">Further Reading</h4>



PLEASE NOTE:&nbsp;More stories regarding the Covid-19 vaccine will be published. However, if you would like to read the full Focus piece by Simone Sribrath, click&nbsp;<a href="https://www.forbesafrica.com/product/single-digital-issue-dec-jan-2020/">here to download the digital copy of FORBES AFRICA.</a>



<a href="https://www.forbesafrica.com/focus/2020/12/07/what-goes-into-a-clinical-trial/">What Goes Into A Clinical Trial? (Forbes Africa)</a>



<a href="https://www.forbesafrica.com/focus/2020/12/07/all-you-need-to-know-about-the-vaccine/">All You Need To Know About The Vaccine (Forbes Africa)</a>

Medical technician preparing a human sample for HIV testing

Q&A: ‘ENDEMIC DISEASES LIKE HIV ARE STILL AN EMERGENCY’

The complex world of Covid-19 vaccine trials explained.



SOMEWHERE IN THE DEEP UNEXPLORED depths of Madagascar, an unknown herb is probably on its way to becoming a global panacea for the pandemic



This is Africa, a continent ripe with possibilities, where you cannot rule out that a cure for Covid-19 could perhaps come from nature itself. Just like Madagascar, currently touting Artemisia Afra (umhlonyane in Nguni languages and previously used as an ingredient for treating malaria) as a potential cure for Covid-19, bigger economies like South Africa are also looking to the botanical world for answers. Its national Department of Basic Education has reassigned R15 million ($960,982) of its budget on Covid-19 interventions such as Artemisia. Nigeria has also made a move towards a more homeopathic approach, as a ministerial committee has been put in place to further examine the potential natural compounds hold in combating the Covid-19 pandemic.



But the focus of this story is exploring humanity’s race to uncover a universal vaccine – or any cure – that can assuage a health crisis confronting the entire world.



Currently, there are over 60 possible vaccines the world over being put through the paces. Of these, only nine are in the third<a href="https://www.forbesafrica.com/focus/2020/12/07/what-goes-into-a-clinical-trial/"> phase of trials.</a> The road to finding a Covid-19 vaccine since the start of the pandemic this year has been long and arduous. For the layperson, desperate to see an effective vaccine come online soon, the deluge of news on vaccine trials can seem complex. This article will discern the facts around them.



In comparison to its European and American counterparts, Africa has seen a relatively lower rate of virus spread and a lower death rate. As of November 11, Africa accounted for 3.7% of the world’s total number of cases; and southern Africa the worst hit with over 800,000 cases.



Scientists are yet to definitively map out the effects of the Covid-19 virus and its ability to recur within individuals who have had it before. Fear of public spaces and physical interactions have become the norm. Face masks and sanitizing products have become staples in every handbag and car cubbyhole.



Put simply, a clinical trial is a series of phases within an experiment being conducted to test a new drug, type of therapy or new medical device. It also looks at the efficacy of pre-existing medical interventions in the treatment of numerous illnesses and different types of patients.



Clinical trials can be performed on both healthy and ill participants. There are a number of protocols and regulations that accompany a clinical trial to ensure that the wellbeing of the participant is maintained as far as possible. It ensures that the benefits of the medical intervention being tested outweigh the risks and each phase of a trial plays a part in testing this.



Clinical trials usually happen in four phases. Before these phases occur, a preclinical test is done. Each phase needs to produce a favorable result in order for the next phase to be conducted. In order for a medical intervention to get to the stage of manufacturing and distribution, all four phases need to have occurred successfully. The success of each phase is measured by the number of medically adverse events that have occurred as a result of the medical intervention being tested. These adverse events include mild to serious medical side-effects that have occurred to the participants of the trial.



Dr. Sinead Delany-Moretlwe, Director of Research at the Wits Reproductive Health and HIV Institute in Johannesburg, South Africa explains how innovations made with expediting the clinical trials for the Covid-19 vaccine could reshape how clinical trials are done across the board. She has also been the lead on HPTN 084, an injectable form of an antiretroviral (ARV) used to prevent HIV in women in sub-Saharan Africa.



The frantic search for a Covid-19 vaccine is being closely watched by every country on earth. At the time of going to press mid-November, there were currently 51 trials between Phases I and III of the clinical trials. When they will be available to all is a question on everyone’s mind.



South Africa’s Health Minister, talking to FORBES AFRICA about vaccine manufacturers, says: “Collaboration across global institutions has led to the transfer of technology and therefore new developments and new discoveries in combating the pandemic.”



In an interview with Aspen Pharmacare CEO and founder, Stephen Saad, he highlights to FORBES AFRICA the need for efficient manufacturing and distribution channels for the vaccine, once it becomes available. Aspen recently partnered with Johnson &amp; Johnson for their vaccine Ad26.COV2-S(now known as JNJ-78436735). This partnership will see the manufacturing and distribution capacity of Johnson &amp; Johnson increase significantly.



Saad explains that Aspen uses just 40% of their current manufacturing capacity for their own products and the other 60% was available for use. “Covid-19 is prevalent everywhere. We were very committed to trying to find a partner that would use our capabilities to be able to provide a vaccine,” says Saad.



At the heart of the partnership is the transfer of technology as Johnson &amp; Johnson share their protocols and blueprint for creating the vaccine so they are able to manufacture it once it has passed Phase III trials.



“We are very pleased because Johnson &amp; Johnson have made big commitments to distribute their vaccine universally, so they’ve made commitments through the Bill &amp; Melinda Gates Foundation and to their own public statements about offering up 500 million doses to the developing world,&#8221; says Saad.&nbsp;



The manufacturing site in Port Elizabeth in South Africa’s Eastern Cape province will be utilized in this partnership where as many as 300 million doses can be produced and this is expected to begin the second quarter of next year should the Ad26.COV2-S proves successful.



“So much depends on the trials and the success of these trials,” says Saad. Aspen, having been linked to the success of the steroid Dexamethasone, and now as a vaccine frontrunner, have proven their reputation as a pharmaceutical powerhouse.



With an investment of R3 billion ($194 million) into their “sterile site”, Saad is confident. “There’s not a lot of companies that can manufacture on this scale,” he says.



Saad recognizes the urgency for a vaccine. “Our first and only priority right now is to get the product out to the world and our focus is on the job that we have to do very quickly over the next period.”



Currently, the only African country involved in the trial phases of these vaccines has been South Africa across different sites. Progress is being made by Oxford University as they await final clearance to begin trials in Kenya and the Uganda Virus Research Institute is aiming to collaborate with the Imperial College London and begin trials in Uganda in December.



Historically, only 2% of all vaccine trials have occurred on the African continent, according to a report in The Lancet.



Despite being no stranger to viral outbreaks, Africa as a whole is often excluded from the vaccine process and as such there is a severe lack of understanding of the African context when trialing a potential vaccine or medical intervention.



There are several factors that could possibly hinder the efficient and comprehensive administration of a Covid-19 vaccine when it eventually becomes available.



Accessibility to the vaccine is seen as a key issue, particularly within developing countries. While there are several initiatives such as the investments made by Coalition for Epidemic Preparedness Innovations as well as the Bill &amp; Melinda Gates Foundation, African countries are still amongst the last buyers of any possible vaccine that emerges.



There is surely light at the end of the tunnel but it may be a while before a cure will finally see the light of day.



<h4 class="wp-block-heading" id="h-further-reading">Further Reading </h4>



PLEASE NOTE: More stories regarding the Covid-19 vaccine will be published. However, if you would like to read the full Focus piece by Simone Sribrath, click <a href="https://www.forbesafrica.com/product/single-digital-issue-dec-jan-2020/">here to download the digital copy of FORBES AFRICA. </a>



<a href="https://www.forbesafrica.com/focus/2020/12/07/what-goes-into-a-clinical-trial/">What Goes Into A Clinical Trial? (Forbes Africa)</a>



<a href="https://www.forbesafrica.com/focus/2020/12/10/qa-endemic-diseases-like-hiv-are-still-an-emergency/">Q&amp;A: ‘ENDEMIC DISEASES LIKE HIV ARE STILL AN EMERGENCY (Forbes Africa) </a>

Dialing medicine into syringe from glass bottle. Ampoule and syringe needle close-up.

All You Need To Know About The Covid-19 Vaccine

This story is part of the &#8216;<a href="https://www.forbesafrica.com/focus/2020/12/07/all-you-need-to-know-about-the-vaccine/">All You Need To Know About The Vaccine</a>&#8216; piece. 



Preclinical Phase



This phase within a study is most intensive and can often require the most amount of time and extensive research into possible cellular reactions between the intervention being investigated and the body’s immune response. This phase is often tested thoroughly with the use of animal test subjects before proceeding to Phase I.



Phase I&nbsp;



This initial phase is conducted on a relatively small number of participants (six-10). It allows scientists to closely study and examine any effects or interactions that the intervention being investigated has in human participants. This phase is used to determine the safety and tolerability elements that an intervention may have in treating human participants. Participants are closely watched for the possible occurrence and severity of any side-effects that may occur.



Phase II&nbsp;



The size of the participant pool could vary greatly here as the size is dependent on the type of illness being investigated (typically between 20-300 participants). In this phase, the dosage is often experimented with. This is done to successfully determine the dosage required for the intervention to be most effective and safe to administer. Different dosages of the intervention could produce different results. As such, multiple simulations of Phase II may occur for a single intervention, being tested within numerous populations of interest.



Phase III&nbsp;



As with Phase II, the sample increases substantially (300-3,000 participants). These large numbers are used to confirm the level of safety and efficacy of the medical intervention. This phase also allows for a significant comparison between the drug being tested and other similar interventions on the market. It can also be used to test the efficacy of the intervention when used as part of a treatment plan and it tests the interactions it has with other medical interventions within the treatment plan. Finally, this phase allows for the prescribed dosage to be finalized.



Phase IV



The last and final phase occurs after regulatory approval has been granted. This phase looks at the long-term administration of the medical intervention and possible side-effects that could occur as a result of prolonged use of the intervention. This phase tests the overall efficacy and safety of the intervention within larger groups and sub-groups within a population. By this phase, the occurrence of any serious medical events has been resolved and the intervention becomes available as a viable treatment option within the sub-area of the medical market. Regulatory bodies keep a close eye on the intervention as it continues to monitor the administration of the intervention to the general public. Doing this ensures that any medical intervention currently in the public domain or in the clinical trial phase is entirely safe for human use.



<h4 class="wp-block-heading" id="h-further-reading">Further Reading </h4>



PLEASE NOTE: More stories regarding the Covid-19 vaccine will be published. However, if you would like to read the full Focus piece by Simone Sribrath, click <a href="https://www.forbesafrica.com/product/single-digital-issue-dec-jan-2020/">here to download the digital copy of FORBES AFRICA.</a>



<a href="https://www.forbesafrica.com/focus/2020/12/07/all-you-need-to-know-about-the-vaccine/">All You Need To Know About The Vaccine</a> (Forbes Africa)



<a href="https://www.forbesafrica.com/focus/2020/12/10/qa-endemic-diseases-like-hiv-are-still-an-emergency/">Q&amp;A: ‘ENDEMIC DISEASES LIKE HIV ARE STILL AN EMERGENCY (Forbes Africa)</a>

Florida Volunteers Take Part In COVID-19 Vaccine Trials

What Goes Into A Clinical Trial?

Topline: As people begin to prepare for the festive season, South African President, Cyril Ramaphosa, has once again taken to the podium to warn the country that until a vaccine is developed and distributed, citizens are to remain vigilant. With that being said, the President has yet again extended the National State of Disaster to January 15, 2021. 



Key Facts



<ul class="wp-block-list"><li>Though it was clear that a second wave would be possible, Ramaphosa was adamant on Thursday evening that evidence of a resurgence of infections in parts of the country “could lead to great suffering and death” if not confronted. </li><li>Since August, South Africa was able to keep the rate of new infections stable. However, on Wednesday evening, South Africa’s National Department of Health reported that the country recorded over 4000 new cases in a single day. </li></ul>



<figure class="wp-block-embed-twitter aligncenter wp-block-embed is-type-rich is-provider-twitter"><div class="wp-block-embed__wrapper">
<blockquote class="twitter-tweet" data-width="500" data-dnt="true">As of today, the cumulative total of <a href="https://twitter.com/hashtag/COVID19?src=hash&amp;ref_src=twsrc%5Etfw">#COVID19</a> cases is 796 472 with 4 173 new cases identified since the last report. Total Deaths: Regrettably, 65 more COVID-19 related deaths have been reported which brings the total to 21 709 deaths. <a href="https://t.co/rk2ZKKdWt7">pic.twitter.com/rk2ZKKdWt7</a>&mdash; National Department of Health (@HealthZA) <a href="https://twitter.com/HealthZA/status/1334212248605233154?ref_src=twsrc%5Etfw">December 2, 2020</a></blockquote><script async src="https://platform.twitter.com/widgets.js" charset="utf-8"></script>
</div></figure>



<ul class="wp-block-list"><li>Nelson Mandela Bay in Port Elizabeth, Eastern Cape, has been declared a Covid-19 hotspot. With this, the municipality will have strict restrictions put in places like a curfew and limited days to purchase alcohol.&nbsp;</li><li>Also accounting for some of the new infections are the Sarah Baartman District in the Eastern Cape and the Garden Route District in the Western Cape.&nbsp;</li><li>“As I said during <a href="https://www.forbesafrica.com/current-affairs/2020/11/11/south-african-president-extends-national-state-of-disaster-by-a-month-and-appeals-to-the-country-to-not-get-complacent/">our last family meeting</a>, at alert level 1, we have the measures we need to control the virus,” Ramaphosa said on a live broadcast. “But our main problem is that there are parts of the country where people are not complying with the current restrictions and the basic prevention measures are not being followed.”&nbsp;</li></ul>



Key Reason Behind the Increase in Transmission in South Africa



<ul class="wp-block-list"><li>Ramaphosa stated that one particular reason behind the rise is that many South Africans are traveling between provinces with high numbers of people, especially with the festive season approaching.&nbsp;</li><li>Furthermore, social, cultural, and religious gatherings are being held in large numbers. These are more numbers than what is permitted under the Alert Level 1 restrictions.&nbsp;</li><li>“What is concerning is that these are also often held in venues with poor ventilation. This is particularly the case for funerals, which are often followed by large so-called “after tears” parties,” the president said.&nbsp;</li><li>However, the main problem is that people are not complying with the current restrictions and the basic prevention measures are not being followed, such as wearing a mask or social distancing.&nbsp;</li></ul>



Crucial Quote&nbsp;



“As much as we want to relax, the virus does not relax. It does not take a holiday. This has been a difficult year for us as a country. It has severely tested our resolve and demanded great sacrifices of each and every one of us. But even as the holidays approach, we cannot let our guard down,” Ramaphosa said.

Interview with South Africa’s President Ramaphosa

South African President Urges Continued Vigilance Against Virus

TOPLINE AstraZeneca will likely conduct an additional global trial of its Covid-19 vaccine candidate, according to a Bloomberg <a href="https://www.bloomberg.com/news/articles/2020-11-26/astra-likely-to-run-fresh-global-covid-vaccine-trial-ceo-says?sref=CSMHWBLp" target="_blank" rel="noreferrer noopener">report</a>, after questions were raised about its trial results — where the company claimed up to 90% efficacy in preventing the disease — and after the company acknowledged a manufacturing error.



KEY FACTS



The new trial would be run separately instead of adding a new arm to ongoing U.S. trials of the vaccine and it would evaluate why people who received lower doses of the vaccine appeared to have better protection against Covid-19, the&nbsp;Bloomberg&nbsp;<a href="https://www.bloomberg.com/news/articles/2020-11-26/astra-likely-to-run-fresh-global-covid-vaccine-trial-ceo-says?sref=CSMHWBLp" target="_blank" rel="noreferrer noopener">report</a>&nbsp;noted.



In an interview with&nbsp;Bloomberg, AstraZeneca CEO Pascal Soriot said that the company has now found what looks like a more effective dose and it has to validate this, “so we need to do an additional study,” which would be outside the U.S. and faster since it would need a smaller number of patients.



Soriot acknowledged that data from the new trial is unlikely to hold up to regulatory scrutiny in the U.K. and the European Union, and noted that the U.S. Food and Drug Administration (FDA) is also unlikely to approve a vaccine based on a study conducted outside the U.S.



The company however expects authorization in some other countries before the end of 2020.



BIG NUMBER



62%. That’s the efficacy rate of the vaccine among people who received two full doses of the AstraZeneca vaccine the company&nbsp;<a href="https://www.forbes.com/sites/roberthart/2020/11/23/astrazeneca-oxford-vaccine-up-to-90-effective-at-preventing-covid-19-early-results-show/?sh=52b58b434fa1">announced</a>&nbsp;on Monday. Compared to that, 90% of the people who received an initial lower dose — which the company&nbsp;<a href="https://www.nbcnews.com/health/health-news/astrazeneca-covid-vaccine-study-results-clouded-manufacturing-error-n1249093" target="_blank" rel="noreferrer noopener">acknowledged</a>&nbsp;was due to a manufacturing error — followed by a full dose were protected against Covid-19. Pfizer and Moderna have both announced that their vaccines are 95% and 94.5% effective in preventing the disease.



CRUCIAL QUOTE



The AstraZeneca vaccine is also being trialed in the U.S. and in his interview, Soriot acknowledged that data from that trial would now be necessary for U.S. approval stating: “The question for us was, will we need the U.S. data to get approval in the U.S. or can we get approval in the U.S. with international data, and it was never clear. Now with those results, it’s more likely that we will need the U.S. data.”



KEY BACKGROUND



The vaccine developed by AstraZeneca and its partner Oxford University is a type of&nbsp;<a href="https://covid-19tracker.milkeninstitute.org/#vaccine_Non-replicating-viral-vector" target="_blank" rel="noreferrer noopener">non-replicating viral vector</a>&nbsp;that uses a harmless virus to stimulate a recipient’s immune system to develop antibodies. Compared to Pfizer and Moderna’s mRNA vaccines AstraZeneca’s shot is&nbsp;<a href="https://www.nytimes.com/2020/11/24/health/astrazeneca-covid-vaccine.html" target="_blank" rel="noreferrer noopener">easier and cheaper</a>&nbsp;to manufacture, transport, and store, which means it is more likely to be used around the world. However, the botched trial data have led to concerns on whether the vaccine will be cleared by regulators. Moncef Slaoui, the head of the U.S. government’s Operation Warp Speed vaccine program&nbsp;<a href="https://www.bloomberg.com/news/articles/2020-11-26/astra-faces-more-vaccine-questions-after-manufacturing-error?sref=CSMHWBLp" target="_blank" rel="noreferrer noopener">first disclosed</a>&nbsp;that the lower dose trial was administered to some people because of an error in the quantity of vaccine put into some vials and he added that this arm of the trial was conducted on a younger population, both of which the company had failed to disclose in its announcement on Monday. Soriot though disputed the idea that the half-dose regimen was a mistake and claimed that once researchers noticed the dosing error they formally altered the trial protocol with the backing of regulators. “I won’t tell you we expected the efficacy to be higher,” Soriot told&nbsp;Bloomberg. “People call it a mistake — it’s not a mistake.”



CHIEF CRITIC



AstraZeneca’s stock took a surprising tumble following their announcement after investment bank SVB Leerink analyst Geoffrey Porges&nbsp;<a href="https://www.marketwatch.com/story/astrazenecas-covid-19-vaccine-data-fails-to-impress-wall-street-analysts-with-its-effectiveness-in-clinical-trials-2020-11-23?mod=mw_latestnews" target="_blank" rel="noreferrer noopener">wrote in an investor note</a>&nbsp;that the company was “clearly already positioning the product as suitable for use in less developed countries, where their relatively favorable storage conditions&#8230;may be advantageous.” Porges added,&nbsp; “We believe that this product will never be licensed in the U.S.” Even Dr. Anthony Fauci, the country’s leading infectious disease official&nbsp;<a href="https://www.statnews.com/2020/11/23/astrazeneca-covid-19-vaccine-is-70-effective-on-average-early-data-show/" target="_blank" rel="noreferrer noopener">told</a>&nbsp;STAT News,&nbsp;“there’s going to be a lot of hand waving” as people try to explain the results.



FURTHER READING



<a href="https://www.wired.com/story/the-astrazeneca-covid-vaccine-data-isnt-up-to-snuff/" target="_blank" rel="noreferrer noopener">Astra Likely to Run Additional Global Vaccine Test, CEO Says (Bloomberg)</a>



<a href="https://www.wired.com/story/the-astrazeneca-covid-vaccine-data-isnt-up-to-snuff/" target="_blank" rel="noreferrer noopener">The AstraZeneca Covid Vaccine Data Isn&#8217;t Up to Snuff</a>&nbsp;(Wired)



<a href="https://www.forbes.com/sites/roberthart/2020/11/23/astrazeneca-oxford-vaccine-up-to-90-effective-at-preventing-covid-19-early-results-show/?sh=52b58b434fa1">AstraZeneca-Oxford Vaccine Up To 90% Effective At Preventing Covid-19, Early Results Show</a> (Forbes)



-By Siladitya Ray, Forbes Staff

Drugmaker CEOs Testify Before Senate Finance Committee On Drug Pricing

AstraZeneca May Conduct Additional Trial For Covid-19 Vaccine After Acknowledging Errors In Initial Trial

TOPLINE The Food and Drug Administration Thursday <a rel="noreferrer noopener" href="https://www.fda.gov/news-events/press-announcements/coronavirus-covid-19-update-fda-authorizes-drug-combination-treatment-covid-19" target="_blank">issued</a> an emergency use authorization for Eli Lilly’s rheumatoid arthritis drug baricitinib and remdesivir for coronavirus treatment, the first drug combination authorized by the FDA as a therapeutic for the virus. 



<h4 class="wp-block-heading">KEY FACTS</h4>



Baricitinib is an existing FDA-approved drug for rheumatoid arthritis, but it has benefits for coronavirus patients used in combination with Gilead Sciences’ remdesivir, which has already been given&nbsp;<a href="https://www.forbes.com/sites/rachelsandler/2020/10/22/fda-approves-remdesivir-for-covid-19-treatment/?sh=680206fe63c8">full FDA approval</a>.



The emergency authorization only applies to hospitalized patients in need of supplemental oxygen.



The drug combination was given emergency approval based on a randomized double-blind trial that found it reduced median recovery time by one day and increased the chances of survival by 35% compared to patients taking remdesivir alone.



Scientists are also interested in the combination of baricitinib and the steroid dexamethasone, the latter of which was taken by President Donald Trump when he was infected, as a potential coronavirus therapeutic.&nbsp;



<h4 class="wp-block-heading">CRUCIAL QUOTE</h4>



“The FDA’s emergency authorization of this combination therapy represents an incremental step forward in the treatment of COVID-19 in hospitalized patients, and FDA’s first authorization of a drug that acts on the inflammation pathway,” Patrizia Cavazzoni, acting director of the FDA’s Center for Drug Evaluation and Research, said in a statement.&nbsp;



<h4 class="wp-block-heading">KEY BACKGROUND</h4>



&nbsp;Eli Lilly has also earned emergency approval for bamlanivimab, a monoclonal antibody treatment for early cases of Covid-19. Other promising therapeutics, including Regeneron’s antibody cocktail and dexamethasone have yet to receive FDA approval. Hydroxychloroquine had its emergency authorization rescinded after data showed it had no benefit for Covid-19 patients.



<h4 class="wp-block-heading">WHAT TO WATCH FOR</h4>



Eli Lilly is conducting a clinical trial for baricitinib by itself, and the company may pursue an emergency use authorization for the drug depending on the results.



-By Rachel Sandler, Forbes Staff

Pharmaceutical research into infectious disease and pandemics, scientist pipetting a sample of a new drug formula into a vial during a clinical trial with the infectious disease on the computer screen

Tag: Covid-19 spike

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