As the fight against the COVID-19 pandemic takes a new and very promising turn with the presence of vaccines, major concerns amongst which relate to issues of human rights on access and use of the vaccine arises. The vaccine is welcomed amidst severe impact of the COVID-19 pandemic. Globally, the pandemic has caused death of more than 3-million people with more than 150-million people being infected. It has halted economic activities and deepened unemployment, poverty and economic inequality. Numerous civil and political rights have also been harmed because of the measures states have taken in an attempt to curb the spread of the virus. Also, a limited attention on human rights discussions of access to COVID-19 vaccines is noted the International AIDS Society-Lancet Community. It is thus imperative to raise concern over issues of human rights to ensure the distribution and rollout of the vaccine does not violet such rights. Concerning the COVID-19 vaccine, dominant concerns have been on adequate distribution and universal access to the vaccine by all groups of people including marginalized and segregated groups such as migrant, refugees and asylum seekers. Also, with the possibility of introducing a COVID vaccination passport looming in the horizon, the individuals’ right of choice to either be vaccinated or not is now put in question.
South Africa received its first batch of COVID-19 vaccine doses early February 2021; with its arrival hope has been restored in the fight against the pandemic among South Africans. According to the COVID-19 pandemic tasks force the vaccine, after undergoing national testing and approvals, it is to be provided to 1.25 million healthcare workers first. South Africa targets to achieve herd immunity by the end of 2021, which is having 67% of the population immunized.
The presence of the vaccine has ignited hope in the nation and the world at large; however, its rollout has sparked some cumbersome controversies amongst which relate to violation of human rights. As nations must strive to protect human kind against this pandemic, they also have an obligation to uphold and fully respect human rights. Against this principle, elements of human rights violation are evident in South Africa. The current practice on distribution and administration of the COVID-19 vaccine posses a threat on human rights amongst which prominent ones include the right to access the vaccine by all and the individual right of choice against being vaccinated or not.
In South Africa, discriminative statements by key players in the vaccine rollout have already emerged among key stakeholders in the vaccine rollout. As the nation received its first shipment of the vaccine, President Cyril Ramaphosa declared universal access for all adults residing in the country irrespective of gender, citizenship or residency status. However, his statement stands in contrast to the preceding statements by government officials mandated to oversee the testing and eventually the rollout of the vaccine in South Africa. For instance, the statement by the Minister of Health, Dr. Zwelini Mkhize, contradicts the president’s statement by indicating only registered South African citizens will be illegible to receive the vaccine. The minister declared that the government did not have the capacity to assist undocumented foreign nationals residing in the country.
Such statements are contrary to the legal obligation of all South African authorities to uphold and respect the human rights of all groups of people. Furthermore, the discrimination based on national origin or residency status violate South Africa’s Constitution and its obligations under the Convention on the Elimination of All Forms of Racial Discrimination (CERD) and the International Covenant on Economic, Social and Cultural Rights (ICESCR). The conventions only provisions for any differential treatment based on national origin or immigration status to only be regarded justified as nondiscriminatory if it pursues a legitimate aim and is proportionate to its achievement. To curb the COVID-19 pandemic, equitable distribution and access of the vaccine must be ensured against all groups of people despite their national origin or residency status in South Africa.
Excluding or limiting certain groups’ access to vaccination based on national origin or residency status undermines the public health goal and interest of ending the pandemic. Such a discriminatory approach is likely to further inflame nationalistic sentiments in a country and thus undermining efforts to end perennial waves of xenophobic violence.
Inequitable access to COVID-19 vaccines and therapeutics mirrors wider health and health-care inequities grounded in broader structural inequalities in South Africa. This puts some populations, such as refugees, asylum seekers and those without legal documentations at greater risk than others. In many countries, COVID-19 cases and deaths are highest among indigenous populations and racial minorities, the working poor, as well as prisoners and detainees. Excluding such groups possess a significant threat to life of South Africans, ta king in to consideration the nature of the COVID-19 spread and infection.
Additionally, while the states’ effort to vaccinate as many people as possible are commendable, they also raises a human rights’ question over an individual’s choice to be vaccinated or not to be vaccinated. The state has the obligation to ensure the entire South African population is protected against further spread of COVID-19 and so it would prefer for everyone to be vaccinated. However, as a constitutional democratic state based on the foundations of equality, freedom and dignity, a person’s decision to have the vaccine should be voluntary. The right to freedom and security of the person, contained in the Bill of Rights, chapter two of the constitution, includes the right not to be subjected to medical procedures without their informed consent. Therefore, no person should be forced by anyone, including the state, to test or be vaccinated. However, COVID-19 testing has become mandatory and integrated, as a requirement for international travels. Also, there is a high possibility in the horizon of enforcing a COVID Passport as a requirement crossing international borders. Both practices are contrary to the bills of rights.
Herd immunity is understood to be resistance to the spread of an infectious disease in a population based on a high proportion of individuals being immune as a result of previous infection or vaccination. The identification and recruitment of the targeted 1.25 million healthcare workers for vaccination poses a human rights deliberation. The choice to present oneself for the vaccination against Covid-19 must be voluntary and based on adequate information about the vaccines. However, with the misinformation on COVID-19 vaccine circulating in social media it is difficult for one discern the truth pertaining to vaccines. This has made it difficult for people to come forth voluntarily for vaccination. Also, the emergence of the anti-vaccine movement globally has resulted in more people opting out of being vaccinated.
To effectively combat the Covid-19 pandemic while at the same time respect and uphold human rights in South Africa, stakeholders in vaccine rollout process needs to observe the following:-
The authorities should strive to fully implement President Ramaphosa’s promise of inclusion by ensuring that everyone living on its territory has equitable access to vaccines and is included in the national vaccination program, regardless of their nationality or residency status. Vaccine distribution in South Africa must adopt an inclusive and non-discriminatory approach. Stakeholders in the distribution channel need to fathom that notion that the COVID-19 virus does not discriminate on any basis, be it gender, race or against documented and undocumented foreign nationals. Also, it is important to acknowledge that the presence of an infected individual even if undocumented poses a health threat to the entire South African population. Therefore, despite the residency status of an individual residing in South Africa the vaccine should be made available to all groups.
Furthermore, as candidates for vaccination need to make informed choices, stakeholders in the vaccine rollout need to intensify and sustain information campaigns for the duration of the vaccination process to counter the negative publicity and misinformation circulating. The authorities should embark on awareness raising, information campaigns, and ensure those without documentation can travel safely to vaccination centers. The focus should be on urging the public to make decisions based on scientific evidence from identifiable and reputable sources, as opposed to baseless claims circulating on social and other media, all-too-often made by faceless, anonymous sources.
Also, stakeholders requires to put more emphasis on good public information campaigns to ensure that as many as possible present themselves to be inoculated. Informed consent will ensure that we will be able to address all the other human rights problems Covid-19 has posed. The poor and marginalised, a number that has increased since quarantines and lockdowns were initiated, are most in need of a restoration and an improvement to the realisation of their socioeconomic rights. A return to work and trade would ensure that the right to food, housing, education and a litany of others are closer to being realized.
Maria Lauda Goyayi is a researcher at the School of Management, IT and Public Governance, UKZN. She writes in her personal capacity.