· Web viewThe Pharmacovigilance and Clinical Trials Committee will implement vaccine vigilance plans to monitor the safety and electiveness of the COVID-19 vaccine in use. The vaccine

In the National Assembly, Tuesday 16 February 2020

MINISTERIAL STATEMENT

COVID VACCINE DEPLOYMENT AND ROLL OUT PLAN

THE VICE PRESIDENT AND MINISTER OF HEALTH AND CHILD CARE (HON. RTD. GENERAL DR. CHIWENGA): Mr. Speaker Sir, let me brief the House on the COVID Vaccine Deployment and Roll out Plan as we have planned it and implementing it. Mr. Speaker Sir, the COVID-19 pandemic has affected the country resulting in 34 949 positive cases and 1 382 deaths as of 11 February 2021. The high numbers of both positive cases and deaths has prompted the country to plan for the introduction of a vaccine. The country has already secured 200 000 doses of the vaccine from Sinopharm from the People’s Republic of China which it has graciously donated to Zimbabwe. This is our first of the vaccines to come into the country which will be administered to priority groups in the country. I want to hasten to add that from now we will be getting the vaccines regularly, maybe every two to three weeks so that the programme of vaccinating our people does not stop. In addition, an operational budget to fund the implementation of planned activities is in place and has been shared with Treasury. The country’s COVID-19 vaccination and deployment plan identifies key areas for successful roll out of the vaccine.

OBJECTIVE OF COVID VACCINATION PLAN

The National Roll-Out, Deployment And Vaccination Plan (DVP) is a guiding document that provides framework for designing strategies for the deployment, implementation and monitoring of the COVID-19 vaccines in the country and ensuring the planned and related financing is well aligned to the Zimbabwe COVID-19 recovery and responses and support plans. That implementation is fully integrated into national governance mechanisms.

Broad Objective

To enable high quality vaccination services and reduce morbidity and mortality due to COVID-19 disease.

Specific Objectives

• To vaccinate eligible population on a voluntary basis for free. • Vaccinate a minimum of 60% of the total population to achieve herd immunity.• To initiate vaccination through eligible high risk target populations. • To provide adequate vaccines and supplies for the activity.• To ensure availability of functional cold chain equipment at all levels.• To monitor progress, adverse events following immunisation (AEFIs) and provide

corrective action.• Create demand for immunisation.

Regulatory Framework

The COVID-19 vaccine is an emergency vaccine registered by MCAZ under Emergency Use Authority. This is in terms of section 75 of Medicines and Allied Substances Control Act. We have registered the vaccines now. As you may be aware Hon. Members, we are watching the print and electronic media and they are now about 15 vaccines. When we get a vaccine which we think is or can be used in this country, it is registered under this section.

The Pharmacovigilance and Clinical Trials Committee will implement vaccine vigilance plans to monitor the safety and electiveness of the COVID-19 vaccine in use.

Ministerial Statement 16 February 2021 COVID Vaccine Deployment and Roll Out Plan

The vaccine consignment shall be physically verified and cleared by the Medicines Control Authority of Zimbabwe upon arrival. The consignment shall be cleared on the basis of the standard vaccine lot release documentation.

The Ministry will set up and implement the safety monitoring plan to enable swift detection of any Adverse Events Following Immunisation (AEFI). Lastly, the Ministry is to consider a study to confirm immunogenicity of the product in the local population

Planning and coordination

Establish or engage an existing committee, a National Coordinating Committee (NCC) for COVID-19 vaccine introduction with terms of reference, roles and responsibilities and regular meetings. This we must make sure is done by this Committee.

Secondly, the Interagency Coordinating Committee (ICC) was tasked to spearhead planning and preparations for COVID-19 vaccination.

Thirdly, the National COVID-19 Response Coordinator was co-opted into the ICC with the Permanent Secretary being the chair of the committee.

Fourthly, Public Partnership initiatives will be coordinated by the Ministry of Finance and Economic Development.

Lastly, the Ministry of Health and Child Care will implement effective deployment of the COVID-19 vaccines through the National EPI programme.

Let us now move to the resources and funding: The total estimated operational budget for COVID-19 vaccination over all phases is US$6 778 777.00. Here we are talking of the operational budget. The total cost for Phase 1, Stage 1 is US$1.3 million.

Budget Summary for Phase 1, Stage 1 and for all stages is indicated in the tables below; Mr. Speaker Sir, we are duplicating the copies so that Hon. Members can have a copy and be able to see some of the figures which I am talking about here as they are tabulated.

THE HON. SPEAKER: Hon. Vice President, you may through your officials, send soft copies to the...

THE VICE PRESIDENT AND MINISTER OF HEALTH AND CHILD CARE (HON. RTD. GENERAL DR. CHIWENGA): It has already been done.

Overall Budget Cost USDPlanning and Training 909,165.00 DSA and lunch for vaccinators 1,442,600.00 Fuel for outreach teams 21,000.00 Preparedness assessments 118,700.00 Support supervision 234,850.00 Coverage survey 200,822.00 Post Implementation evaluation 19,460.00 Advocacy and communication 1,268,450.00 Vaccine distribution 30,750.00 AEFI Surveillance 46,620.00 Data collection and tools 1,216,360.00 PPE 1,200,000.00 Waste Management 70,000.00 Total Cost 6,778,777.00


So the USD6 million and what it is going to do has been broken down so that Hon. Members can look at it and be able to see what it is all about. This is because it will start from training and planning right up to the waste management. Remember we are dealing with a vaccine and from the training to disposal, we have to incinerate all these things after use because we also do not want to be spreaders of the virus. That breakdown is there. So Hon. Members will be able to go through it.

The breakdown for Phase 1, Stage 1 which I talked about, USD1.3 million will start at the National Planning and Training has got its figure.

Budget Breakdown for Phase 1 Stage 1

Overall Budget Cost USDNational Planning and Training 2,640.00 Provincial Planning and Training 45,480.00 Vaccination 741,577.00 Supportive Supervision 136,364.00 Advocacy and Communication 262,240.00 Logistics Vaccine Supply and cold Chain

14,530.00 Data Management 27,678.00 Total 1,202,831.00 Public Private

Target population for vaccinations

Population % of population

Phase 1 ( stage 1 and 2) 3 662 279 22%

Phase 2 3 050 855 18.4%

Phase 3 3 050 855 18.4%

Subtotal 9 763 988 58.8%

Total population under 16 yrs

6 795 000 41.2%

Total Populations 16 558 987 100%

The total population will be confirmed when the census is done in a year’s time but this is just an estimate.

Target population for Phase 1, Stage 1 which we are talking about; who are these departments and ministries? We have got the total number and the health workers for vaccination.

Target Population for Phase 1 Stage 1

Department/ Ministry TotalMinistry of Health and Child Care 49000


Ministry of Heath Private Sector Zimbabwe Defence Forces 30000Zimbabwe Prison Service 50000Zimbabwe Prisons Service and Correctional Centre 13000ZIMRA

We have got the health workers for vaccination; Ministry of Health and Child Care, 49 000 and all these we will vaccinate them. Defence and Security starting with ZDF 4000 and they have 3000 plus of their health workers who are the ones who will be vaccinated. The Police have got plus 500 health workers who will be vaccinated. The Zimbabwe Prisons and Correctional Services will be vaccinating over 700 health workers. Besides, these we will be vaccinating all members of ZIMRA and our immigration workers who we term the frontline workers. There are others who have not been put in this report, the Agritex officers under Agriculture and there can be a few who might have been left out but I have just highlighted the major areas which will constitute Phase 1.

Target groups for vaccination – Phase 1 populations at high risk stage 1 –frontline workers which are health workers, port of entry personnel like ZIMRA, immigration, customs, security and others which I have talked about. Stage 2 will be those in the vulnerable groups such as those with chronic illnesses such as cancer, diabetes, TB etcetera because you do not want to get this virus while having underlying conditions as it will be very difficult to treat such patients. The elderly population people who are 60 years and above. Prison population and others as well as confined settlements like refugee camps are considered to be in stage 2 as they are likely to get this disease because of staying together in big numbers. Even some of our urban settlements are not the best settlements we can talk about. So, we will look at that and make sure that those people are saved.

Going to Phase 2, we are looking at lecturers. All school staff populations and other staff at medium risk depending with the epidemiological picture of the disease at that time. We will also be looking at how the disease will be playing havoc in our population.

Phase 3 will be the population at low risk which will be the last group. We have divided our people into three phases but Phase 1 has got two stages which are frontline workers and those with underlying conditions that is stage 1 and stage 2.

Training – development and adoption of training materials for all activities

The Ministry has arranged trainings of trainers (ToTs) for provincial and district trainers.

Provincial and District trainers will in turn train health workers at service delivery centres.

Exapanded programme on immunisation or EPI will support planning and conduct of the (ToTs).

Online in person and blended learning that is the combination of online and in person which are the most common method which will be used to train staff.

Areas of training to include vaccine storage, communication, surveillance, vaccination and monitoring and evaluation and the AEFI and waste management.

Vaccination Service Delivery

The actual administration of the vaccine will be done at fixed and outreach points.

One to two outreach teams will be allocated per rural district depending on the size of the district with five people per team. For example, City of Harare will be allocated 11 teams, Bulawayo 4 teams, Chitungwiza 2 teams to deal with the vaccination. So vaccination teams will require fuel, lunch and daily subsistence allowances. The assumption is vaccination will be


conducted over 10 days in the first round and five days in the second round. You might be asking why 10 days first – it is because our staff is still learning and obviously when you are starting something you have not yet learnt the tricks and by the second round we think they will be more experienced and they will do it faster because we want to deal with this thing as fast as we can because the faster we go means our people will be given the necessary antibodies and that their bodies will be able to fight the virus. Supervisors drawn from head offices, provinces and districts will monitor planning, implementation and outcomes.

Let me go to the supply chain management, the immunisation supply chain of Zimbabwe consists of 4 levels which are central, provincial, district and service delivery. Vaccine distribution follows this channel from central vaccine to 10 provincial, 63 districts vaccine stores and then to more than 1800 service delivery facilities. The central vaccine stores distributes vaccines to provincial vaccine stores, provinces distribute vaccines to district vaccine stores and district to service delivery as well. Distribution of COVID 19 vaccine will follow the existing distribution structure of routine vaccine and supplies.

The vaccine will be received at the airport and distributed to provinces and districts under police escort. The vaccine distribution flow chart is there. When the documents are out, Hon. Members will be able to follow and we have also put it in a diagrammatic format so that Hon. Members will be able to follow wherever they will be in their constituencies, whether everything is going according to plan. We also put our delivery vehicles which will be refrigerated so that they are easily identified if they move in the area.

On the supply chain, distribution planning is based on targeted population per province. We will ensure adequate supply of potent vaccine to all illegible population. We shall ensure functional cold chain equipment at all levels. The cold chain we are talking about is from where the vaccine is manufactured, if it has to maintain a temperature of between 2 to 8 degrees Celsius right up until it has been given to the recipients. It must maintain that temperature, that is the cold chain we are talking about. Any variance to that will cause us problems and we want to make sure this does not happen, and this is why the first consignment which came, my Deputy had to go in there together with the head of the Medicine Control Authority of Zimbabwe and Ministry of Finance to see and to be with the vaccine until they got to Harare. The vaccine had to be taken to NATPHARM to make sure it is within that same range of temperature. So that is what we are talking about when we say the cold chain.

There will be police escorts accompanying Zimbabwe extended programme on immunisation distribution vans, wherever that van travels it will have police escort. Distributed to provincial cold rooms with capacity of nine square meters under police escort and distributed to districts with cold chain capacity of an average of 200 litres or two to 3 refrigerators; logistical support for vaccine distribution and cold chain management throughout the period from planning to implementation. Lastly, supply fuel for central level and provincial standby generators.

So, during this period, we want also to make sure and we are working with the Ministry of Finance and Economic Development to make sure that all our generators in all our areas are working in the event that there is power cut because we are also in the rain season. In the event that there is a power cut, the generators must kick off to make sure that we do not spoil and end up losing a lot of vaccines. The cold chain capacity description is also included, you will be seeing it in your papers Hon. Members which you are going to receive and we have also put pictures of the cold rooms so that you can see where we are going to be keeping that vaccine and the type of equipment which we will use to keep those vaccines.


Information dissemination and advocacy communication and social mobilisation, advocacy meetings and activities to be conducted at all levels. Whilst we do this, we also ask Hon. Members to help in this matter that it is the duty of everyone to make sure that our people are educated. There will be national vaccination launch to be conducted virtually to rally all stakeholders for COVID-19, social mobilisation done at all levels in order to create demand for the vaccine. Finally, community mobilisation for vaccination will be conducted via radio, television programmes and announcements; interpersonal communication with target groups, newspaper article and advertisement and social media campaigns, Facebook, WhatsApp, Twitter and bulky SMEs and lastly billboards, banners, posters and board media and crisis communication addressing serious AEFIs.

Let me now come to vaccine safety monitoring and management of AEFIs and injection safety; in partnership with MoHCC-ZEPI, the National Pharmacovigilance & Clinical Trials Committee and MCAZ are the main drivers of vaccine safety surveillance. Covid-19 vaccine safety surveillance will be guided by already existing MoHCC’s Adverse Events Following Immunisation (AEFI) surveillance guidelines and the WHO COVID-19 vaccines safety surveillance manual. Safety surveillance for COVID-19 vaccine will be further strengthened through additional:

Training of national stakeholders and investigation teams. Training of national AEFI committee on causality assessment of adverse events

following COVID-19 vaccination. Training and preparation of health care workers on identification, management and

reporting of potential cases of anaphylaxis and ensuring availability of comprehensive emergency tray at all vaccination points. A lot of people might react, just like any other drug. Some people are given simple stop pain and they react. Therefore, we have to be prepared to deal with such situations. That is what is being explained here.

• The trainings will be provided as part of comprehensive COVID-19 vaccine introduction trainings.

• Instituting active surveillance of Adverse Events of Special Interest following COVID-19 vaccination.

ZIMBABWE AEFI REPORTING

Biohazard and immunization waste management


Management of waste related to COVID-19 vaccination requires special attention due to the infectious nature of the virus. Waste generated from COVID-19 vaccination will be according to the country’s existing waste management guidelines for treatment of health waste. There will be waste segregation at point of generation following existing protocols. All medical waste will be incinerated either at point of generation if there is a functional incinerator or at some central incineration point in which case transport will be provided to move the waste to the incineration point.

Monitoring and Evaluation

Development of Monitoring and Evaluation Framework to guide planning and implementation – There will be pre vaccination demographic data collection. Conduct Preparedness Assessment to assess readiness at all levels. Development of data collection tools that is tally sheets, summary sheets and vaccination cards, all these will be required to be there. Consolidation and reporting of the number reached will be done on a daily basis using existing platforms and structures. Disease surveillance will include AEFI monitoring. There will be blood collection to determine antibodies before and after vaccination. Conduct of a Post Campaign Coverage Survey to validate administrative data and conduct a post introduction evaluation to assess the quality of the introduction of the COVID-19 vaccine and help inform future introductions.

Tentative Timeline of Activities

We started training today and was supposed to have ended today but we will continue to monitor as from today whether other all the other stations have completed their training. On procurement, the first batch of donations has arrived and the next procurements have already started. We are making sure that before the end of this month we should have received the other batch of the vaccines. Vaccine distribution started yesterday and we should go up to the 26th February. Cold chain inventory is ongoing. Advocacy, communication and mobilisation have already started and if you watch our electronic media, social media and in our newspapers, this programme is ongoing. Monitoring and evaluation started and is ongoing programme. We hope our first job of vaccination will start in two days Mr. Speaker Sir. I want to thank you Mr. Speaker. This is what I wanted to inform the House. I thank you.

[MPs then raised questions to which the Vice-President and the Deputy Minister responded.]

HON. MISIHAIRABWI-MUSHONGA: Thank you very much Mr. Speaker Sir. I am sure you will allow me to thank the Minister for the presentation. My first question to the Minister and Vice President is to do with the figures that you have given us in terms of the targets, particularly for the first phase. If you are looking at your frontline workers, you are only looking at the workers not necessarily their partners. When we look at partners those figures substantially change. May you explain how it is feasible to just do one person and not necessarily their partner?

The second question is - if the vaccination is really to create head immunity, one does not get a sense that we are hearing of the role of the private sector; that is the majority of your people Hon. Vice President go to private doctors and there is a lot of money in that area. We are paying medical aid and one does not understand why if one is paying medical aid, CIMAS and all the monies that we are paying and a vaccine is at a cost of $5. Why are we then asking the Government of Zimbabwe to cover that particular cost instead of creating the head immunity by ensuring that the private sector comes in? In that line, one is also wondering why as Government we are saying every citizen has to get vaccinated for free. What is the logic of having somebody who lives in the low density suburb and drives Merc competing for the same vaccine with somebody who is at


Mbare or Tsholotsho? Why are we not clearly demarcating ourselves because our system is very clear, we have the public sector health and the private sector health? Why are we not creating a situation where those that are in the private sector also go into that vaccination so that we can create a large number of people and deal with the issue of head immunity? In the presentation, I did not hear anything that speaks to how the private sector is going to be involved.

The third one, the Hon. Vice President indicated that we have 15 vaccines currently. What is going to happen when the vaccination is taking place? Are we going to have a situation where we have just a few of those vaccines because you have to do one dose and have a second dose or are we going to have a situation where today we have a Russian vaccine, the Chinese vaccine? Are there choices to the vaccine that you are having because you cannot have a mixture of the Russian vaccine and have the Indian vaccine tomorrow, particularly in circumstances where you are dealing with pregnant women? Are pregnant women going to be vaccinated also? Are there serious problems associated with getting vaccines for pregnant women?

HON. SACCO: Thank you Mr. Speaker Sir. Firstly, I would like to applaud the Hon. Vice President and Minister of Health for the timely intervention for bringing in the vaccines to Zimbabwe. My question is around the use of alternative treatments for COVID-19. There is talk about the use of Ivermectin drug which I know has been authorised for investigations to be done around the use of Ivermectin for treatment as well as prophylaxis. Could the Hon. Vice President comment on Ivermectin . Can it be used as a drug for human beings and how effective is it? Thank you.

HON. BITI: I want to thank the esteemed Vice President and Minister of Health and Child Care. I have got four questions for the esteemed Minister. Hon. Minister Sir, why are you pursuing head count instead of a target of just immunising every Zimbabwean? Head counting did not work in the United Kingdom and other countries. So, why is your strategy on head-count instead of just immunising everyone because everyone can fall sick and die? We have lost so many people. My suggestion is that you must go for a target of immunising every Zimbabwean.

Secondly, why have you registered Sinopharm? The Sinopharm drug itself has not yet been peer-reviewed and has not been approved by the World Health Organisation (WHO). In China itself, Sinopharm is not the dominant drug, the dominant drug is actually Sinovac. So why are you accepting from China a drug that Chinese themselves are not using?

Thirdly Hon. Minister Sir, I did not hear you utter a single word on Covax. Has the Zimbabwean Government made an application for Covax and if so, what is the stage with regards to Zimbabwe acquiring drugs under the Covax scheme.

The fourth question; in view of the fact that the Minister of Finance and Economic Development did not allocate any budget for COVID-19 vaccinations in the 2021 Budget, what has the Government budgeted for? In your Statement Hon. Minister, you were referring to a budget of USD6 million, even to buy a herd of cattle in Matebeleland South, USD6 million is not enough. What is the budget for COVID-19 vaccines that will be sufficient to vaccinate the people of Zimbabwe? I will stop here for now Sir even though I have many questions. Thank you very much Hon. Vice President.

HON. MATARANYIKA: Thank you very much Hon. Speaker Sir. I would want to take this opportunity to thank the Hon. Vice President and Minister of Health for such a comprehensive and instructive report. I had so many questions but they got answered along the way. So, I am just left with two questions. The first one Hon. Minister is, I did not hear in your report where you are placing Members of Parliament. Are they part of the frontline workers or what?


The second one is; if we are considering opening schools, certainly teachers have to be considered in terms of a strategy on how they can also be placed as frontline workers. I thank you.

THE HON. SPEAKER: Order, order, Hon Mliswa, if you have got a point of order, you rise and you are recognised accordingly so that you can correct whatever you want to correct.

HON. CHINYANGANYA: Thank you Mr. Speaker Sir. I also want to thank the Hon. Vice President for the comprehensive report. My question is how effective are the vaccines against the new variant especially the South African one. I thank you.

HON. RTD. GEN. DR. CHIWENGA: Mr Speaker Sir, as I respond to Hon. Members’ questions, I have got a team of scientists and expects who I will ask when it comes to a particular area where they are required to respond if you may allow me.

If I might start with the first questions asked by Hon. Misihairabwi-Mushonga. The frontline workers have got partners, yes. Everyone who would have come to majority age will have a partner. That issue we are dealing with people who are going in to handle patients who are affected by this deadly virus. In the hospital, we have the red and green zone. Even at the reception, when one comes trying to get the assistance of the doctor the individual does not know whether he or she has been affected by the disease. It is only after diagnosis that they will recognise that they have been affected by the disease.

So, it is during that time that we need to protect our workers. Everybody is going to be protected. Let us get that one clear. But who is our first priority? These wake up everyday but the partner might be working somewhere else. So the partner has to wash up, mask up, sanitise and social distance to ensure they are safe. This however does not happen to the frontline worker who is dealing with the people affected.

Hon. Misihairabwi-Mushonga, we are aware of that and everybody will be vaccinated. It will not take too long but with what we have at the present moment, let us pay attention to those in great danger. You went further to ask the role of the private sector. A lot has happened and if I was going to advise the Hon. House what has taken place to date, we would go until midnight. It was on the 26th that we had a meeting with the corporate sector. They are involved in this whole programme.

Hon. Biti asked what Government has done. Government has come up with a budget of $100 million and the private sector has also come up with their budget to contribute towards vaccines. An account has been opened where the corporate are putting their money and all this is under the Ministry of Finance and Economic Development. The corporate sector is cooperating. However, when it comes to life, life does not know whether you are rich or poor. You die and unfortunately whether you are rich or poor you do not get up, you are gone. As I said earlier on that life cannot be bought, we want to make sure that every life in Zimbabwe is saved, no matter the person is rich or poor. We want that life to be saved. That is why the President has asked and he chaired the meeting of the corporate sector to find what they were going to do and they came and volunteered their assistance. They have pledged quite a lot, for instance, some have pledged up to 10000 doses which means they can treat a few of their workers and the rest will be to assist other Zimbabweans. That is how they are contributing.

Hon. Misihairabwi-Mushonga, every citizen at the end will be vaccinated. Here what we are saying is we cannot vaccinate everybody even if we had all the vaccines, we cannot vaccinate everybody in one day. We are saying what is our priority, we have lined up the priority area to say the health or frontline workers, those with chronic illnesses for example if we take two Hon. Members here one is diabetic and one is healthy, we will take the one with diabetes and give him first priority because the healthy one stands a better chance to survive when attacked by the virus.


The 15 vaccines I was talking about are the vaccines that have been manufactured or researched on by various companies or countries. You will find in one country they might have come up with 3 or 4 vaccines. The example that has been given of the People’s Republic of China, they have got more than five, America has got more than four, they have got Pfizer, Moderna, Johnson and Johnson, - [HON. BITI: Astrazeneca] – no, Astrazeneca is for the British – We look at how those vaccines have been made. I will ask my deputy to explain with the permission from the Speaker. We have got what we call the MRNA, those you have gone into the laboratory but when you go to the attenuated, you actually kill the virus and then make a vaccine out of it. This is the one we would want because that is the genuine one. The other one can give you wrong signals in your body.

I will ask my scientist to come on that one so that Hon. Members understand. The Medicine Control Authority of Zimbabwe is where we have our experts. They will look at all the vaccines and say choose the best vaccine for our country not what those people are saying out there, each one saying their vaccine is the best. If 3 people are saying shirts, you cannot say but Hon. Biti’s shirt is the better one and mine is the best you will say mine is the best. It is upon us to choose what we want – [HON. MEMBERS: Hear, hear.] –

So, this will now answer the issue, there are vaccines which we have already been told cannot be taken by pregnant women, so what are they going to do, there are some that cannot be taken by breast feeding women and some that cannot be taken by a person who is under 16. So, we will try to find a vaccine that will suite our own condition and no one will say my child has died because they have not been vaccinated. I think I have tried to answer Hon. Misihairabwi-Mushonga.

Hon. Sacco, eva pharma, we have two drugs in there, the other one is for animals and the other one for human beings. This will also be dealt with by my deputy who has more knowledge on it. The eva pharma we have already authorised it one and a half months ago; the one for human beings because we have two-one for the human beings and the other one for animals. The one to be used by human beings, we gave it what we call emergency use one and a half months ago and it is being used – [HON. BITI: Zumbani] – zumbani we have asked our university to study it but there is nothing wrong because we grew up taking zumbani when we were kids to treat colds and fl. This disease is in the flu family and if you take zumbani there is no problem. We have developed interest because we have found something in zumbani which can help and the University of Zimbabwe is looking at that – [AN HON. MEMBER: Inaudible interjection.] – zumbani you can use it but we have found a component which is useful in there. My deputy will come and explain – [HON. BITI: Ko kunatira!] – keep on doing that it will help you.

Now coming on to Hon. Biti, head count did not start now, it started many, many years ago. The virus is killed under certain temperatures and we have to maintain the desired temperature for the vaccine to be effective. The vaccine mutates when in the body or when it is passed from one person to the other, that is how it survives, it cannot survive outside the body for long. If we are all vaccinated in this House, this will help our immune system to fight the virus. The 60% is not a number which was stamp sacked, it is scientifically proved.

The sinopharm was approved by WHO and it was attenuated and that is why we chose it. My deputy is the one who went to get the delivery and we are also taking sinovac because it was approved by WHO. The Covax, we signed for it they required me and the Minister of Finance to sign and we did that, we also signed the Covax for the AU. On all the things which can help Zimbabwe, we have done. What we are now waiting for is to see the delivery. What we have said to everyone is, you do not determine the vaccine for Zimbabweans. It is Zimbabweans who will determine their own vaccine. That way we will not be given what is not required by Zimbabweans.


Hon. Mataranyika, I can see there are some Hon. Members here who are above 60, so they will get vaccinated. They will get vaccinated, no problem. We are aware that Hon. Members would need to be protected. We will not turn a blind eye on that issue.

Hon. Chinyanganya asked about the RSA variant. We have got three variants which have caused a lot of problems. There is the RSA which is B11256, the B1.1.1.7 which is the UK one. We have also the variant for Brazil. These are the ones which are very virulent and infectious. It does not mean that the South African one kills more than what we had. The difference is that it spreads very fast and it is a matter that we are looking at – [HON. BITI: Is it here in Zimbabwe?] – The South African one, of course it is here but we have dealt with it effectively. We are very happy that you are supporting us with the measures that we have taken and we are also dealing with that matter. These are the questions that had been asked but Mr. Speaker Sir, I was going to ask the Deputy Minister to respond to two areas; that of Sinopharm and Ivermectin , with your permission.

THE HON. SPEAKER: Thank you Hon. Vice President. We have received some questions online and I have indicated to the Deputy Minister while you were speaking that some of them have been covered in your Statement but some people were not listening. There are few grey areas left. Hon. Deputy Minister, can you address those areas which have been indicated by the Hon. Vice President.

THE DEPUTY MINISTER OF HEALTH AND CHILD CARE (HON. DR. MANGWIRO): Thank you Mr. Speaker Sir. Thank you all Hon. Members for the good questions. I will address the vaccines issue and I will make it simple. Vaccines for now are the sure way that we can curb or retard the spread of the SARS-CoV 2, the coronavirus which causes the Covid-19 disease. Vaccines are made in different ways and people take the virus. The virus itself has got portions that can be targeted by manufacturers. It has got its cell wall, the nucleus and all those things. One can take something that goes into the ribosomal area of the virus like the Modena virus. Some take the particles on the cell wall and all that. The idea is that the particle when injected into a person will alert the body that the virus is in you. The body will produce antibodies which are the soldiers of the body to fight infections and in this time in particular, the SARS-CoV 2 virus which causes the Covid-19 disease. These vaccines are made in a manner that some need to be stored in temperatures less than minus 75ºC. We do not have the capacity, maybe we can go the lowest of 30ºC. We will say no to those ones for ourselves.

Secondly, other viruses will be kept in the ranges of 2 to 8ºC. Our infrastructure has been in existence. We are vaccinating our children for time immemorial. So the infrastructure for us to use certain vaccines is already there because we have been vaccinating our children for polio and other diseases. A vaccine that has such characteristics and behaviour will be one of our choices. What we will also look at any vaccine that we are likely to take should go through phases of studying.

Phase 1, they have looked at 100 people to be given the vaccine and they see the result that it produces the antibody; it does not harm people. They go to phase 2 where they give a thousand people; they look at it again and do phase 3. This is what happens before we accept any vaccine in our country. They have to give us the phase 1, clinical records and studies and we see if it is genuine. Then phases 2 and 3, we do the same. We also check to see if they are registered with World Health Organisation and other organisations for peer review to make sure we are dealing with a genuine product.

If you see a vaccine that is here, that has happened. Our Medicines Control Authority gets dossiers of the vaccine as we require. Sinopharm has gone through that. Sinovac and Sinopharm are two Chinese manufacturers. Sinopharm is one of the companies and is now being used in China. Sinovac produces larger quantities and it is also registered. We are in the process of


registering Sinovac right now. They have given us phase 1, phase 2 and we are waiting for documents for the next phase and they will be registered shortly. When it comes to vaccines, those people who will have gotten Sinopharm vaccine requires two vaccination times. If you get vaccinated on the 8th February with the Sinopharm vaccine, we will keep your second dose for the next 28 days of the sinopharm vaccine. If we give you Sinovac vaccine we will also keep the dose for you for the next phase. There is also the Sputnik victory from Russia, we will also go through the phases and everything. Covax is a group of vaccines including Sinopharm, Sinovac, Sputnik, Modena, Astrazaneca, Johnson and Johnson, Pfizer and others. So as a country, we will choose from those and say can we look after it, is our infrastructure compatible with what this vaccine is all about, how long are we going to do it? When we negotiate prices, all those things we look at them but we will not negotiate prices for anything that is less. We will take the best for our people. Vaccines are there and we will choose what is best for our country and we will look at literature and make sure things are okay. For the vaccines, I have tried my best and if there is anyone with a question I will still answer.

HON BITI: What is the efficacy rate of the Sinopharm?

HON. DR. MANGWIRO: The efficacy of the Sinopharm is 76 to 86%. If you go to Astrazaneca, at times it is 10%; it can range up to 92%. You go to Johnson and Johnson, you go to Chile or Argentina; they range from 51% to everything. What we do is to look at the average performance of each vaccine before we take it. We look at those performances very rigorously. We do not take a thing just because it is this. If a vaccine is performing below 50% through and through, the manufacturers will not bring it into the market. When we take a vaccine we would have looked at the performance as well as safety, that is what we do.

I will also answer on how effective it is against the South African variant. I want to say something about these viruses. These viruses mutate on a daily or weekly basis. There is no country that will say everyday they make a vaccine against each mutant. The vaccines we are getting now - for a vaccine to be on the market, it would have been looked at for at least not less than six to eight months. The vaccines we are getting now, the studies started last year using a particular virus that they saw that time. People will start making vaccines according to the variants and we will be following the virus from behind. There is no way we can say UK has this variant, now make the vaccine. It is impossible. You need a year. By the time you finish making the variant that is there now, next year you will have 100 more variants. All what the virus is doing just like human beings, we are all here to pass on our genes – survival. That is your job here on earth. It is to pass on genes. The virus also is trying to survive. As we go along, we will also be saying this variant that we have now, by the next three months maybe it is no longer there. What are you going to do if you had made the vaccine for this one today? It is something that we are scientifically following correctly and working on.

One cannot say that there is a variant in Tsholotsho; is this vaccine going to work - we cannot work like. Every other time there is a mutation. We use what we are doing scientifically during that time. By the time we get to next year, people will be making a variant that they will have found next month in June or so.

Ivermectin is the genuine thing that we have now that can change the course of this disease. Ivermectin is just like what people said about chloroquine, remdesivir, retnovia, alluvia – all antiretroviral. People have said those on antiretroviral will not get this disease. A lot of things are said. Zumbani has been mentioned, kunatira, kufandichimuka - all those things. On Ivermectin , what has happened with scientists is that there have been several scientific arguments so that whatever we do we follow science. The argument for Ivermectin and its reasons have not been enough to defeat those who say no. Their arguments have not been enough to say this one can be


used. It is going to be used on compassionate basis. People who feel that this person deserves the Ivermectin , the doctor is given the choice to use it.

What we do when we use medicine is that I read about medicine. For this Ivermectin to kill the virus you need toxic levels. It is also anti inflammatory. You can use it for that. Personally, I would say if a doctor has read and says the little information for the use of Ivermectin is present in my patient, one can use it on compassionate basis. What we do as professionals is, if you use that medicine which is not allowed or registered, we will take you to task if the patient dies. What happens with the NIH and other big organisations that sit and determine directions the drugs should take, agreed that there is not much evidence for and there is not much evidence against. People said yes it can be used but the decision is left to a particular doctor. When an untoward event happens then we can also understand to say the patient had massive inflammatory reactions in the lungs, so I used it and people will understand. Right now, I will not go out and say Ivermectin is the silver bullet. This is why as a nation we are rushing out to use vaccine because when you get anti bodies to fight the virus, we are going to be in the right direction scientifically. Even zumbani, mufandichimuka, kunatira – I have seen people vachiisa dombo rakatsvuka mumvura inotonhora roputika rokuvadza vanhu kumeso. We need to be careful with some of these inventions. Our inventions and adventure, we need to be careful. I am repeating that the vaccine for now is our proven something that we can be using.

I will look at some of the questions which came online. Is it practical to test the vaccine by our scientists in just 48 hours? Is this not dangerous trial and error with people’s lives? This one I want to correct the question. What I am understanding is that he thinks that the vaccine has to be tested there and there. This thing when it comes here, it is already tested like I said in those phases and then it has already been proved to be effective and safe. Our Medicine Control Authority people have already looked at the vaccine and its results. There is no new testing of the vaccine. We are not here to experiment on the vaccine afresh. This is not our vaccine, it is something that has already been tested elsewhere and it has proved that it is working. It has been peer reviewed by others and it has been seen to be effective. There is no testing of Zimbabweans that is going on with this sino-vaccine.

What is 60% of our population in terms of actual figures? This is about 10 million if we are 16 million.

Minister, is the Inter-agency Committee chaired by the Permanent Secretary already in place? If so, who heads it and is it devolved? Yes it is there and it is devolved. Our Permanent Secretary of Health is Dr. Jasper Chimedza.

Are the reports that people with immune suppression disease like HIV and those on chemotherapy correct that they should not take the vaccine? I am not sure where the writer got that message from because immunosuppression does not mean HIV only. Diabetes is a chronic inflammatory disease and it is an immunosuppressive disease. That is not a correct supposition that people with HIV cannot take the vaccine. People with diabetes or hypertension and cancer can take the vaccine. People with cancer have massive immunosuppression because of the cancer – it is an immunosuppresive disease, they can take the vaccine.

Clarification from the Minister of Health that 60% will leave over 5.5 million people vulnerable – why not over 100% say over the next year; I am sure the Minister has already answered that this is a target and that we going to continue vaccinations as we go along even if we can vaccinate everyone, the better. We need to work with figures and targets.

What are the timelines of this – I am sure the Hon. Minister said the next batch will come every two to three weeks. Definitely, the timetable is there. Wherever you are, if you watch the


print media, you will see that every two weeks – for instance at the end of this month, we are going to get about 600 000 doses of the vaccines and we will continue to get this. It is a continuous stage by stage process that is going on. We will try to make sure that every Zimbabwean is protected.

The last one is that Hon. Minister, while we appreciate the distribution channel, there is no Government hospital in Mt. Pleasant Constituency while the only council clinic which we had is currently closed as all workers there have resigned. How do you propose to deal with a Constituency which has no functional health facility? I am sure this one is being handled. We have many places without clinics and everyone is covered. What people must know is that most of these council facilities are now under Government. We have taken over and we will take care of every Zimbabwean whether there is a clinic or not, everyone will be covered. Remember we have fixed places where people will get their vaccine and we have mobile units that will come to your places to have your vaccine given to you. There is no need to worry too much.

Has there been any pre-trials on this vaccine? I said that we have had phase 1, 2, 3 – we are not doing any trials, we are actually using the vaccine. The trials were done by the manufacturers in different areas in their different countries. We are now treating our people using the vaccine to achieve the targets that have been set.

Documents

· Web viewThe Pharmacovigilance and Clinical Trials Committee will implement vaccine vigilance plans to monitor the safety and electiveness of the COVID-19 vaccine in use. The vaccine