The Ministerial Advisory Committees and 3 years of COVID-19 expertise – is the Department of Health’s model for information-sharing pandemic-ready?

Authors

  • M Richter School of Public Health, Faculty of Health Sciences, University of Cape Town, South Africa, and African Centre for Migration and Society, University of the Witwatersrand, Johannesburg, South Africa. Former researcher at the Health Justice Initiative, Cape Town, South Africa
  • Y Nokhepheyi Former researcher at the Health Justice Initiative, Cape Town, South Africa

DOI:

https://doi.org/10.7196/SAMJ.2024.v114i8.1943

Keywords:

Pandemic readiness, Access to information, Expert Advice

Abstract

Effective pandemic decision-making depends on scientific expert evidence, transparency about public health policy decision-making, its rationales and the evidence on which it is based. The South African government laudably committed its COVID-19 response to be guided by science and evidence. Yet, the expert advice that it received was not always readily made available to the public. This submission analyses the time elapsed between the submission of COVID-19 Ministerial Advisory Committees memoranda to the Minister of Health, and the Department of Health’s subsequent publication of these for the period August 2020 - January 2024. It also summarises the outcomes of the Health Justice Initiative’s access to information legal action against the department on expert advice and government decision-making during the pandemic.

References

Bradshaw D, Dorrington R, Laubscher R, Groenewald P, Moultrie, T. COVID-19 and all-cause

mortality in South Africa – the hidden deaths in the first four waves. S Afr J Sci 2022;118(5/6):1-7.

Spaull N, Oyenubi A, Kerr A, et al. Overview and Findings National Income Dynamics Study –

Coronavirus Rapid Mobile Survey (NIDS-CRAM) Wave 1, 15 July 2020. https://cramsurvey.org/

wp-content/uploads/2020/07/Spaull-et-al.-NIDS-CRAM-Wave-1-Synthesis-Report-Overview-and-

Findings-1.pdf (accessed 7 February 2024).

Spaull N, Oyenubi A, Kerr A, et al. Synthesis Report: National Income Dynamics Study – Coronavirus

Rapid Mobile Survey NIDS-CRAM Wave 5, 8 July 2021. https://cramsurvey.org/wp-content/

uploads/2021/07/1.-Spaull-N.-Daniels-R.-C-et-al.-2021-NIDS-CRAM-Wave-5-Synthesis-Report.pdf

(accessed 7 February 2024).

Alam U, Nabyonga-Orem J, Mohammed A-A, Malac DR. Redesigning health systems for global heath

security. Lancet Glob Health 2021;9(4):E393-E394. https://doi.org/10.1016/S2214-109X(20)30545-3

Ramaphosa C. SA’s response to Coronavirus COVID-19 pandemic. 23 April 2020. https://www.gov.

za/speeches/president-cyril-ramaphosa-south-africas-response-coronavirus-covid-19-pandemic-23-

apr-2020 (accessed 14 December 2021).

Ramaphosa C. From the Desk of the President. 4 May 2020. https://www.thepresidency.gov.za/fromthe-

desk-of-the-president/desk-president%2C-monday%2C-4-may-2020 (accessed 14 December

.

Cullinan K, Thom A. The Virus, Vitamins & Vegetables - the South African HIV/AIDS Mystery.

Pretoria: Jacana Media (Pty) Ltd., 2009

Nattrass N. The Moral Economy of AIDS in South Africa. Cambridge: Cambridge University Press,

Chigwedere P, Seage GR 3rd, Gruskin S, Lee TH, Essex M. Estimating the lost benefits of antiretroviral

drug use in South Africa. J Acquir Immune Defic Syndr 2008;49(4):410-415. https://doi.org/10.1097/

qai.0b013e31818a6cd5

Singh JA. How SA’s Ministerial Advisory Committee on Covid-19 can be optimised. S Afr Med J

;110(6) 439-442. https://doi.org/10.7196/SAMJ.2020.v110i6.14911

Jarman H, Rozenblum S, Falkenbach M, Rockwell O, Greer S L. Role of scientific advice in Covid-19

policy. BMJ 2022;378:e070572. https://doi.org/10.1136/bmj-2022-070572

Intergovernmental Negotiating Body to draft and negotiate a WHO convention, agreement or other

international instrument on pandemic prevention, preparedness and response, 77th World Health

Assembly A77/10, Provisional agenda item 13.4 on 27 May 2024, available https://apps.who.int/gb/

ebwha/pdf_files/WHA77/A77_10-en.pdf (accessed: 24 July 2024)

Morich D, Strobeyko A, Moon S, Burci GL, et al The Pandemic Agreement: Why What Has Been

Achieved So Far Matters. Health Policy Watch 24/05/2024, available https://healthpolicy-watch.news/

the-pandemic-agreement-why-what-has-been-achieved-so-far-matters/ (accessed 24 July 2024).

Richter M, Nokhepheyi Y, Hassan F. When secrecy and expert advice collide in a pandemic: Access

to information and the National Department of Health’s tardy publication of Ministerial Advisory

Committee advisories. S Afr Med J 2022;112(3):190-191. https://doi.org/10.7196/

Nokhepheyi Y, Richter M, Hassan F. Tracking the South African ‘MAC’ Advisories – when expert advice

and secrecy collide in a pandemic: Assessing government transparency in public health decision making

and vaccine prioritisation and selection. August 2020 - August 2021. Briefing Paper No 1. Cape Town:

Health Justice Initiative, 2021. https://healthjusticeinitiative.org.za/2021/12/15/mac-advisories/ (accessed

February 2022).

National Department of Health, South Africa. MAC Advisories – Vaccinations. https://sacoronavirus.

co.za/category/mac-advisories-vaccinations/ (accessed 27 September 2023).

National Department of Health https://x.com/HealthZA/status/1760393735928430777 21 Feb 2024

(accessed 24 July 2024).

Gray A, Miot J, Mokgatle M, Rees H. ‘Following the science’: The role of an independent advisory structure

in the COVID-19 pandemic response and beyond. S Afr Health Review 2022;1:25. https://hdl.handle.

net/10520/ejc-healthr-v2022-n1-a4 (accessed 23 July 2024).

HJI v Minister of Health et al 2022. https://healthjusticeinitiative.org.za/wp-content/

uploads/2022/06/220331-HJI-MAC-Founding-Papers-served.pdf.pdf (accessed 24 July 2024).

Crisp N. Answering affidavit in HJI v Minister of Health et al., 2022 https://healthjusticeinitiative.org.za/

wp-content/uploads/2022/04/19323-22-MAC-Answering-Affidavit-2.pdf (accessed 23 July 2024).

SA Coronavirus. Ministerial Advisory Committee (MAC). https://sacoronavirus.co.za/2022/02/16/macon-

covid-19-members-as-of-february-2022/ (accessed 2 February 2022).

SA Coronavirus. Vaccines Ministerial Advisory Committee (VMAC). https://sacoronavirus.

co.za/2022/06/24/vaccine-vaccines-ministerial-advisory-committee-vmac/ (accessed 2 February 2022).

De Oliveira T. 31 August 2023. https://twitter.com/Tuliodna/status/1697252420940927154 (accessed 26

July 2024).

VMAC ‘Advisory developments around indications that Astra-Zeneca Covid-19 Vaccine may be deficient

in its protectivity against the 501y.V2 Variant virus’. Memorandum dated 7 Feb 2021, signed-off by

Chairperson on 18 March 2021. https://sacoronavirus.co.za/wp-content/uploads/2021/07/12-Advisory_

AstraZeneca-retrospective-publish_V2.pdf (accessed 7 February 2022).

HJI v Minister of Health and others (Case no 10009/22) https://healthjusticeinitiative.org.za/wp-content/

uploads/2023/08/F-1000922-the-health-justice-vs-min-of-health-judgm.pdf (accessed 2 February 2022).

Health Justice Initiative. ‘One-sided’: The big pharma bullies: Secrecy for vaccine supplies in a

pandemic - A multi-stakeholder analysis: South African COVID-19 vaccine procurement contracts’

HJI & multi-stakeholder group, 5 September 2023. https://healthjusticeinitiative.org.za/pandemictransparency/#

dearflip-df_5317/1/ (accessed 3 October 2023).

Health Justice Initiative. South Africa’s National Health Insurance Bill and the future of medicine selection,

pricing and procurement – some critical questions for affordable patient access. National Health Insurance

Series: Issue Paper 1, October 2022. https://healthjusticeinitiative.org.za/wp-content/uploads/2022/10/

National-Health-Insurance-Series_Issue-Paper-1_3rd-draft.pdf (accessed 7 February 2022).

Richter M. Why access to information and expert advice given to government is important in a pandemic.

A case study of the Covid-19 Ministerial Advisory Committees in SA’s pandemic response transparency

matters. In: Health Justice Initiative Edited Volume. Pandemics and the Illumination of ‘Hidden

Things’ – Lessons from South Africa on the Global Response to COVID-19. HJI, June 2023. https://

healthjusticeinitiative.org.za/2023/09/18/pandemic-lessons-compendium/ (accessed 7 February 2022).

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Published

2024-08-02

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How to Cite

1.
Richter M, Nokhepheyi Y. The Ministerial Advisory Committees and 3 years of COVID-19 expertise – is the Department of Health’s model for information-sharing pandemic-ready?. S Afr Med J [Internet]. 2024 Aug. 2 [cited 2025 Oct. 29];114(8):e1943. Available from: https://samajournals.co.za/index.php/samj/article/view/1943