Sisonke : a critical appraisal of South Africa's Covid-19 vaccine trial

Abstract

When South Africa’s Covid-19 pandemic emerged in March 2020, scientists mobilised quickly and effectively to parse and produce evidence to inform the state’s response. South Africa became a site for numerous Covid-19 vaccine trials. While many publications in scientific journals have explored the effects of Covid-19 vaccinations, in South Africa and globally, the social aspects of the vaccination rollout remain underexplored, particularly concerning the scientists and medical officials who were responsible for vaccine development. This article analyses the insights and experiences of vaccine trial investigators and other healthcare workers in South Africa. The study is based on in-depth, qualitative interviews conducted with 16 trial investigators and participants in three provinces – the Western Cape, KwaZulu-Natal and Gauteng – as well as with recipients and providers of the vaccine. Sisonke, meaning ‘together’ in isiZulu, is one of the most ambitious public health endeavours yet pursued in South Africa. Initially targeting frontline healthcare workers and then a more broadly defined notion of ‘healthcare worker’, the vaccination trial brought almost half a million South Africans into a new ‘experimental order’, facilitated by a consortium of vaccine providers. Crucially, the Sisonke trial was conducted largely through the same healthcare system that provided public treatment for another pandemic of communicable disease: HIV. Collaborations built in the struggle against the HIV/AIDS pandemic provided a critical framework upon which partners built the response to the Covid-19 pandemic.