Vaccines: SA's immunisation programme debunked

The top national Department of Health (NDoH) EPI managers resigned in August and December last year, taking with them large chunks of institutional memory and invaluable expertise. SA remains in the top five underperforming EPI African countries (according to World Health Organization (WHO) standards), for the third year running. According to Johann van den Heever, the recently resigned (in December) national EPI manager, a \'lack of leadership vision\' and a ZAR1.4 billion national budget provides exclusively for vaccine purchase, hugely under-prioritising human resources, social mobilisation and surveillance, supervision, and monitoring and evaluation. The ongoing frustrations of inaccurate and unscientific data collection, severe understaffing and lack of a pragmatic operational budget led to his resignation. A former Gauteng EPI and communicable diseases specialist (8 years), he has spent the past 11 years as national EPI manager. His national senior specialist, Dr Ntombenhle Ngcobo, resigned last August, followed by their EPI data manager. None of this leadership had been replaced by early March this year. According to Van den Heever, only six of the original 13 national EPI posts (created in 1994) remain, all with relatively junior incumbents, making basic data quality audits and accurate evaluations for immunisation even more difficult. The NDoH\'s national vaccination coverage figure stands at 90% - a full 20% higher than the WHO/UNICEF estimate (a sore point with both parties).