As South Africa's battle against increasing Covid-19 cases continues, medical schemes are collaborating to help fund vaccinations for some people without medical aid, but the battle against the pandemic might be lost without universal access to the vaccine.

The country has seen a dramatic climb in Covid-19 cases since the second wave began, with 21 832 new cases reported on Wednesday, taking the total infections since the pandemic began last year to more than 1.1-million.

Hospitals, both private and public, have been buckling under the pressure of the pandemic as beds fill up with Covid-19 patients and shortages begin to be an issue.

South Africa, like many countries across the globe, has been scrambling to secure a vaccine. And its medical aid schemes are collaborating with the government to fund some of the country's uninsured population. The schemes, which cover 7.2-million of South Africa's 59.62-million population, will provide their members with the Covid-19 jab once it is available.

"The [health] minister [Zweli Mkhize] has now legislated Covid-19 vaccinations as a prescribed minimum benefit (PMB). So, by law medical schemes have to provide vaccinations for all their members," Ronald Whelan, the chief commercial officer at Discovery Health, told Fin24 on Wednesday.

He added that for every scheme member who got vaccinated, medical aids would provide one person without medical aid with a shot. This means that 14.4-million South Africans will be vaccinated through the programme.

"We need to drive vaccine equality across South Africa, it is important that everyone has equitable access to vaccines, both in the public and private sector," said Whelan.

He added medical schemes would dip into their reserves to fund the vaccine and the first phase of the rollout would target the elderly who have underlying medical conditions. 

"This cross-subsidisation mechanism is not unusual in South Africa's health sector. In South Africa's health sector, the private sector typically pays more for medication and medical products [and devices] than the public sector pays. And that's been the same configuration for many years now," Whelan said.

The medical scheme funding is in addition to the R283-million down payment made by the Solidarity Fund as part of the agreement South Africa has with the Covax initiative by the World Health Organisation and Gavi to provide the vaccine to 10% of the country's population, which amounts to about six-million people.

The clarity on the full cost of the vaccine will come in the next few weeks as discussions continue.

According to the Council for Medical Schemes, the aim of the vaccinations was to achieve a herd immunity of more than 67%. 

Whelan said the group would have a centralised procurement and distribution process, which was being put in place.

Vaccinations for the rest of the population will likely be covered by funding from the private sector as well as the government. However, that mechanism is still being ironed out.  

Political analyst Somadoda Fikeni said there needed to be clarity on just how and which parts of the population would be prioritised for vaccination along with medical scheme members.

This also needs to be done in a way that does not result in spatial inequality in the distribution of the vaccine.

He added pooling their resources with the government for the vaccinations was the best move for medical aids and the resultant herd immunity would lessen their burden to fund Covid-19 care.

However, it is important that the uninsured part of the population, which the country is dependent on for labour and services, is also vaccinated.

"If medical aid schemes were given a chance today to cover their members and yet the rest of the population is still very sick, [then] you may have the medical schemes collapsing, precisely because the country is not covered," Fikeni said.

Equitable provision of the vaccine is a priority for the schemes and Damian McHugh, the executive head of marketing at Momentum Health Solutions, said schemes have a role to play in ensuring that all members of society have equal opportunity to access the vaccine.

"As such, it is critical that the private and public sectors work together to protect our citizens," he added. 

McHugh said that over the past two weeks, South Africa's second largest open health insurer had been in talks with stakeholders and other parties on how the vaccines would be procured and provided to the country's population.

"We believe it will be in everyone's best interest to procure and distribute the vaccine as soon as possible, to as many people as possible," he added. 

At Bonitas Medical Fund, the third largest scheme, principal officer Lee Callakoppen said although it had not been contacted by anyone about partnering on funding the vaccine, the scheme was open to engaging on the matter.