Minister Zweli Mkhize confirms total of 671 669 cases of Coronavirus COVID-19

28 September 2020

As of today, the cumulative number of detected COVID-19 cases is 671 669 with 903 new cases identified since the last report.

The cumulative number of tests conducted to date is 4 152 480 with 9 014 new tests conducted since the last report.

Total Deaths and Recoveries

Regrettably, we report 188 more COVID-19 related deaths: 3 from Eastern Cape 1 from KwaZulu-Natal, 2 from Gauteng, 4 from Western Cape and 178 from the Free State. This brings the total number of COVID-19 related deaths to 16 586.

There has been a two week delay in the reporting of Free State deaths as the province collated data from the various districts and verified this against Home  Affairs Data. This is part of efforts to improve the quality of data by aligning information from facilities with Home Affairs statistics. Data from postmortem swabs also had to be collated and verified. This is in line with the recommendations of the Medical Research Council. The data is now up to date.

We extend our condolences to the loved ones of the departed and thank the healthcare workers that treated the deceased patients.

Our recoveries now stand at 604 478 which translates to a recovery rate of 90%

Statement on Ministerial Advisory Committees (MAC’s) in Health

We have now confirmed, both with the NICD and World Health Organisation Surge Team reports, that we are now past the surge and that our epidiomelogical curve has demonstrated a plateau for several weeks. Therefore, based on the conduct of the South African pandemic, we have re-evaluated our national response and identified new challenges that require new approaches. To quote from a publication in the highly respected medical journal The Lancet, author Richard Horton observes that “The ‘science’ that has guided governments has been driven mostly by epidemic modelers and infectious disease specialists… but what we learnt so far tells us that the story of COVID-19 is not so simple… The [syndemic] nature of the threat we face means that a more nuanced approach is needed if we are to protect the health of our communities.” (Horton, The Lancet Vol 396 September 26 2020). Indeed these sentiments do align with with our own observations, as such we have now reevaluated the progress of the pandemic and the work of the MAC on COVID-19 and resolved that this MAC requires strengthening to ensure that it is able to address gaps and target new challenges.

We therefore wish to clarify that the MAC on COVID-19 is not disbanded - the Minister has merely strengthened the entity in line with developments of South Africa’s COVID-19 pandemic.

The MAC on COVID-19 was established on 30 March 2020 with the best intentions: consisting of pathologists; laboratory practitioners; clinicians; public health practitioners and researchers.

As we find ourselves in an extremely fortunate position of achieving effective transmission control, the true test lies in our ability to maintain low transmission rates.

This requires a more wholistic approach to case management, preventive measures and public policy. It therefore became necessary to strengthen the MAC on COVID-19 so that it falls in line with its mandate to advise on effective mechanisms for the prevention of onward transmission of COVID-19.

Recognizing that the composition of the current MAC was focused on a biomedical approach, The Minister has taken a decision to augment the existing committee with various other experts from different sectors.

In that regard, the reinforced MAC on COVID-19 consists of bio-medical practitioners; clinical experts; specialists in ethics; the nursing profession; social scientists; researchers; and community leaders to advise on interventions that should be considered in responding to the epidemic and to influence the behavioural change that is required to mitigate against the spread of COVID-19.

The strengthened MAC will still maintain a degree of continuity, retaining many of the experts from the original clinical-biomedical MAC, including the incumbent chair Prof Abdool-Karim, Prof Marc Mendelson, Prof Sthembiso Mkhize, Prof Rudo Mathivha and Prof Nombulelo Magula, amongst others.

The Minister has seen this as an opportunity to diversify the skills set in order to ensure that government is now advised on issues that not only relate to medical sci- ence but also social sciences, behaviour and psyche of the population. The MAC on COVID-19 will internally establish Technical Working Groups (TWGs) and workstreams. The scope and composition of the workstreams will be determined by the MAC members and revised based on the need for the revised scope. Additionally, the workstreams will co-opt Resource Individuals (RIs) who are not government officials but are skilled in specific disciplines. The RIs may be called upon to assist in the MAC’s sub-committees and TWGs. It will be through this mechanism that entities such as the National Institute of Communicable Diseases (NICD), Medical Research Council (MRC) and National Health Laboratory Services (NHLS) will continue to interact with the MAC on COVID-19. It should be noted that such entities continue to input directly into departmental policies and annual performance plans on day to day basis working with the Director Gener

It is important that we remain relevant as we endeavour to bring on board and educate communities on averting the risk of a second wave. This requires experts who are well versed in human behaviour. Containment measures in work and social spaces has now become the key focus under the new normal. The Minister therefore requires experts who are specialized in those areas in order to advise government on the continued response.

The notion that the Minister “disbanded” the MAC because he does not want to heed its advice is furthest from the truth. The fact is that the Minister accepted and implemented almost all (more than 95%) of the advisories from the MAC on COVID-19 and, in the interest of transparency, published the advisories digitally despite there being no legal obligation to do so. Where there was divergence from the advisory, this was due to the Minister and government having to consider factors and/ or inputs from other stakeholders. Those who persist that government has not heeded the advices from the MAC on COVID-19 are dishonest and intent on misleading he public.

It is also concerning that there appears to be an expectation from some for the Minister to consult individuals when he terminates their participation. The National Health Act, 2003 provides a legislative mandate for the Minister of Health to establish Advisory and Technical Committees. The Minister is empowered to determine the composition, functions and working procedure of the Advisory and Technical Committees. Therefore, the Minister is well within his rights to exercise his discretion to reduce, increase, reconfigure, augment or even disband a MAC. He also has a responsibility to ensure that the structures that he forms remain relevant and responsive.

In his letter to MAC members, the Minister has expressed gratitude for their contribution. In Minister’s view, the MAC has done an outstanding job and he believes that the newly appointed members will also add value to this great work.

During the course of the pandemic, three distinct Ministerial Advisory Committees (MACs) have been established to guide government’s response to the COVID-19 pandemic : The MAC on COVID-19, the MAC for Coronavirus Vaccine and the Multi-sectoral MAC for Social Behavioral Change, co-chaired by the Minister of Health and the Minister of Social Development.

The MAC SBC was launched on Youth Day, June 16 2020 and its members announced on the same day. The MAC SBC focuses entirely on social mobilization and contracting not only to combat COVID-19 but also on devising a comprehensive response to the socio-economic sequelae of the pandemic. The MAC SBC is using lessons from the campaign on HIV and AIDS in which the importance of stakeholder mobilization was critical for behavioral change.

The MAC on Coronavirus Vaccine (MAC-Vacc) was announced in the 14 September Statement and the names of those members were published. This MAC focuses exclusively on the developments of the COVID-19 vaccine and ensuring we are well positioned to access adequate amounts of doses when the technology becomes available.

On behalf of the nation, Government thanks all members who have and continue to serve on all the Ministerial Advisory Committees - the captains who have steered us through the COVID storm and kept us afloat. We believe that the MACs as they stand now more accurately reflect the needs of this country’s health and economic response as we look to rebuild our lives after the wreckage of the storm. These experts are fellow South Africans who stand ready to give of their expertise, commitment, and passion; turning ideas into action and innovation. For this we are truly grateful and also wish to reassure the members of our support as Ministers and as Government.

Attached is a list of all MAC Members in Ministerial Advisory Committees advising on COVID-19 (Annexure A, B, C). We also attach a list of all Ministerial Advisory Committees in the Department of Health (Annexure D)

Annexure A: Ministerial Advisory Committee on COVID-19

Infectious Disease Epidemiologist - Prof Salim Abdool Karim (Co-chair)

Public Health Medicine - Prof Marian Jacobs (Co-Chair)

Behavioural Scientist - Prof Nhlanhla Mkhize (Vice-Chair)

Virologist - Prof Barry Schoub (Vice-Chair)

Critical Care Nursing - Prof Portia Jordan (Vice-Chair)

Infectious Diseases Specialist - Prof Marc Mendelson, Prof Nombulelo Magula, Prof Jeremy Nel

Critical Care Specialist - Prof Rudo Mathivha, Dr Dean Gopolan

Paediatrician - Prof Sithembiso Velaphi

Infection Control Specialist - Prof Shaheen Mehtar

Health Systems Specialist - Prof Ian Sanne

Health Promotion - Prof Matildah Mokgatle

Mathematical modeler - Dr Juliet Pulliam

Health financing specialist - Prof Jacqui Miot

Diagnostic, therapeutic and vaccine regulatory expertise - Prof Helen Rees

Psychologist (Behavioural psychology) - Dr Heidi van Rooyen

Nursing (Infectious diseases) - Ms Dikeledi Tsukudu

Ethicist - Prof Doug Wassenaar

Occupational health specialist - Dr Thuthula Balfour

Annexure B: Ministerial Advisory Committee on Coronavirus Vaccines

Chair: Professor Barry Schoub Members:

Dr Morena Makhoana, CEO Biovac

Ms Glaudina Loots, Department of Science and Technology

Dr. Boitumelo Semete-Makokotlela, CEO South African Health Products Au- thority

Prof. Greg Hussey, Vaccines for Africa (UCT)

Prof. Jeff Mphahlele, MRC, Immunologist and SAHPRA Board Member

Prof. Helen Rees, WHO Expert Advisor

Prof Ames Dhai, Ethicist

Dr Mark Blecher, National Treasury As observers in this MAC are:

Prof. Salim Abdool Karim, Chair MAC on COVID-19

Bishop Malusi Mpumlwana, Chair MAC Social and Behavioral Change

Annexure C: Multisectoral Ministerial Advisory Committee on Social and Behavioral Change

Ms Steve Letsike                    South African National AIDS Council (SANAC)

Mr Thulani Tshefuta               NEDLAC

Dr Lydia Cairncross                People's Health Movement of SA

Mr Mluleki Zazini                    NAPWA National Association of People Living with HIV and AIDS

Ms Lauren Pretorius               Health Users Sector Network Member

Mr Lucas Qhakaza                 National Working Committee for the South African National Civic Organisation (SANCO)

Mr Lawrence Bale                  South African National Apex Cooperative (SANACO)

Mr Dan Kekane                      Disabled People South Africa (DPSA)

Mr Tebello Radebe                 National Coordinator Financial Sector Campaign Coalition (NPC)

Mr Solly Nduku                       National Unitary Professionals for African Tradition Health Practioners of SA

Ms Phephisile Maseko           Traditional Healers Organisation

Ms Ingrid Cupido                    Age-in-Action Organisation

Ms Sasha Stevenson             Section27

Rev Bafana Khumalo             Sonke Gender Justice

Ms Jannie Oosthuizen           Public Servants Association of South Africa (PSA)

Ms Susan Ntlatleng                HOSPERSA

Mr Khaya Xaba                      National Education, Health and Allied Workers’ Union (NE- HAWU)

Mr Cassim Lekhoathi             DENOSA

Mr Inkosi Sipho Etwell Mahlangu   National House of Traditional Leaders (NHTL)

Mr Zolani Mkiva                     CONTRALESA

Pastor Ray McCauley            Rhema Family Church

Elder Ephraim Msane            The Church of Jesus Christ of Latter-Day Saints

Chief Rabbi Warren Gold- stein      Jewish

Moulana Ebrahim Bham        Muslim

Pundit Ashwin Trikamjee       Hindu

Bishop Malusi Mpumlwana (Chair)   Mpumlwana Melusi Church

Apostle Collins Dhlomo          Alliance of Pentecostal and Charismatic Churches of SA

Bishop Mosa Sono                 Grace Bible Church

Ms Mary Kluk                         SA Jewish Board of Deputies

Ms Yamkela Makupula           Diaz Rues Africa

Ms Sulosh Pillay                     Daughters of Africa

Mr Joseph Mbereni Maada    Mudzi Religious Organization

Mr Buti Joseph Tlhagale        SA Catholic Bishops

Ms Lisa Vetten                       Activist - Violence against Women

Dr Nokuzola Ndende              Icamacu Institute

Mr Jacob Skosana                 Older Persons Forum Chairperson

Mr Bernard Molokoane           ZCC (Engenas)

Mr Piet Lekganyane               ZCC

Ms Avhasei Mulovhedzi          SA Interfaith Council

Mr Abdul Khaliq Allie              Moslem judicial Council

Mr Vilal Vaid                           Council of Muslim Theologians

Annexure D: MINISTERIAL ADVISORY OR TECHNICAL COMMITTEES

Committee Name

Advisory Committee on E-Health

Advisory Committee On The Prevention And Control of Cancer

National Advisory Group on Immunisation (NAGI)

National Committee on Confidential Enquiries into Maternal Deaths (NCCEMD).

Advisory Committee on organ Transplant

National Health Research Committee

National Essential Medicine List Committee

Ministerial Advisory Committee on Antimicrobial Resistance

Committe on Morbidity and Mortality in Children (CoMMiC)

Ministerial Advisory Committee on NHI- Legislative Processes

Ministerial Advisory Committee on NHI- Policy and Implementation

National Immunisation Safety Expert Committee

1. National Certification Committee

2. National Polio Expert Committee

3. National Authority on Containment

4. National Task Force on Poliovirus Containment

Expert Review Committees of NEMLC

The final one is the Ministerial Advisory Committee on Youth and Adolescent Health

National Forensic Pathology Services Committee (currently expired.)

Ministerial Task Team on Nursing

Ministerial Task Team for Human Resources for Health

Advisory Committee on Mental Health

Occupational Health and Safety Committee

National Perinatal Mortality Committee

Adolescent and Youth Advisory Panel

National Environmental Health Committee

The following MACs were gazetted (gazette details indicated) but not established:

Committee Name

Advisory Committee on Health Technology Assessment on NHI No. 40969 N.R 625 of 7 July 2017

Advisory Committee on Health Benefits for NHI No. 20969 of 7 July 2018

National Health Pricing Advisory Committee on NHI No. 20969 of 7 July 2018

National Advisory Committee on Consolidation of Financing Arrangements No. 20969 of 7 July 2018

Issued by Department of Health, 29 September 2020