Could the long history of racist medical malpractice, social media conspiracy theorists and big pharma profiteering threaten the success of South Africa's biggest vaccination programme?
As we entered the new year, the National Coronavirus Command Council announced the government's bold plan to inoculate 40 million people over a 12-month period. It's part of a grand campaign to achieve national herd or population immunity against Covid-19. The goal has become urgent as the death toll rises and infection rates intensify during the second wave of infections in South Africa.
However, the government is already coming up against a rising mistrust of vaccines. This is fuelled in part by a cocktail of online conspiracy theories, and a history of callous profiteering by big pharma and racist medical malpractice.
Conspiracies against vaccines are an age-old feature of contentious public discourse. But the long history of racist medical malpractice and vaccine development took centre stage in April last year when two French doctors suggested a vaccine could be tested on the African continent. World Health Organization director general Tedros Adhanom Ghebreyesus, other leaders and celebrities condemned their remarks, but was it too late?
Social media activists seized on the news to remind internet users of the long history of Black suffering at the hands of big pharma and former colonial powers in the Global North. And official state communication channels have done little to dispel growing fear and mistrust among pandemic-battered populations.
Then, as if on cue, a video emerged of Chief Justice Mogoeng Mogoeng praying against "any vaccine that is not of you, if there be any vaccine that is of the devil meant to infuse 666 in the lives of people, meant to corrupt your DNA. Any such vaccine, Lord God Almighty, may it be destroyed by fire." The remarks coming from the highest legal office in Africa's most developed democracy gave credence to both uninformed fears of vaccines driven, in part, by a bitter history.
Pfizer's disgraceful past
Social media users who are dismissive of vaccines draw on bits of historical truth to fuel conspiracies, giving them power, especially because times of medical crises in Africa have often been made worse by pharmaceutical company profiteering.
In 1996, Kano in the north of Nigeria was the site of a cholera outbreak compounded by an epidemic of meningococcal meningitis. The disease killed 12 000 people in six months, severely straining the country's healthcare system.
In the midst of the pandemic, one of the world largest and richest pharmaceutical companies saw a profitable opportunity. Pfizer rushed to the scene with an experimental drug that had never been tested on children, a broad-spectrum antibiotic known as trovafloxacin. Pfizer markets it as Trovan.
According to reports by the United States National Center for Biotechnology Information, Pfizer, acting without the approval of an ethics committee or the consent of parents, carried out an open label trial on 200 children. Half of these infected children were given trovafloxacin and half the gold standard treatment for meningitis, ceftriaxone. In the end, 11 children died. Five of them had been given trovafloxacin, six were given ceftriaxone. Dozens were left disabled: blind, deaf and with brain damage.
Although Pfizer said that only 200 children had been given Trovan or the older antibiotic, 547 families sued. Pfizer failed to produce consent forms for the 200 children they had tested for the vaccine. The company settled the case, though still said that meningitis, not its drugs, was responsible for the deaths and injuries.
The European Union, US and other wealthy nations at the World Trade Organization in November opposed a proposal to waive intellectual property rules for Covid-19 medicines, putting pharmaceutical profits over people. The proposal was raised by India and South Africa in October, saying that existing intellectual property rules create barriers to access to affordable generic medicines and vaccines as they did during the Aids epidemic. This is particularly true for impoverished countries with a majority Black population.
This decision to put profit over people is a throwback to 2001, when more than 40 of the world's largest and most powerful pharmaceutical companies took the South African government to court to stop it from passing legislation aimed at reducing the price of medicines for South Africans. The case is just one instance in a litany of questionable behaviour by the medical fraternity during the HIV and Aids epidemic that has fuelled people's mistrust of the sector during times of crises. Reports of hospitals sterilising some pregnant, HIV-positive women without their consent is another case that fuels conspiracy theorists. It's part of a long history of racialised medical malpractice against impoverished Black women.
How the past is affecting the present
In other parts of the world such as the US, there is a history of Black women being given hysterectomies while in hospital for minor surgeries. This was so common it was known as a "Mississippi appendectomy".
The memory of these cases has seen the history of eugenics and phrenology dragged into the conspiracy cocktail, too. Eugenics is a bogus racist 'science' that informs social programmes of improvement by selective breeding of the human species; phrenology, an equally bogus 'science' involves studying skull shapes to indicate mental abilities. Historically, this has meant population control and the killing off of "undesirable parts" of the human race. Disabled members of society, women deemed promiscuous, homosexuals and Black people became its prime targets.
The contemporary mutation of the horrors of the eugenics age are connected with population control conspiracies. Theorists have co-opted the efforts of people like Bill Gates who have warned against the dangers of growing global populations, especially their effects in impoverished parts of the world. In significant parts of the social media imagination, Gates is said to be part of an agenda to use vaccines to depopulate and control the world, particularly impoverished countries with Black populations.
In a convoluted and confusing way, legitimate concerns and real fears connected to a repeat of hurtful histories is fuelling disinformation. As such, the mention of a Covid-19 vaccine has become a Pavlovian bell in the imagination of many everyday social media users. Mention it and people start conjuring all manner of nefarious conspiracies hedged by the powerful against the people.
Unless the state develops a campaign to sanitise our communication channels of conspiracies, the biggest vaccination programme in South African history is in danger of falling to unfounded fears.