When the pandemic ends, those unlawful mandates are going to haunt us

THERE has been a plethora of verbiage on the subject of ‘vaccine mandates’ over the past weeks. Several pieces written by legal academics and health scholars all present these measures as a fait accompli, and worse, present public health policy as if the extraordinary measures contemplated do not require anything resembling rational debate inside our nation’s democratic institutions.

Mandates are usually associated with elections and the resulting laws and policies are ordinarily drafted by parliament. Instead public health activism has adopted the fever pitch of the imperative, the unquestioning injunction and ever-present directive. What passes for debate these days, usually 5-minute opinion provided by so-called expert ‘talking heads’ on television followed by equally vapid ‘vox pops’ from the public with absolutely no balance provided by presenters, is leading the country assuredly down the road of internal passports and vaccine score cards.

As I have already written, this country has an egregious history when it comes to internal passports, in particular the aparthied era dompas, not to mention a troubled past — one haunted by the evil doctoring and medical experimentation of the likes of Dr Verwoerd et al. All the more reason to tread carefully lest we forget the lessons of the past and ignore the imperatives enshrined in our constitution?

Instead a paid-for-promotion by Investec, boldly claims without providing any citations: “Unvaccinated people are driving up the chances of mutation, creating more opportunities for the Covid-19 virus to bypass the immune system. The more people who are vaccinated, the closer we will get to a point of containment like we have with the flu.”

The same piece is remarkable for its failure to disclose the banking group’s considerable investment in Aspen Pharmacare, and instead presents an Aspen Senior Executive, Dr Stavros Nicolaou as an expert in the field of epidemiology. Then Professor WD François Venter of the Wits Centre for Reproductive Health is presented as an expert on virology. The webinar is a far cry from a national science symposium on the subject and a long way away from resembling anything like a colloquium or conference.

At the same time as these paid promotions, other health propaganda pieces are published in the media.

One by Safura Abdool Karim of the Bhekisisa Centre for Health Journalism falsely claims “South Africa’s laws allow for the government to implement mandatory Covid-19 vaccinations but these mandates won’t necessarily infringe on individual rights.” Then proceeds to jump the gun in claiming “under the Notifiable Medical Conditions Regulations, a healthcare provider would be allowed to administer a vaccine even if a person refuses to accept it.”

While the National Health Act of 61 of 2003 certainly allows for the quarantining of individuals suspected of being infected with a notifiable disease, (and Covid-19 is a notifiable disease according to regulations), the act does not provide for mandatory vaccination as such, nor does it define vaccination nor even provide a relevant immunisation section. The astonishingly brazen claims made by Karim, instead appear to refer to draft regulations which have yet to be promulgated, and thus an as yet unfinalised government vaccine mandate policy — a policy which remains moot, and which is already the subject of a legal challenge by a religious group.

It is worth considering first principles and discussing what exactly we are dealing with here.

A piece ‘comparing SARS-CoV-2 with SARS-CoV and influenza pandemic’ published in the Lancet in September 2020, may be considered required reading:

Cheadle-stan, a country where your medical practitioners may as well be the Taliban

HALTON CHEADLE claims to be an ’emeritus professor of law at UCT’. In reality the self-styled ‘drafter of the Labour Relations Act’ was pushed into early retirement following revelations of his business relationship with then Speaker of the House of Assembly, Max Sisulu, and Kagiso, a company in business with Media24.

In 2010, Cheadle handed down a labour decision gutting the TRC Report, inverting the facts of apartheid, and inter alia altering my religious affiliation.

It would come as no surprise that his own client, Media24 was given a free ride when it came to apartheid-era justifications for separate development, de facto newsroom segregation, race profiling and a set of alternative facts used to pillory the late jazz legend Robbie Jansen. At the same time this writer was falsely accused inter alia of ‘misleading the public’ by deploying the phrase, “Speaking from his home, Robbie Jansen said…”

I interviewed a Professor of Linguistics, not only is the above phrase covered by journalistic privilege, is referred to as common speech and a turn of phrase, but the writer is entirely absent.

When Cheadle isn’t inventing lies, gutting the country’s transitional justice arrangements, or rigging the LRA in his own favour, and thus engaged in corrupt activities, prescribed under the ‘Prevention and Combating of Corrupt Activities Act‘, he spends his time in Glencairn, Cape Town, declaiming upon our Constitution, a document for which some delusional citizens, including news subs, seem to want to give him a little credit.

The Constituent Assembly which convened from 1994-1996 was the only body which drafted the Constitution. Many MPs, including civil society procured attorneys to assist in the drafting process. But for anyone to claim Cheadle was orchestrating the content, or was somehow an MP at the time, is to grossly exaggerate his influence as a practitioner of law.

Having put the above matter to rest, I need to point out that the Cheadle is not only corrupt, but is also a regular cuckoo clock when it comes to legal matters. And my apologies at the outset for how this is going to play out when it comes to the MRC’s Glenda Grey.

Not even the Taliban

A piece published by the Daily Maverick, tackling the question “Can the government constitutionally require that everyone be vaccinated against Covid-19?” begins with what appear to be Cheadle and Gray’s summary answer regarding compulsory immunisation:

“The simple answer is it can,” the duo claim at the outset, (‘trust us, we can’), before pursuing an ill-advised motion for removing what remains of patient consent and human rights during the pandemic. These are hard won rights, gained from the struggle for freedom (see here).Vaccines save lives, removing consent destroys the foundation of our democracy.

As both a potential beneficiary and a party insider situated above the law, nothing more than polemic is provided in support by Cheadle — not a single citation from a person who claims to be an ‘academic’ supremely qualified to answer such questions.

Gray should know better than to rely upon a legal practitioner, whose past dealings and involvement with Kagiso, chart a course of investments spanning Aspen, a company responsible for local production of the Johnson & Johnson Vaccine. The Kagiso Domestic Balanced Fund showed a 2.5% investment in Aspen as at 2019.

There are certainly good reasons for universal immunisation, and yes ‘deaths are more likely to occur amongst the unvaccinated’, and ‘new mutations may emerge’ — but none of the reasons supplied by the pair demonstrate why these are foregone conclusions and why our rights should be forfeited in the process? Why are voluntary participation, incentivisation and the normal societal strictures failing if at all?

The bold assertions beg the question, why weren’t our rights similarly removed during earlier epidemics and vaccination programmes? Just about nobody encounters a legal writ forcing one to take a measles vaccine, and we have never possessed internal vaccine passports, nor any attempt to document patient histories with the self-same rigour. The resulting precedent opens us all needlessly, to mandatory annual shots for any manner of public health concerns. You need blood statins, well, you don’t have any choice over the matter, sir?

And thus what follows in part one of a three part series, isn’t a legal argument per se, nor a scholarly jurisprudence essay calling for the adoption of vaccine mandates, and citing local case precedent (mostly in favour of HIV rights), but rather two individual’s self-interested rhetoric placed in the public domain and deserving of our antipathy. As already noted in my earlier post, the only South African case law provided for this type of overly robust medical intervention refer to the plight of the already incarcerated, criminals and state patients.

The government’s steadfast refusal to embrace vaccine mandates is seen as no small obstacle:

Esidimini must be seen within broader context of psychiatric abuse

THE SCANDAL involving the deaths of nearly 100 so-called ‘mental patients’ deserves more consideration. Missing from the press narrative regarding the tragedy, involving an investigation by Health Ombudsperson Malegapuru Makgoba and the many understatements and obfuscations by Health Minister Elias Motsoaledi, is any criticism of the designated methodology used to commit patients, namely psychiatry.

Until 2002 when the Mental Health Care Act was implemented and then amended in 2004, it was considered acceptable to incarcerate persons for political and socio-economic reasons. Involuntary psychiatric commitment was a hallmark of the apartheid regime. Yet the practice of ‘torture as treatment’ deployed by persons such as Dr Aubrey Levin, aka ‘Dr Shock’, continued long past the transition.

It should be remembered that thousands of SADF conscripts ended up in South African asylums, and many were only dehospitalised in 1994. Despite these amendments outlawing involuntary commitment on specific grounds, psychiatry remains the designated methodology deployed by our health department.

All it takes today is two doctors to commit a patient. There is no obligation for these doctors to even see the patient, and thus involuntary commitment of political dissidents may occur even via remote control. Once inside the system, it is extremely difficult for patients to gain access to what little remains of human agency, both in terms of human rights and decision making.

Despite provisions within the Act, it must be noted the so-called Mental Health ‘review boards’, do not function as personal ombuds as such, and even if they did, the problem arises, that of legal representation.

Bar the existence of the general health ombud, there is still no dedicated and practical ombud system focused on South Africa’s so-called mental institutions, nor an independent watchdog for that matter, and we still lack genuine means by which such persons may safely contest a commitment decision and especially when their rights are infringed.

A psychiatric patient for instance, might appear before a judge or lawfully convened health panel, but in a highly medicalised state, and without a dedicated representative, present, to argue his or her case. The situation is akin to being charged with a crime, in this case in the form of a medical diagnosis, and yet to be cast within a situation where there is no defense against what is essentially the medical dismissal of one’s ideas and behaviour.

A dire state which makes the possession of other rights in the constitution, meaningless.

It is not surprising, and given the many articles on this issue in the foreign press, that South Africa has consistantly failed to provide UN country reports on the status of its psychiatric patients, and by most accounts, has failed to honour its obligations in terms of the Convention on the Rights of Persons with Disabilities (CRPD).

The release of the damning health ombud report is however to be welcomed as one small step towards rectifying this horrendous situation.

Both article 12 of the CRPD convention and article 12 of our own Constitution, guarantee that psychiatric patients have human rights and are also to be considered in possession of ‘psychological integrity’, — an all-important concept when one remembers — whether unconscious or asleep, citizens do not automatically lose the presumption of consciousness, as they did under the past regime.

While the UCT sponsored psychiatric consortium has received massive funding from central government and is currently expanding the Valkenberg facility to twice its size, these funds could be better spent on providing therapies within complementary modalities. Instead Big Pharma is the big winner in a model which provides persons with a diagnosis and then treats the diagnosis instead of the individual.

Mental diseases unlike physical diseases are invented. It takes two persons to have a mental illness. Every year the psychiatric profession vote on what to include in the Diagnostic Statistical Manual (DSM). The same cannot be said of cardiologists and neurologists. Mental illness labels are thus a social construction.

Medical professionals such Dr Aubrey Levin and others, who administered Electroconvulsive Shock Therapy (ECT) to persons suffering from what was then considered a mental illness, namely homosexuality, were never prosecuted by the TRC. The commission failed to investigate the use of ‘torture as treatment’ under apartheid.

Psychosurgery as well as ECT are still considered ‘therapies’ under the current act, which fails to provide for comparative therapies and other treatments. It is time for a commission of inquiry into abuses and gross violations committed by psychiatry under apartheid and for new thinking on this important subject.

Health Ombud Esidimeni Report findings

Key Findings

Upon the investigation, the Ombud has established that:

  1. A total of ninety-four (94+) and not thirty-six (36) mentally ill patients (as initially and commonly reported publicly in the media) died between 23 March 2016 and 19 December 2016 in Gauteng Province. This total number of 94 should be seen as a working and provisional number.
  2. All the 27 NGOs to which patients were transferred operated under invalid licences; therefore, all patients who died in these NGOs died in unlawful circumstances
  3. The NGOs where the majority of patients died had neither the basic competence and experience, the leadership/managerial capacity nor ‘fitness for purpose’ and were often poorly resourced. The existent unsuitable conditions and competence in some of these NGOs precipitated and are closely linked to the observed ‘higher or excess’ deaths of the mentally ill patients.
  4. 75 (79.78%) patients died from 5 NGO/hospital complexes (Precious Angels 20, Cullinan Care and Rehabilitation Centre (CCRC)/ Siyabadinga/Anchor 25, Mosego/Takalani 15, Tshepong 10 and Hephzibah 5);
  5. There were 11 NGOs with no deaths, 8 NGOs with average deaths and 8 NGOs with ‘higher or excess’ death;
  6. Only 4 Mental Health Care Users (MCHUs) died in hospitals compared to 77 MCHUs deaths at NGOs; in absolute numbers for every 1 death at the hospitals there were 19 deaths at the NGOs but correcting for the total base population the ratio is 1:7. This ratio is very high.
  7. When the MEC of Health made announcement on 13 September 2016, 77 patients had already lost their lives.
  8. At the time of writing the Report, 94 patients had died in 16 out of 27 NGOs and 3 hospitals.
  9. 95.1% deaths occurred in the NGOs from those directly transferred from LE Health Care Centre.
  10. Available evidence by the Expert Panel and the Ombud showed that a ‘high-level decision’ to terminate the LE Health Care Centrecontract precipitously was taken, followed by a ‘programme of action’ with disastrous outcomes/consequences including the deaths of Assisted MCHUs. The Ombud identified three key players in the project: MEC QedaniDorothy Mahlangu, Head of Department (HoD),Dr. Tiego Ephraim Selebano and Director Dr. Makgabo Manamela at times referred to as ‘dramatis personae’ in the text. Their fingerprints are ‘peppered’ throughout the project. The decision was reckless, unwise and flawed, with inadequate planning and a chaotic and ‘rushed or hurried’ implementation process.
  11. Several factors in the ‘programme of action’ were identified by the (Expert Panel, OHSC Inspectors, Ombud and Ministerial Advisory Committee) that contributed and precipitated to the accelerated deaths of mentally ill patients at the NGOs. The transfer process particularly, was often described as ‘chaotic or a total shamble’;
  12. The Gauteng Mental Health Marathon Project, as it became known was: done in a ‘hurry/rush’; with ‘chaotic’ execution; in an environment with no developed, no tradition, no culture of primary mental health care community-based service framework and infrastructure;

Human Rights Violations.

There is prima facie evidence, that certain officials and certain NGOs and some activities within the Gauteng Marathon Project violated the Constitution and contravened, the National Health Act and the Mental Health Care Act (2002). Some executions and implementation of the project have shown a total disregard of the rights of the patients and their families, including but not limited to the Right to Human dignity; Right to life; Right to freedom and security of person; Right to privacy, Right to protection from an environment that is not harmful to their health or well-being, Right to access to quality health care services, sufficient food and water and Right to an administrative action that is lawful, reasonable and procedurally fair.

Negligent/Reckless Decisions/Actions

The Ombud established that the following decisions/actions were negligent or reckless by the Department of Health:

  1. Overcrowded NGOs which are more restrictive, is contrary to the deinstitutionalization policy of the MHCA and MH Strategy and Policy.
  2. Transfer of patients to far-away places from their communities, is contrary to the policy of deinstitutionalization.
  3. Transfer of patients to NGOs that were ‘not ready’, that were ‘not prepared properly for the task’.
  4. Transfer of patients without the provision of structured community mental health care services is contrary to the Mental Health policy.
  5. NGOs without qualified staff and skills to care for the special requirements of the patients.
  6. NGOs without appropriate infrastructure and not adequately financially resourced.
  7. NGOs without safety and security.
  8. NGOs without proper heating during winter, some were described as ‘cold’.
  9. NGOs without food and water, where patients became emaciated and some died of ‘dehydration’.
  10. Grant and sign licences without legal or delegated authority.

The seven sins and the seven virtues of Universal Health Coverage

Universal Health Coverage is likely to become the backbone on which the health development agenda beyond 2015 will be constructed. To avoid unintended effects, Universal Health Coverage should keep away from committing seven sins and should try to practice seven virtues.

Backed by most actors in the global health scene, Universal Health Coverage (UHC) is likely to become the mantra that will drive health transformations for years to come and the backbone on which the health development agenda beyond 2015 will be constructed. There is now widespread agreement on the need to extend access to health care to all individuals and populations, as illustrated by UN statements (1), WHO reports (2), and a number of articles in medical journals, including a Lancet series (3). The call for UHC comes at a time when, after decades of neoliberal policies, privatization of health care services has reached a peak leading in many countries to further exclusion and/or catastrophic expenditures. To help reverse this trend, however, and to avoid unintended effects, UHC should keep away from committing seven sins and try to practice seven virtues.
1. Sloth (failure to do things that one should do and to make the most of one’s talents and gifts) vs. Diligence (upholding one’s convictions at all times, especially when no one else is watching)
To many people, UHC may sound like Health for All (4). However, what is currently proposed differs substantially from what was proposed in Alma Ata. Primary health care intended to transform health systems, as opposed to health care systems, within a broader social transformation. The signatories of the Declaration were aware of the importance of the social determinants of health well before the report of the WHO Commission (5). Primary health care included education, nutrition, water and sanitation, in addition to essential health care. Unless UHC is served with an extensive dressing of primary health care and social determinants of health, i.e. unless it is implemented within a framework of social and economic transformation, it will not transform health as profoundly as hoped. Paradoxically, an excessive focus on UHC could divert attention and resources from other sectors with a bearing on health (6).
2. Greed (inordinate desire to acquire or possess more than one needs) vs. Charity (benevolent giving and caring, solidarity)
To some people, UHC may seem to be synonymous of health insurance schemes that would fund a limited package of services, with governments playing a range of different and often minimal roles. The equation of UHC with financial coverage is implied also in the title of the WHO World Health Report for 2010 (7). Such an interpretation of UHC focuses on the mere element of affordability, or economic accessibility. It may pave the way to a massive infiltration of the private sector into health care systems that in some countries are still mostly public, and it may undermine the efforts of those countries that have undertaken reforms towards a stronger public sector. To avoid this, UHC should aim at increasing the proportion of health care services that are mastered and managed by the public sector (8), and financed by progressive taxation systems. In places where the private sector is prevalent and likely to remain so for a long time, governments should strongly regulate it, especially as far as quality of care and lucrative attraction for health professionals are concerned, while progressively investing to reinforce the public sector (9). Also, UHC should be robust enough to accommodate new challenges, e.g. the new burden brought about by the changing epidemiology of non-communicable diseases (10), and to resist the downwards swings brought about by present and future economic and financial crises (11). Ad hoc goals and targets on access to the public sector should be developed if UHC is included in the post-2015 development agenda.

South African National Health Assembly 5 + 6 July 2012

The National Health Assembly leads into the People’s Health Assembly

Extraordinary opportunity for South African patient advocates to participate in the South African National Health Assembly (NHA) in alliance with the National Health Insurance Coalition. The People’s Health Movement (PHM) is hosting the event. The importance is linked to the National Department of Health’s proposed a 10-point plan to transform the health system and this includes the National Health Insurance (NHI).  The NHI is in need of civil society engagement and citizen participation. This is a great opportunity to participate and learn and engage around how this process will affect you, your patients and our health system. It is also an ideal space to make inputs into how you see the NHI working and to place your best ideas on the table for discussion. Registration form National Health Assembly 5-9 July 2012 NB THESE DATES INCLUDES  THE GLOBAL, PEOPLE’S HEALTH ASSEMBLY, A SERIES OF HEALTH FOCUSED EVENTS!!!.

PHM will facilitate this engagement and re-frame the mainstream discussion around the NHI while working to achieve universal coverage in South Africa.

Who will be attending: Participants will include grassroots activists from communities around South Africa, policy makers, interested citizens, government officials and interested delegates from PHM Global countries (such as India, Thailand and Latin America) who are interested in taking part in the NHA.

WHEN: 5th July 08:30 -18:30 (Thursday) and 6th July 08:30 -13:00pm (Friday).

WHEREUniversity of the Western Cape, Bellville, Cape Town.


WHAT
: The upcoming National Health Assembly will play a catalytic role in rebuilding, re-energizing and unifying health civil society in South Africa and the broader global health community. Using the proposed NHI as a platform, the National Health Assembly is thus an ideal event from which to build momentum and mobilise civil society engagement in the NHI process and towards universal coverage in South Africa.

Overall objective of the NHA is to mobilise a mass movement promoting the right to health for all and a progressive NHI .

Specific objectives are to:

  • Agree on an agenda and priorities for building universal access to quality health care among health activists in South Africa;
  • Build a coalition of health and social justice organisations that can work together towards realizing this agenda;
  • Plan a campaign to realize the agenda and priorities agreed by the NHA
  • Assess plans for the NHI and agree on a way forward to ensure that it realises the fundamental rights to health of all through a progressive Family Medicine approach;
  • Examine specific health issues in SA, including primary care, disability, sexual & reproductive justice and others;
  • Consider ways to assist with the implementation of other aspects of the government’s 10-point plan with particular attention to those areas where civil society has key roles to play.

Workshop & Plenary sessions:

Starts each day 2 hour plenary. Participants can select which sessions they would like to attend under the below themes. These will be facilitated by PHM but hosted by partner organisations and groups involved in the NHI Coalition.

National Health Assembly Themes:

  • Social determinants of health ( e.g. food, sanitation, water, work conditions)
  • Equitable and comprehensive health care
  • Political and economic implications for health system transformation

HOW: To register, complete attached registration form and send to [email protected] before July 5th, 2012. 

Registration Fees (Includes Access to Sessions, AGM & Lunch for 2 days):

Student/Unemployed Rate: R60.00

Standard Fee: R100.00

Student Fee: R60

National Health Coalition formed

The newly formed National Health Insurance Coalition (NHIC) gives civil society voice on National Health Insurance

National Health Insurance holds the potential to drastically improve health care across South Africa; civil society is organising to secure its success

 Key members of civil society recently formed the National Health Insurance Coalition (NHIC) to collectively respond to and help develop National Health Insurance (NHI). The NHIC also intends to jointly endorse key submissions on NHI, encourage civil society participation in the NHI policy process and launch an advocacy campaign, among other things.


This week, the NHIC published a discussion document to facilitate exchange over the Green Paper on NHI. On 7 – 8 December 2011 the Department of Health (DoH) held an international consultation on NHI, during this consultation the NHIC held a successful side meeting to discuss the way forward.


To inquire about the National Health Insurance Coalition or join our efforts email: [email protected]. We can go far together. Find the discussion document here.

NHIC comes at a crossroads in the development of NHI. The DoH has published the Green Paper on NHI, invited commentary and signaled an eagerness for input from civil society. The next step will be for DoH to publish a White Paper on NHI.

Engagement and dialogue from civil society are crucial during this stage of the NHI policy development process. In this moment of contingency NHI’s failure or success may depend on our efforts; collective action and public debate are the fulcrum, we must use them now. Together we bring a more forceful voice to the debate, and can ensure that NHI achieves its potential to be a major step toward quality health care for all.


Members of coalition and signatories to the discussion document include: People’s Health Movement South Africa (PHM-SA), SECTION27, Treatment Action Campaign (TAC), Black Sash, Rural Health Advocacy Project (RHAP) Rural Rehab, Rural Doctor’s Association of South Africa (RuDASA), Passop, EarthLife Africa, Africa Health Placements (AHP).


To inquire about the National Health Insurance Coalition or join our efforts email: [email protected]. We can go far together. Find the discussion document here.

Health leaders call for urgent action on climate

Durban — International health leaders in Durban for the global climate talks have called on negotiators to push for the most ambitious commitments possible, warning that the direction of current negotiations risks the lives of billions of people around the globe.

Over 200 leaders from more than 30 countries have issued a Declaration and Call to Action following a Global Climate and Health Summit.

“No-one is immune from the health impacts of climate change; people in developed and developing nations are all at risk,” said Dr Hugh Montgomery from Climate and Health Council, UK.

“Without bold action by governments, climate change will magnify existing health crises,” said Dr Rajendra Niadoo, from Nelson R. Mandela Medical School in Durban.

Doctors, nurses, public health experts, health and medical scientists, medical students, and health officials from major international health organizations are meeting in Durban to try and influence negotiations by raising awareness about the health risks of climate change and the health benefits of climate action.

“Strong climate policy is an investment in people’s health,” said Fiona Armstrong of the Climate and Health Alliance, Australia.

The delegates have called for a fair, ambitious and binding global treaty, and urged all countries to commit to immediate strong climate action to protect and promote health.

“If governments agree to delay for another decade, history will judge Durban as a moment of global political malpractice,” said Josh Karliner, Health Care Without Harm.

“I’m a 21 year old medical student, and these negotiations have been carrying on my entire life. If we don’t reach a legally binding agreement on climate change soon, the protection and promotion of public health will be seriously undermined, world-wide.” said Nick Watts of the International Medical Students Association.

Delegates agree the urgent replacement of fossil fuel-based energy with clean renewable energy is vital, saying fossil fuels cause “immense harm” to both climate and health, and urge negotiators to commit to equitable contributions to a green climate fund to assist adaptation and mitigation strategies to support human health.

They have themselves committed to action to cut emissions in the health sector, and have urged health professionals worldwide to engage in advocacy for climate action, to help prevent unprecedented loss of life and human suffering.