South African Medical Association

SAMA Weekly Newsletter | 7 May 2021



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Department of Health Vaccination Training - Module 4 has been updated

You are invited register for the Module 4 Update: Use of the Med Safety App for Reporting of Adverse Events Following Immunisation sessions.

Main objectives:

  • Explain key vaccine safety concepts and their implications in COVID-19 vaccine safety
  • Identify and respond to an adverse event following immunisation (AEFI)
  • Explain how to report and investigate adverse events following COVID-19 vaccination, incl. reporting tools
  • Define adverse events of special interest (AESI) and describe its practical application
  • Discuss the importance of causality assessment within the COVID-19 vaccine safety context

Please note that the sessions will be held over four days, but you only need to attend one day of training. Please ensure you register and attend the correct session.

Session dates and times:

Session 3: Monday, 10 May 1pm

Session 4: Thursday, 13 May 6pm

Once you have registered, you will receive a confirmation email with details on how to join the webinar.

For queries or technical assistance, please email

Thank you for your participation.

Ms Thabile Msila
Human Resource Strategic Programmes
National Department of Health


World Medical Association International Code of Medical Ethics - SAMA Opportunity to participate in Commentary

On 3 May 2021, the World Medical Association (WMA) published the draft of a revised version of the International Code of Medical Ethics (ICoME).

This is now open for public consultation and may be downloaded below.

SAMA will be in a position to send inputs from our own country members for this important Code.

Please send any comments that you may have on the Draft (see links below) to Mr Brandon Ferlito in the SAMA Knowledge Management, Research and Ethics Department (KMRED) at

Comments and inputs should reach SAMA by Friday 20 May to allow us to prepare a SAMA submission to the WMA.

The revision process so far

The International Code of Medical Ethics was adopted by the World Medical Association (WMA) in 1949 as a complement to the newly adopted Declaration of Geneva: The Physician’s Pledge (DoG). The ICoME outlines the guidelines, norms, and central duties of the medical profession. It is a powerful document with great potential in its own right and therefore deserves the same level of exposure and recognition as the DoG or the Declaration of Helsinki (DoH).

Since its adoption, the ICoME has been amended three times – most recently in 2006. In 2018, on the heels of the adoption of the revised DoG in 2017, the World Medical Association formed a workgroup to begin a careful long-term review of the ICoME with due consideration for the gravity of this document. The mandate of this workgroup is to update the ICoME to be more compatible with the revised DoG and the full spectrum of WMA policy, as well as to explain some of the concepts in the revised DoG in further detail.

Workgroup members and observers representing more than 15 countries (including the South African Medical Association) have reviewed the document carefully to determine what might be missing from the ICoME, what might be superfluous, what could potentially be organised differently.

The revised draft presented here is the result of the workgroup’s careful analysis, along with feedback received during regional conferences in Kuwait and Brazil (with further regional conferences in the African and Asian regions postponed due to the Covid-19 pandemic), a WMA Associate Members webinar, and during the annual meeting of the International Association of Bioethics in 2020.

In April 2021, the Council of the WMA approved this draft version for public consultation.

How to participate in the public consultation

The WMA has invited all experts and stakeholders to submit comments on this draft version via email no later than 28 May 2021. The workgroup will thoroughly review all comments and consider all input; however, please note that it may not be possible to take all the suggestions received into account in the new draft declaration.

The current version of the ICoME is available here:

The new draft revised version can be downloaded here:

All submissions will be kept on file and may be made available to members of the public upon request to the WMA following completion of the revision process.



he Ministerially appointed National Essential Medicines List (EML) Committee has reviewed the following sections of the Standard Treatment Guidelines (STGs) and Essential Medicines List (EML) for Primary Healthcare (PHC) and Adult Hospital Levels of care:

Level of care Chapter Section/ STG
Primary Healthcare Ch 7: Family planning Section 7.2.2: Levonorgestrel intra-uterine device (LNG-IUD) - to be added to the existing grouping of contraceptives on the EML
Primary Healthcare Ch 13: Immunisation Section 13.7: Other vaccines – influenza vaccines - update of the chapter

The Department of Health is seeking constructive comment regarding the identification of major errors, particularly involving diagnosis and treatment. Please include a short motivation to substantiate any comment made.

As per our standard processes , SAMA will be making comments to these chapters if necessary and appropriate. All the relevant information is attached for review:

  • Invitation to comment letter from the Department of Health
  • Revised Family planning chapter including the addition of LNG-IUD
  • Rational behind the revision of Family planning and addition of the LNG-IUD
  • Revised Immunisation Chapter including recommendations for influenza vaccine timing in relation to COVID-19 vaccination (2 week interval)
  • Report of NEMLC discussions about National Influenza vaccination guidelines for the 2021 flu season and rationale for the STG Update.

SAMA members are welcome to submit any comments you may have to the SAMA Knowledge Management, Research and Ethics Department (KMRED) by 1 May 2021.
Please send comments, suggestions and responses for inclusion in he SAMA submission to Shelley McGee at

Comments can also be directed through to the Department of Health by 10 May 2021:

Trudy Leong
Essential Drugs Programme
Private Bag X828

Supporting Documents

Guidance on the use of the Janssen Ad26.COV2.S (COVID-19) vaccine in pregnant and lactating women

Background Pregnant women are at higher risk of severe COVID-19 compared with women of childbearing age who are not pregnant, and COVID-19 has been associated with an increased risk of preterm birth. This document offers some preliminary recommendations on the use of the Janssen Ad26.COV2.S (COVID-19) vaccine in pregnant or lactating women in the context of the Sisonke trial and in the future national rollout of the Janssen COVID-19 vaccine. These recommendations consider the safety of the vaccine including the recent reports of Vaccine induced Thrombotic Thrombocytopaenia (VITT).

View more info

SAMA says the Gauteng Department of Health must act swiftly to assist cancer patients from the Charlotte Maxeke Johannesburg Academic Hospital

The South African Medical Association (SAMA) says the Gauteng Department of Health must act swiftly to assist cancer patients from the Charlotte Maxeke Johannesburg Academic Hospital. The Association says without urgent intervention, these patients will not receive the necessary cancer care.

“Following the fire that ravaged the hospital in mid-April, doctors do not have access to the linear accelerator nor any patient files which are in a block deemed unsafe because of fire damage. While some arrangements have been made with Steve Biko Academic Hospital in Pretoria, this is insufficient, and many patients are merely sitting at home without receiving any care at all. Urgent intervention is needed here,” says Dr Angelique Coetzee, Chairperson of SAMA.

Dr Coetzee says SAMA has received information that there are currently 160 cancer patients from Charlotte Maxeke Hospital who are not receiving cancer care because files, and the computerised planning system servers of the Radiation Oncology Department, are all in the same block which closed after the fire and which has not reopened since.

“Waiting times for radiation patients before the fire were already extremely long – up to six weeks – and Steve Biko can only assist with palliative radiation. Curative treatment patients are all at home waiting and those who are being seen there are facing long waiting times. All of this points to the need for an urgent alternative arrangement at Charlotte Maxeke,” says Dr Coetzee.

SAMA says the long waiting times for patients will render most radiation treatments non-curative. It proposes that some form of “holding chemotherapy” be administered to patients while attempts are being made to get them back on radiation treatment.

Among the other urgent steps SAMA is asking the Gauteng Department of Health to undertake is to give doctors immediate access to the block in which files and servers are stored, and to consider erecting tents outside the main building to enable access for patients to the necessary radiation machines.

“We realise this is not optimal nor standard but we have to consider every option to maintain treatment for these patients. We want to urge the Gauteng Department of Health to apply its mind seriously to this situation with a view to resolving it as soon as possible. As always, SAMA remains available to assist the department and doctors in arriving at this solution,” concludes Dr Coetzee.



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CCMDD: “The right medicine, for the right patient, in the right parcel, in the right place, at the right time.”

The Health Systems Trust reports that the Central Chronic Medicine Dispensing and Distribution (CCMDD) programme has alleviated an overburdened and under-resourced public health system, reports Lilita Gcwabe. “Because we serve such a large community, there would often be elderly patients having to arrive as early as 6AM in order to collect their medicine,” Dr. Dimakatso Letsie at the George Mukhari Academic Hospital.

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South Africa on high alert over new Covid-19 variants: Mkhize

Health minister Dr Zweli Mkhize says that South Africa is on high alert amid concerns that new Covid-19 variants could be imported into the country, which could lead to a spike in cases. In a statement on Tuesday evening (4 May), Mkhize said a number of passengers were found to be carrying different Covid-19 variants at South Africa’s ports of entry over the past week, and the health department is in talks with scientific advisors on how to limit the impact of these variants.


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WHO warns of new COVID-19 wave in Africa

BRAZZAVILLE - The World Health Organization on Thursday warned of a new wave of COVID-19 infections in Africa due to delayed vaccine supplies, a slow rollout and new variants. The African bureau of the UN agency said the continent had to catch up with the rest of the world in terms of vaccine rollouts. "The delay in the delivery of vaccine doses from the Serum Institute of India earmarked for Africa, the delay in the deployment of vaccines and the emergence of new variants means that the risk of a new wave of infections remains very high in Africa," it said in a statement.

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COVID-19: Gauteng in early stages of third wave

JOHANNESBURG - The third wave is upon us. That’s according to Gauteng premier David Makhura. The premier says while the province has sufficiently prepared for the wave, non-pharmaceutical methods are key to defeating the virus. Makhura has also expressed concern about the situation developing in India.

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India coronavirus cases top 20 million as US, Europe ease curbs

NEW DELHI - India's coronavirus caseload topped 20 million on Tuesday as it struggled to contain a huge outbreak, in stark contrast to gradual reopenings in the United States and Europe. Rapid immunisation programmes in wealthier nations have helped suppress outbreaks, and the European Union was even looking at allowing vaccinated foreign tourists into the bloc as early as next month.


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Crew member from quarantined ship hospitalised

DURBAN - A crew member aboard a vessel that came from India and docked in Durban has been taken to hospital. Fourteen crew members have tested positive for COVID-19 while another died of a heart attack. The Filipino vessel was on a 17-day direct sail from India and arrived at Durban harbour on Sunday..


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The South African Medical Association - Postal Address-The South African Medical Association P O Box 74789,Lynnwood Ridge Pretoria 0040, South Africa
Physical address The South African Medical Association, Block F Castle Walk Corporate Park Nossob Street Erasmuskloof Ext3 Pretoria 0181, South Africa

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