SANDF defends acquisition of interferon drug from Cuba


The South African National Defence Force (SANDF) has issued a statement defending its controversial acquisition of Heberon, meant to treat COVID-19, from Cuba, following renewed criticism that it could have compromised 40% of the R200 million shipment due to improper storage.

Defence and Military Veterans Minister Nosiviwe Mapisa-Nqakula was on 27 January scheduled to brief the media “to clarify matters related to the medication acquired by the South African National Defence Force,” but the briefing was cancelled.

A statement was subsequently issued on 28 January by Defence Corporate Communication on behalf of the Military Command following a meeting to deliberate on the matter. Military Command is the highest decision-making body in the SANDF, headed by the Chief of the SANDF General Solly Shoke and consisting of the heads of the Air Force, Army, Navy, Military Health Service, Joint Operations, and Defence Intelligence.

“Over the last four months a lot has been reported and written about the Interferon alfa-2b or the Heberon alfa R, since the South African National Defence Force acquired the medication from Cuba on emergency basis following the outbreak of COVID-19 in March 2020. There has since been a great interest in the drug and its efficacy as an immune-modulator in mitigation of COVID-19 complications including death and need for hospitalisation,” the statement read.

The SANDF said it embarked on extensive consultations with fraternal militaries including the Chinese and Cuban militaries to see what was available to mitigate against soldiers being compromised in their frontline duties. “Objective data shows that more than 8 000 subjects in Cuba, Pakistan, Iran, Ukraine, Brazil and others have safely benefited from Heberon use. Furthermore other western countries followed suit.”

Darren Olivier, defence expert and Director at African Defence Review, said the statement is “an arrogant, ignorant, remorseless, and tone-deaf response that proves the SANDF’s top brass have learnt nothing from this debacle,” and said the claim Heberon is beneficial “is false, there are no peer-reviewed studies showing any beneficial effect of Heberon in treating COVID-19. No country has adopted it for large-scale use for that purpose.”

The statement continued: “It should be placed on record that the SANDF communicated with the Cuban military and in these exploratory talks. It was revealed that the use of Interferon alfa-2b as an immune-modulator in the management of COVID-19 was beneficial to patients who had tested positive and those who have been in close contact with a positive person. In fact evidence is mounting that countries that use Heberon have lower mortality rates due to COVID-19.”

“Again, this is false,” Olivier states. “No peer-reviewed study has found any benefit from Heberon, in fact the opposite is true: Proper studies on it have found no benefit. There’s a reason we leave decisions on medicine approval to SAHPRA [South African Health Products Regulatory Authority]: They know how to read the reports of efficacy studies.”

According to the SANDF, “The drug was not procured for wholesale and distribution but for the sole use by members of the SANDF who were employed to assist the country in managing the pandemic. It should be mentioned that Interferon is not a vaccine and does not treat COVID-19 pneumonia among hospitalised patients, but it confers heightened protection against COVID-19 as the SARS-2 Corona Virus is known to attack natural interferons of the victim.”

Olivier counters that, “Once again the SANDF’s commanders make a medical claim without any justification or an understanding of the actual mechanism. All interferons are not equal, and while interferon-beta has shown limited promise interferon-alfa has shown none.”

According to the statement, “This pro-active approach by the SANDF was informed by the generally accepted understanding, that the military is the last line of defence in all countries. Defence forces around the world are well known for their medical research for protecting their own forces and results of that research has had beneficial impact on the wider society just like other technologies that have been developed by the military. The SANDF is no exception.”

“What this paragraph doesn’t tell you is that the Military Health Service did not want Heberon,” Olivier states. “Major-General Lesley Ford, the Chief Director for Military Health Service Support, said as much in a memo to the SANDF’s senior commanders.”

This memo was leaked in October last year. It states: “The drug is not SAHPRA approved for use within RSA. A post facto application has been made to SAHPRA for the first batch of Interferon subsequent to the receipt in the depot [but has] seemingly not been granted to date”.

The SANDF paid R34 million for 135 000 doses of the drug, with R182 million to be paid later. According to Ford’s memo, the payment could have been deliberately made against an “incorrect expenditure classification to avoid detection”.

The imported drug could not be used because the defence force did not make the necessary applications before procuring the drug. The procurement was not captured on the SAMHS inventory, he said, and was done without following due process.

The South African Military Health Service applied for Section 21 for the use of the drug to SAHPRA and received approval on 5 October 2020 – months after acquiring the drug.

The statement concludes by saying, “as the Military Command, we want to put it on record that the Surgeon-General is the only authority for medical force protection in the SANDF during war time and peace time. The health and lives of our soldiers is of paramount importance.”

Olivier believes the final paragraph is a cop out, and misleading. “Not only are the Surgeon General’s powers not unlimited and immune from national laws on medication, but as Maj-Gen Ford’s statements show this procurement wasn’t done through the Military Health Service or at their request.”

Olivier points out that the statement makes no mention of the potential spoilage of 40% of the shipment. According to a December Auditor General report: “The department [of Defence] did not monitor and evaluate the transportation of the shipments according to SAHPRA’s post-importation guidelines…As a result, approximately 387 000 (39.8%) of the 970 895 vials were exposed to temperatures outside of the required range (temperature as well as duration) during transportation and/or warehousing.”

The Auditor General also found that none of the regular SANDF or SAHPRA procedures were followed. The medication wasn’t assigned inventory numbers, it wasn’t tracked, the SANDF could not provide invoices, airway bills, manifests, etc., and it was misclassified on the financial system.

Olivier believes the Interferon saga and the “misrepresentation of the facts” by the SANDF “is completely unacceptable” and called for resignations by the SANDF Chief and any others involved. “It cannot be acceptable for the SANDF to reject the findings of the Attorney-General in this way,” he stated.

“After all, it’s clear that we can’t trust the SANDF to investigate itself, because the culprits appear to be its most senior commanders. So those resignations must be accompanied by a wide-ranging investigation by an outside team. We can’t allow this to happen again.”