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EF: Could you share with us the Role of B4SA?

MK: I serve as VP and Deputy Chair on the board of BUSA (Business Unity SA). Last year, at our board meeting, we concluded that it was inevitable that the pandemic would hit South Africa. As the country’s apex business association, we agreed upon the need to have an integrated and coordinated response to combat the pandemic’s impact and to work closely with with the government and other social partners. To ensure that we could operate as nimbly and flexibly as possible, we created a virtual platform called Business for South Africa (B4SA) with the Black Business Council. BUSA sponsored it at the beginning, and the Black Business Council joined in the middle of March last year. We co-opted people onto the platform whether they were part of formal business structures or not, based on their ability to add value. On the 26th of March of 2020, South Africa went into hard lockdown for five weeks. During the two weeks previous to the lockdown, we assembled the critical elements for B4SA, opting for three primary pillars of activity: 

  1. A healthcare platform – Its primary but not exclusive goal was to bring PPE and other critical medical supplies into the country. At the time there was no PPE in the country. 
  2. A labour market platform, similar to a ‘furlough system’ as many other countries used. We put in place structures to provide some level of support to businesses and individuals who were temporarily rendered incapable of working due to the pandemic. By the end of last year, working with our social partners (government, labour and civil society) we had paid out R60 billion to more than six million people.
  3. An economic intervention platform, which I chaired, with two primary areas of focus: a) engaging with government on finding ways to protect the economy from the pandemic including determining lock down levels and practical mechanisms to apply lock downs, b) work on devising a post-Covid accelerated economic recovery strategy for the country. When the pandemic arrived, we were already in a recession and about to be downgraded to sub- investment grade as an investment destination. This accelerated economic recovery strategy, covering the short, medium and long term, has been a critical input into the government’s reconstruction recovery program. 

In addition, B4SA covered other support aspects; we had a team that gave legal advice, a group that gave communications support, a team that looked at risk and a team that engaged with the community at large. We had about 450 people on this platform. Most of them had never met each other before, let alone worked together. We all worked together virtually, and the mantra was to forget egos, sharp elbows and personal and institutional brands, and work together on a pro bono basis for B4SA. This was unprecedented; it was the first time businesses large and small, black and white, formal and informal, domestic and international across all sectors had collaborated to formulate a strategic economic vision for the country. The work is carrying on today, housed in BUSA, and together with Cas Coovadia, we are driving it from BUSA and with the government. We took the result from the healthcare platform, packaged up the IP, and handed it to the National Department of Health. The labour market platform did its job in helping people get temporary unemployment support. Toward the end of last year, we realised there would be a second Covid wave, something that none of us had initially thought. Little did we know that many countries, including South Africa, would be caught on the back foot by the second wave. With the second wave came the awareness that we didn’t have a vaccination program in place, and in December of last year, we started working on that. This year, we refocused the organisation on implementing the vaccination rollout strategy. It’s a public-private partnership with the government working across five key disciplines: 1. Procuring the vaccine, 2. Ensuring logistics and supply chain are intact, 3. Ensuring the vaccine financing and payment mechanism of the vaccines, 4. Establishing sites in place in public and private sectors to vaccinate as many people as quickly as possible, and 5. Communication, stakeholder engagement and advocacy workstream. These five workstreams have been working 24/7 for the past four months or so on an integrated basis with the government and overseen by the Director-General, the most senior civil servant in the Department of Health where I have led the business involvement. We meet twice a week now, and we are accelerating the process across the country, intensifying the rollout program, and moving through the age bands very quickly. 

EF: How did you get companies to join quickly, and how could other countries do something similar?

MK: As far as we know, no other country in the world has done what we have done here, with the private sector being an integral part of the rollout program. In the UK, the vaccination is run, administered, overseen and implemented by the public sector with limited if any private sector involvement. In South Africa, it is much more sophisticated: i) we have a history of social compacting in South Africa, which is hard-wired into the regulation and legislation of consultation between government, business, labour and civil society, and there is a formal structure established in 1994-5 through an organisation called NEDLAC (National Economic Development and Labour Council). ii). Before the lockdown, we all thought it was a Wuhan problem. It became an Italian problem, and then it started spreading through Europe and the United States. All we would hear about was the spread: the numbers of the people dying, the struggle to get PPE and overburdened hospitals, something that hasn’t changed, but the world’s attention has moved on.

Our first case was detected on the 10th of March, and we knew it was a question of time before it spread throughout South Africa. The business community was very involved in social dialogue, and BUSA had significant convening power. A group of us spent time mobilising people with the time and skills to join B4SA. We identified the three essential workstreams: healthcare, labour and economic interventions and provided the necessary support. We recognized the needed to bring in specialist skills to deliver the project management backbone for the organisation, so we approached the management consulting arms of the big four accounting firms: Deloitte, KPMG, EY and PWC – all competitors – and asked them to assemble an integrated project management office, which they did. We had five or six physical meetings before we went into lockdown and everything after that was virtual. At the same time, industry and government together conceived the Solidarity Fund, which was completely independent of both government and business, and accountable to society at large, and which raised around R3.3 billion in a month. Again we mobilized specialist skills to work  pro bono for a year. There was an extraordinarily strong sentiment of solidarity in the Fund, which motivated and still motivates many people. It has an unprecedented structure, there isn’t a single piece of paper that explains how decisions are taken, but they were born and driven by the architects of an economic blueprint for the country motivated from sentiment and patriotism because we all want the government to succeed. We knew the significant challenges that needed to be addressed, and if we didn’t act, they would be magnified. Hence, and when we developed some momentum, it snowballed. The initial two or three weeks were crucial to assemble the leaders. There were many leaders in this process – not egos, but leaders – and as a result, we attracted a lot of talent, subject matter experts, and people who wanted to get involved. Because we had already established the systems with the project management office, it became easier for everybody to operate. 

EF: What do you think will be the future for B4SA in 2022?

MK: B4SA was a single purpose vehicle exclusively related to the pandemic. We were specific from the start that if there was ongoing work to be done in the economic recovery strategy, it needed to be put in the permanent structure of BUSA. Our only focus now is the vaccination rollout program, and I think we have broken the back of the problem after five challenging months with all the early-stage issues addressed, and we are now fine-tuning how to optimise the process. Today, our most significant issue is getting people vaccinated, not because of vaccine hesitancy, but due to logistical and practical constraints. Next week we will be vaccinating three hundred thousand people a day. Our target is four hundred thousand, of which 50% will be from a private sector platform and 50% from the public sector platforms working on an integrated basis. We think the 4th wave will arrive in November, and we are not through the third wave yet, but now we all understand better how the virus works, and we need to vaccinate the majority of our adult population by the end of the year. I see us plateauing in terms of intensity, and then we move on in care and maintenance. B4SA is a great brand and a great story, but put in place for a very particular reason and not for any ongoing reason. 

EF: How did you measure your impact? 

MK: In our case, because we have no structure, therefore we have no KPIs to measure our impact. In vaccination, the KPI is obvious, vaccinate as many people as quickly as possible and meet our quite aggressive targets in ambitious time frames. There are many disciplines involved, and we work in seemingly irrelevant areas relative to expertise or experience. We established an innovation platform with a lot of very well-intentioned people working on it. Still, my sense was it needed to be professionalised with a competent leader. Hence, I approached a friend, Chris Griffith, who was the chief executive of the biggest platinum company in the world after a long dynamic career in the mining industry. I persuaded him to take over and run the innovation platform whose primary and almost exclusive focus was to see to what extent we could localise the manufacture of PPE because, like most countries, we were importing from China when it is pretty simple to manufacture if the systems are in place. By the time Chris finished six months later, we were churning out PPE in South Africa. He didn’t have prior experience in PPE, but he had management experience and was highly committed. 

One of the two most affected sectors in South Africa has been tourism, which has been shut down to all intents and purposes. It is a very significant employer and generator of foreign exchange. The other most affected industry is the liquor industry, from farming and vineyards to manufacturing to restaurants and liquor outlets and bars. There are over a million people who operate in the liquor industry and it has been significantly affected by the lockdowns because the government decided it needed to restrict activity because it contributes to pressure on the healthcare system through alcohol-related trauma such as violence, gender-based violence, traffic accidents, etc. which overload the healthcare system. The consequence of closing the industry has been that the government has forfeited a considerable amount of tax – 90% of the sale of every bottle is tax duties – and an illicit sector has been established. We think now that about 50% of the industry in South Africa doesn’t play by the rules or pay taxes. South Africa’s three most significant problems are poverty, unemployment, and inequality. According to the GINI formula, to put that in context, we are an unequal society in the world. We are more unequal in 2021 than in 1994, which means poverty levels have grown, as has inequality. Unemployment of the adult population stands at 44%, and two-thirds of the youth do not have a job – a ticking time bomb – and the only way to deal with it is through inclusive economic growth. Still, when confronted by a pandemic, inclusive economic growth isn’t an option. Covid is part of the integrated challenge that must be addressed. The future prosperity of a small or large business depends on the macroeconomic stability and the potential of the country, so it is in our self-interest to have a thriving, inclusive economy: otherwise, there is no business. The president has been open, honest, and public that we have significant capacity constraints in the public sector. We must harness and utilise the skills and experience appropriately, and B4SA has been an excellent example of doing so. It can act as a template or a model for other forms of cooperation into the future. 

EF: When tackling healthcare, what would be the first thing you would aim to fix in South Africa?

MK: Historically, the private sector has been quite insular, seeing the government more as a client than as a partner, which is a big difference. There have been high levels of suspicion as to the motives of the healthcare sector, particularly the private healthcare sector, insofar as the vast majority of the country doesn’t have medical insurance or access to private healthcare. There are long-standing concerns that pharmaceutical companies were gouging profits at the expense of impoverished countries, and this we know has been the narrative. Secondly, the government’s lack ofcapacity at a national and provincial level in a crisis gets amplified, so we see today how challenged parts of the system have become. Thirdly, the country’s economic policy is in part orientated to what I would characterise as a developmental state or agenda, including national health. In South Africa, we don’t have an effective national health system. There is a significant focus on the NHI (National Health Insurance), which is fine if we can afford it as a country, have the capacity to implement and can ensure that it is equitable to all relevant stakeholders. My view is that there has not been the level of collaboration there might be. I refer to private providers of healthcare and medical scheme companies, which is not unique to the healthcare industry. The pandemic has amplified South African problems, showing up enormous healthcare challenges disproportionate to other parts of the world that have repositioned the industry in the eyes of the public to be a vital sector of the economy. We need to provide the requisite assurance that we have a functional, efficient, equitable healthcare industry, but our work has demonstrated this is not the case so far. 

EF: Is there any final message you would like to share in the healthcare sector?

MK: It has been an extraordinary privilege to be associated with repositioning what collaboration is about. When I look back and see what was achieved in the space of six to eight months with the vaccination program or in the last eighteen months in the context of the overall lifespan of B4SA, it is a great credit to all the people concerned. 

August 2021
South Africa