Roles of public service and private stakeholders in the 2017-2018 listeriosis epidemic in South Africa: An ethical conjecture
DOI:
https://doi.org/10.5055/jem.0711Keywords:
ethics, consensus decision-making, etiology of inherited inequalitiesAbstract
The aim of this article is to carry a bioethical and a limited policy analysis on the progression and aftermath of the 2017-2018 listeriosis epidemic or disaster in South Africa. This links the context of the listeriosis epidemic/disaster to the overall public health systems, disaster medicine, and ethics in South Africa, with specific focus on standards of public service and private stakeholder conduct in the country. The public service angle is unpacked in terms the policy framework relevant to ethics and public health/disaster management. In addition, the process and ethical implications of the management, as well as the role of the various stakeholders, in the 2017-2018 listeriosis epidemic/disaster in South Africa are analyzed and reflected upon. Results of the current study indicate that actions of the public health officials and biomedical scientists, who investigated the listeriosis epidemic/disaster as public servants, were executed in line with the code of conduct of the public service in South Africa. The relevant public service legislation and ethical norms of the public service in South Africa were also adhered to. A slightly different approach was discovered in the conduct of the ready-to-eat (RTE) meat producer that had owned the factory, which was identified as the source of the listeriosis epidemic/disaster. The narrative of online resources indicates that there were many negative outcomes of the 2017-2018 listeriosis epidemic/disaster in South Africa. Those were stories about negative outcomes of the epidemic that impacted individuals, who were listeriosis sufferers. Their voices and their stories’ representation provide an important resource of data on the impacts on the complex disasters on the South African population. Novel approaches are proposed to address the challenges identified along the public–private goods continuum and approaches to food production and access to sources of dietary protein in South Africa.
References
Bateman C: No disasters yet, please—We’re catching up. S Afr Med J. 2008; 98(5): 344-348. Available at http://www.scielo.org.za/pdf/samj/v98n5/11.pdf. Accessed July 15, 2022.
Van Hoving DJ, Smith WP, Kramer EB, et al.: Haiti: The South African perspective. S Afr Med J. 2010; 100(8): 513-515. DOI: 10.7196/SAMJ.4258.
Bateman C: Emergency care doctors—Off-task and in the wrong places. S Afr Med J. 2014; 104(11): 725-727. DOI: 10.7196/SAMJ.8989.
Rogers AD, Price CE, Wallis LA, et al.: Emergency medicine: Burns disasters—A plan for South Africa. S Afr Med J. 2011; 101(1): 16-17. Available at http://www.scielo.org.za/pdf/samj/v101n1/v101n1a10.pdf. Accessed July 18, 2022.
Rode H, Millar AJW, Castle B, et al.: Issues in medicine: Ethical decision making in severe paediatric burn victims. S Afr Med J. 2011; 101(1): 17-19. DOI: 10.7196/samj.4250.
Bateman C: Izindaba: Gauteng’s disaster management clinicians outline world cup shortfalls. S Afr Med J. 2010; 100(4): 198-202. Available at http://www.samj.org.za/index.php/samj/article/view/4102. Accessed October 3, 2021.
National Disaster Management Centre of South Africa: INSARAG guidelines. 2016. Available at http://www.ndmc.gov.za/guidelines/forms/allitems.aspx. Accessed October 3, 2021.
National Disaster Management Centre of South Africa: Notice 488 of 2012: Department of Cooperative Governance and Traditional Affairs—Publication of the Urban SEARCH and Rescue Framework (draft for public comment). 2012. Available at http://www.ndmc.gov.za/Notices/COGTA-Publication%20of%20the%20Urban%20search%20and%20rescure%20framework%20(%20Gazette%2035427).pdf. Accessed October 3, 2021.
United Nations Office for Humanitarian Affairs (OCHA): IEC USAR-South Africa. Available at https://www.insarag.org/iec/news/478-iec-usar-south-africa and https://www.insarag.org/wp-content/uploads/2016/04/RSA_Approach_to_USAR_Capacity_Building_in_RSA_October_2015.pdf. Accessed October 3, 2021 and July 18, 2022.
United Nations Office for Humanitarian Affairs (OCHA): Insarag: Aeme contacts. Available at https://www.insarag.org/regional-groups/africa-europe-middle-east/africa-europe-middleeast-contacts/contacts-2/. Accessed October 3, 2021.
National Department of Health: National Health Act, 2003 (Act no. 61 of 2003): Regulations relating to emergency care at mass gathering events (regulation no. 566), Government Gazette no. 40919, Government Printing Works, Pretoria, South Africa. 2017. Available at https://www.gov.za/documents/national-health-act-regulations-emergency-care-mass-gathering-events-15-jun-2017-0000. Accessed July 18, 2022.
National Department of Health: National Health Act, 2003 (Act no. 61 of 2003): Emergency medical services regulations (regulation no. 1320), Government Gazette no. 41287, Government Printing Works, Pretoria, South Africa. 2017. Available at http://www.kznhealth.gov.za/mediarelease/2018/41287_gon1320.pdf. Accessed October 3, 2021.
Singh JA: COVID-19: Science and global health governance under attack. S Afr Med J. 2020; 110(6): 445-446. DOI: 10.7196/SAMJ.2020v110i5.14820.
Parker A, Karamchand S, Schrueder N, et al.: Healthcare delivery: Leadership and early strategic response to the SARSCoV-2 pandemic at a COVID-19 designated hospital in South Africa. S Afr Med J. 2020; 110(6). DOI: 10.7196/SAMJ.2020v110i6.14809.
Morens DM, Breman JG, Calisher CH, et al.: The origin of COVID-19 and why it matters. Am J Trop Med Hyg. 2020; 103(3): 955-959. DOI: 10.4269/ajtmh.20-0849.
Rulli MC, D’Odorico P, Galli N, et al.: Land use change and coronavirus emergence risk. 2020. DOI: 10.1101/2020.07.31.20166090. Available at https://www.medrxiv.org/content/10.1101/2020.07.31.20166090v1. Accessed October 3, 2021.
Simonsen KA, Snowden J: StatPerals: Smallpox (continuing education activity). 2021. Available at https://www.ncbi.nlm.nih.gov/books/NBK470418/. Accessed October 3, 2021.
Bulíková T, Dobiáš V, Hlavácˇková D, et al.: Disaster medicine, Osveta, Bratislava, Slovakia (in Slovak). 2011: 18-35.
Health Professions Council of South Africa: Ethical Guidelines for Good Practice in the Health Care Professions. Pretoria, South Africa: Health Professions Council of South Africa, 2016: 294, Booklet 16. Available at https://www.hpcsa.co.za/Uploads/Professional_Practice/Ethics_Booklet.pdf. Accessed October 3, 2021.
Avert.org: HIV and tuberculosis CO-infection programmes. 2019-2021. Available at https://www.avert.org/professionals/hivprogramming/hiv-tb-coinfection. Accessed October 11, 2021.
Vhiriri EP, Irwin Y, Laubscher RK, et al.: Legislation and policy analysis on management of listeriosis epidemic disaster in South Africa. Am J Disaster Med. 2020; 15(2): 113-128. DOI: 10.5055/ajdm.2020.0361.
Thomas J, Govender N, McCarthy KM, et al.: Outbreak of listeriosis in South Africa associated with processed meat. N Engl J Med. 2020; 382: 632-643. DOI: 10.1056/NEJMoa1907462.
Manganye P, Desai B, Daka M, et al.: Listeriosis in the city of Johannesburg, South Africa. Southern Afr J Public Health. 2018; 2(3): 55-58. Available at http://shsjournal.org/index.php/shsj/article/viewFile/63/38. Accessed July 18, 2022.
Centers for Disease Control and Prevention: Listeria (Listeriosis): Symptoms. Available at https://www.cdc.gov/listeria/symptoms.html. Accessed October 3, 2021.
Todd ECD, Notremans S: Surveillance of listeriosis and its causative pathogen, Listeria monocytogenes. Food Control. 2011; 22(9): 1484-1490. DOI: 10.1016/j.foodcont.2010.07.021.
Mbonane TP, Naiker N: Knowledge, attitude and practices of environmental health practitioners conducting food-borne disease outbreak investigation at a local municipality in Gauteng province, South Africa. Health SA. 2020; 25. Article number 1359. DOI: 10.4102/hsag.v25i0.1359.
Walt G, Gilson L: Reforming the health sector in developing countries: The central role of policy analysis (review article). Health Policy Plan. 1994; 9(4): 353-370. DOI: 10.1093/heapol/9.4.353.
Statutes of the Republic of South Africa—Constitutional Law (SRSACL): Constitution of the republic of South Africa no. 108 of 1996 (as amended). 1996-2003. Available at https://www.gov.za/sites/default/files/images/a108-96.pdf. Accessed October 3, 2021.
Tchatchouang C-DK, Fri J, De Santi M, et al.: Listeriosis outbreak in South Africa: A comparative analysis with previously reported cases worldwide. Microorganisms. 2020; 8(1): Article number 135. DOI: 10.3390/microorganisms8010135.
Department of Public Service and Administration: Public Services Act of 1994 as amended by Act no. 30 of 2007. Available at http://www.dpsa.gov.za/dpsa2g/documents/acts®ulations/psact1994/PublicServiceAct.pdf. Accessed October 3, 2021.
Public Service Commission of South Africa (PSCSA): Code of conduct for public servants. Published as Government Notice/Gazette: Regulation Gazette 5947, No. R. 825, on June 10, 1997. 1997-1999. Available at http://www.psc.gov.za/documents/code.asp. Accessed October 3, 2021.
Public Administration Management Act no. 11 of 2014: 2014. Available at http://www.dpsa.gov.za/dpsa2g/documents%5Cacts®ulations%5Cpamact2014%5CPAM%20Act2014.pdf. Accessed October 3, 2021.
Public Service Regulations: Conduct, financial disclosure, anti-corruption and ethics management part 1—Code of conduct. 2016. Available at http://www.dpsa.gov.za/dpsa2g/documents/acts®ulations/regulations2016/Public%20Service%20Regulations,%202016%20(effective%201%20August%202016).pdf. Accessed October 3, 2021.
National Health Laboratory Service Act no. 37 of 2000: Government Gazette Vol. 426, No. 1353, Cape Town, South Africa. 2000. Available at https://www.gov.za/sites/default/files/gcis_document/201409/a37-000.pdf. Accessed October 3, 2021.
Public Finance Management Act no. 1 of 1999 (PFMA): Chapter 1: Definitions. 1999. Available at http://www.treasury.gov.za/legislation/pfma/act.pdf. Accessed October 3, 2021.
National Institute of Communicable Diseases: Situation report on listeriosis outbreak South Africa. 2017. Available at https://www.nicd.ac.za/wp-content/uploads/2017/12/NICD-Situation-report-on-listeriosisoutbreak-South-Africa_20-December-2017.pdf. Accessed July 18, 2022.
National Institute of Communicable Diseases: Search results for: Listeriosis. 2017-2020. Available at https://www.nicd.ac.za/page/7/?s=listeriosis. Accessed October 3, 2021.
United States Department of Health and Human Services (HHS): The Belmont report office of the secretary ethical principles and guidelines for the protection of human subjects of research the national commission for the protection of human subjects of biomedical and behavioral research (summary). 1979-2020. Available at https://www.hhs.gov/ohrp/sites/default/files/the-belmont-report-508c_FINAL.pdf. Accessed October 3, 2021.
National Department of Health: Media statement by the Minister of Health Dr Aaron Motsoaledi on the outbreak of a food borne disease in South Africa. 2017. Available at https://www.hst.org.za/publications/Documents/Media%20statement%20-%20Outbreak%20of%20a%20food%20borne%20disease%20-%20Listeriosis%20in%20South%20Africa.pdf. Accessed October 3, 2021.
Department of Public Service and Administration: The Batho Pele vision: A better life for all South Africans by putting people first. Available at http://www.dpsa.gov.za/documents/Abridged%20BP%20programme%20July2014.pdf. Accessed October 3, 2021.
Wentink G, van Niekerk D: The capacity of personnel in disaster risk management in South African municipalities. J Transdiscipl Res Southern Afr. 13(1): a427. DOI: 10.4102/td.v13i1.427.
Marbaniang D: Philosophy of science: An introduction. Archived from (section 1.2.1.3). 2009. Available at www.geocities.com/rdsmarb and available through Google Books app on Google play.
Tompkin RB, Scott VN, Bernard DT, et al.: Guidelines to prevent post-processing contamination from Listeria monocytogenes. Dairy Food Environ Sanit. 1999; 19(8): 551-562. Available at https://www.foodprotection.org/upl/downloads/get-involved/committee-pdg/resources/dfes-article-tomkin-et-al--food-hygiene-&-sanitationprofessional-development-group.pdf. Accessed July 18, 2022.
Olanya OM, Hoshideb AK, Ijabadeniyic OA, et al.: Cost estimation of listeriosis (Listeria monocytogenes) occurrence in South Africa in 2017 and its food safety implications. Food Control. 2019; 102: 231-239. DOI: 10.1016/j.foodcont.2019.02.007.
Nkosi DV, Bekker JL, Hoffman LC: Factors affecting the registration of slaughter facilities as formal abattoirs in South Africa. J Consum Prot Food Saf. 2021; 16: 195-203. DOI: 10.1007/s00003-021-01337-x.
Child K, Gernetzky K: Tiger brands sells processed meat business to country bird. 2020. Available at https://www.businesslive.co.za/bd/companies/retail-and-consumer/2020-08-17-tiger-brandsto-sell-meat-businesses-for-r253m/#:~:text=Tiger%20Brands%20has%20sold%20its,termed%20a%20%E2%80%9Cgood%20price%E2%80%9D. Accessed July 18, 2022.
Maggs M: Executives ill prepared for reputational crises. 2020. Available at https://www.businesslive.co.za/redzone/newsinsights/2020-03-05-executives-ill-prepared-for-reputational-crises/. Accessed October 3, 2021.
Herd F, Kleyn N: Book extract: When crisis strikes—How tiger brands messed up when a simple apology could have worked. 2020. Available at https://www.dailymaverick.co.za/article/2020-05-05-how-tiger-brands-messed-up-when-a-simple-apology-could-haveworked/. Accessed July 18, 2022.
Witzel M: Maple leaf food’s response to a crisis. 2013. Available at https://www.ft.com/content/8c8d3668-adb5-11e2-82b8-00144feabdc0. Accessed October 3, 2021.
Tiger Brands: NEWS: Tiger brands enters into agreements for the sale of its value-added meat products (VAMP). Business, August 17, 2020. 2020. Available at https://www.tigerbrands.com/Global/Articles/Sale-of-Value-Added-Meat-Products. Accessed August 9, 2021.
Koo: Some of our cans are not worthy of our name. 2020-2021. Available at https://www.koo.co.za/Product-Recall. Accessed November 10, 2021.
Areff A: 20 Million Koo and Hugo’s canned products to be recalled. 2021. Available at https://www.news24.com/fin24/companies/20-million-koo-and-hugos-canned-products-to-be-recalled-20210726. Accessed November 10, 2021.
Food Safety News: Listeria outbreak survivor tells how illness changed perspective on life. 2020. Available at https://www.foodsafetynews.com/2020/02/listeria-outbreak-survivor-tells-how-illnesschanged-perspective-on-life/. Accessed July 18, 2022.
Ndebele N, Pierce T: Maverick citizen: Life after listeriosis: Photo essay. 2020. Available at https://www.dailymaverick.co.za/article/2020-01-28-life-after-listeriosis/. Accessed July 18, 2022.
Logically Fallacious: Fallacy of division. 2020. Available at https://www.logicallyfallacious.com/logicalfallacies/Fallacy-of-Division. Accessed October 22, 2021.
Britannica: Ecological fallacy. 2021. Available at https://www.britannica.com/science/ecological-fallacy. Accessed November 6, 2021.
Merriam-Webster: Fallacy of composition. 2021. Available at https://www.merriam-webster.com/dictionary/fallacy%20of%20composition. Accessed November 6, 2021.
De Noordhout CM, Devleesschauwer B, Angulo FJ, et al.: The global burden of listeriosis: A systematic review and meta-analysis. Lancet Infect Dis. 2014; 14(11): 1073-1082. DOI: 10.1016/S1473-3099(14)70870-9.
Witbooi PJ, Africa C, Christoffels A, et al.: A population model for the 2017/18 listeriosis outbreak in South Africa. PLoS One. 2020; 15(3): e0229901. DOI: 10.1371/journal.pone.0229901.
National Health Act no. 61 of 2003 as amended: Government Gazette vol. 469 no. 869, Cape Town, South Africa, June 2004. 2003-present. Available at https://cisp.cachefly.net/assets/articles/attachments/22019_a61-03.pdf. Accessed October 3, 2021.
Smith AM, Tau NP, Smouse SL, et al.: Outbreak of Listeria monocytogenes in South Africa, 2017-2018: Laboratory activities and experiences associated with whole-genome sequencing analysis of isolates. Foodborne Pathogen Dis. 2019; 16(7): 524-530. DOI: 10.1089/fpd.2018.2586.
National Agricultural Marketing Council: Food basket price monthly. 2017-2020. Available at http://www.namc.co.za/category/research-publications/publications/food-basket-price-monthly/. Accessed October 3, 2021.
Wendy Owens and Associates: Chapter 1: Introduction. In The Role and Significance of State Owned Enterprises, Public Entities and Other Public Bodies in the Promotion of Urban Growth and Development in South Africa. 2013. Available at https://www.cogta.gov.za/cgta_2016/wp-content/uploads/2016/05/IUDF-STATEOWNED-ENTEPRISES.pdf. Accessed July 18, 2022.
World Health Organisation (WHO): Listeriosis—South Africa: 2018—South Africa. 2018-2021. Available at https://www.who.int/emergencies/disease-outbreak-news/item/28-march-2018-listeriosissouth-africa-en. Accessed July 18, 2022.
Kopecká K: Ethics as a scientific discipline (Chapter 1). In Kopecká K, Jobbágyová D, Korcová M, et al. (eds): Healthcare Ethics. Bratislava, Slovakia: Osveta, 2008.
Sokol J: Jaký liberalizmus neboli jaká svoboda? (what liberalism, what freedom?). Vesmír. 2002; 81: 348-352.
Parliamentary Monitoring Group: Agriculture, land reform and rural development: Listeriosis outbreak and recall of certain products by retailers; with Ministers of Trade and Industry & Agriculture, Forestry and Fisheries. 2018. Available at https://pmg.org.za/committee-meeting/26087/. Accessed October 3, 2021.
Southwest Network for Environmental and Economic Justice (SNEEJ): Jemez principles for democratic organizing. 1997. Available at https://www.ejnet.org/ej/jemez.pdf. Accessed October 3, 2021.
APA-Dictionary: Availability heuristic. 2021. Available at https://dictionary.apa.org/availability-heuristic. Accessed November 6, 2021.
Health Professions Council of South Africa: Health professions council of South Africa: Guidelines for good practice in the health care professions general ethical guidelines for health researchers (booklet 13). 2017. Available at https://www.hpcsa.co.za/Uploads/Professional_Practice/Conduct%20%26%20Ethics/Booklet%2013%20Gen%20Ethical%20Guidelines%20for%20Health%20Researchers.pdf. Accessed October 3, 2021.
Seeds for Change: Consensus decision making. Available at https://www.seedsforchange.org.uk/consensus and https://codeofgoodpractice.com/wp-content/uploads/2019/05/Seeds-for-Change-Consensus-Decision-Making-2.pdf. Accessed October 3, 2021 and July 18, 2022.
Kayode AJ, Okoh AI: Incidence and genetic diversity of multidrug resistant Listeria monocytogenes isolates recovered from fruits and vegetables in the Eastern Cape province, South Africa. Int J Food Microbiol. 2022; 363: 109513. DOI: 10.1016/j.ijfoodmicro.2021.109513.
Downloads
Published
How to Cite
Issue
Section
License
Copyright 2007-2023, Weston Medical Publishing, LLC and Journal of Emergency Management. All Rights Reserved
