The role of modelling and analytics in South African COVID-19 planning and budgeting

The consortium developed several tools in response to the needs of decision makers in the different stages of the epidemic, allowing the South African government to plan several months ahead. The SACMC's tools included epidemic projection models, several cost and budget impact models, and online dashboards to help government and the public visualise projections, track case development, and forecast hospital admissions. Information on new variants, including Delta and Omicron, were incorporated in real time to allow the shifting of scarce resources when necessary. The models were regularly updated to reflect the changing policy priorities over the course of the epidemic, the availability of new data from South African data systems, and the evolving response to COVID-19 in South Africa. The updates took into account the changing lockdown levels and ensuing mobility and contact rates, testing and contact tracing strategies, and hospitalisation criteria. The models also incorporated notions of behavioural heterogeneity and behavioural responses to observed changes in mortality. The SACMC's models supported national and provincial government to plan several months ahead, expand hospital capacity when needed, allocate budgets, and procure additional resources where possible. Across four waves of COVID-19 cases, the SACMC continued to serve the planning needs of the government, tracking waves and supporting the national vaccine rollout. The SACMC is a group of researchers from academic, non-profit, and government institutions across South Africa. Established in late March 2020 by the National Department of Health (NDOH), its mandate is to provide, assess, and validate model projections to be used for planning purposes by the Government of South Africa. The SACMC's work is coordinated by the South African National Institute for Communicable Diseases (NICD), which maintains the datasets used by the SACMC's models. The SACMC convenes experts across a range of disciplines to provide insights, guide the selection of appropriate parameter values, ensure a close alignment to current clinical practice, and sense-check model outputs. Since its establishment in March 2020, the SACMC has provided policy-driven modelling and analytics support in response to the evolving priorities of decision makers across the different stages of the epidemic. The SACMC's tools supported the South African government at national and provincial levels to conduct timely resource planning, shift scarce resources, and implement appropriate public health and social measures (PHSM). The SACMC's work is supported by various funding agencies, including the American People and the President's Emergency Plan for AIDS Relief (PEPFAR) through the United States Agency for International Development (USAID), the Wellcome Trust, the Clinton Health Access Initiative, and the Bill & Melinda Gates Foundation. The SACMC's models were used to inform the public and a range of decision makers, including the Ministerial Advisory Committee on COVID-19 (MAC) advising the Minister of Health, staff in the NDOH and National Treasury, officials in the provincial departments of health, and the private health sector. The SACMC's work has been critical in supporting the South African government's response to the COVID-19 pandemic, particularly in the areas of resource planning, hospital capacity expansion, and vaccine rollout.