Ramallah, occupied West Bank – Prime Minister Benjamin Netanyahu received a coronavirus vaccine on December 19, kicking off a nationwide rollout that has made Israel the world leader in the COVID-19 vaccination campaign.
But if Israel’s vaccination campaign includes even Jewish settlers living deep in the illegally occupied West Bank, it will exclude the nearly five million Palestinians living under occupation there or in the stranded Gaza Strip.
They will have to wait until the cash-strapped Palestinian Authority (PA), which administers parts of the West Bank under interim peace agreements signed in the 1990s, delivers the blows.
The Palestinian Health Ministry expects the first batches of AstraZeneca COVID-19 vaccine to arrive in the occupied West Bank and Gaza in early March, more than two months after Israel began its deployment.
“We have just signed an agreement with AstraZeneca to obtain two million doses,” May al-Kaila, the Palestinian Minister of Health, told Al Jazeera.
The two million doses of Oxford-AstraZeneca would only be enough to inoculate a million people.
The vaccination will be free and voluntary. Each dose will cost the PA around $ 5, which works out to around $ 10 million.
More than 148,100 Palestinians have so far tested positive for the coronavirus, and more than 1,610 COVID-19-related deaths have been reported in the West Bank and Gaza since the start of the pandemic.
But with infections soaring, many Palestinians living in the occupied territories cannot afford to wait until March. New daily infections in the West Bank and Gaza have consistently exceeded 1,000 over the past month. In the second half of December, the number of cases detected daily averaged nearly 1,500, a threefold increase from July 2020.
‘We are a poor country’
The PA also expects to receive vaccines from COVAX – a global collaboration of the World Health Organization, the European Commission and France – which has pledged to provide COVID-19 vaccines to 92 countries to “low and middle income” in response to the pandemic.
“COVAX is going to provide us with 20 percent of our incremental vaccine needs,” Yaser Bouzieh, a senior official in the Palestinian health ministry, told Al Jazeera.
COVAX shipments are also expected in early March.
Despite being cash-strapped and competing for access to many countries, the Palestinian health ministry said it has also contacted six vaccine manufacturers: Pfizer, Moderna, Oxford-AstraZeneca, the Russian Sputnik V, Johnson & Johnson and Chinese Sinovac.
The Health Ministry requested the vaccine from all six but only received a response from AstraZeneca. “We are a poor country but we are trying to protect people by all means,” al-Kaila said.
For now, health officials plan to vaccinate around two million Palestinians by May. Front-line workers and the elderly will be a priority.
According to the Ministry of Health, nearly 40 percent of the Palestinian population is under the age of 18. This large demographic of young people should provide some relief to health officials, as young people are much less likely to be severely affected by COVID-19.
But if vaccines are delayed, it would mean more deaths as well as more lockdowns and economic suffering. The pandemic has virtually crippled the economy and strained an already vulnerable health system.
Numerous general and partial closures have been imposed in the West Bank and Gaza since March last year.
According to the Palestinian Central Bureau of Statistics, the unemployment rate in Palestine rose to 28.5% in the third quarter of 2020, up almost 4% from the same period in 2019.
Even under such pressure, the pandemic has forced the Palestinian health system to find a way to thrive.
Since the start of the pandemic, five new hospitals have been opened in the West Bank. These were to open as general hospitals, but had to be re-designated to provide care for patients with COVID-19.
The Department of Health does not foresee any difficulties in deploying the vaccine, especially with AstraZeneca as it only requires a storage temperature of 2 to 8 degrees Celsius (35.6 to 46.4 degrees Fahrenheit).
But there are doubts.
“The scale required to vaccinate people in a significant amount of time is enormous,” Dr Robin Abu Ghazaleh, a virologist at the Polytechnic University of Palestine, told Al Jazeera.
Acquiring the Pfizer vaccine would speed up vaccinations, but this would pose challenges as it must be stored at minus 80 ° C (-112F), but the Department of Health has the capacity to store only about 150,000 doses at that time.
“We only have two [suitable] freezers throughout [West Bank]Al-Kaila said.
The challenges of Gaza
Nearly 2,000 new health workers were trained and employed in the West Bank last year. They include lab technicians, doctors and respiratory specialists, al-Kaila said.
But in Gaza, under a blockade imposed by Israel and Egypt since 2007, the situation is more critical.
“Every day without a vaccine means more infections, more people admitted to hospitals, more deaths and high costs,” Majdi Dheir, a senior health ministry official in Gaza, told Al Jazeera.
Dheir said that in December, an average of 240 patients per day were admitted to the ICU. “In January, the figures are better, they have fallen to 135 per day.”
He added that Gaza has five freezers suitable for handling the Pfizer vaccine. “I hope donor and friendly countries will provide us with the vaccine very soon, because it is the lifeline for our exhausted and besieged people,” he said.
“The health infrastructure here is strained, the medical teams are under great pressure.”
Dheir said Israel was obliged to help the besieged enclave. “Israel has the responsibility of providing us with the vaccine, they are the occupying power.”
The vaccines will arrive first at Israeli airports before being transferred to the occupied Palestinian territories, making delays a real possibility.
Ghassan Nimer, PA spokesperson for the Interior Ministry, told Al Jazeera: “We are still anticipating complications on the Israeli side. It is certainly possible, they control the borders.
Israel ‘ignores its obligations’
Israel began rolling out the Pfizer vaccine on December 23, and in less than three weeks it has successfully vaccinated more than 1.5 million of its citizens, including settlers in the West Bank. Palestinian residents of East Jerusalem are also eligible for the vaccine.
Netanyahu recently said Israel expected to vaccinate all of its citizens over the age of 16 by the end of March. “We will be the first country in the world to emerge from the coronavirus,” he boasted.
But the Israeli coordinator of government activities in the occupied Palestinian territories, COGAT, told Al Jazeera that tackling COVID-19 in the West Bank and acquiring vaccines was the PA’s obligation under the Oslo accords.
COGAT also said Israel had allowed the entry into the West Bank of medical equipment donated by the international community, including “thousands of test kits, protective items, face masks”, and even coordinated “a joint training for Israeli and Palestinian medical teams “.
“It is important to mention that Israel has not refused any request for medical assistance that arrived at its doorstep.”
Israeli Minister of Public Security Amir Ohana ordered the Israeli prison service not to vaccinate Palestinian prisoners in Israeli jails.
According to the prisoners’ rights group Addameer, there are 4,400 Palestinian prisoners in Israeli jails, including 160 children detained, 440 in administrative detention and 37 women.
The argument that the Oslo accords exempt Israel from providing medical care to Palestinians is false, according to some human rights activists.
“Sixty percent of the West Bank is under full Israeli control,” Francesca Albanese, lawyer and international author, told Al Jazeera.
“Israel is under an obligation to protect the Palestinian population from the virus, this means planning the vaccination of Palestinians without discrimination,” she added.
Amnesty International also called on Israel to “stop ignoring its obligations as an occupying power”.
“Israel’s COVID-19 vaccination program highlights the institutionalized discrimination that defines the Israeli government’s policy towards Palestinians,” the rights group said in a statement.