Israel's vaccine success unleashes a debate on Palestinian inequities

Israel quickly became the world leader in vaccinating its population against COVID-19, but almost all Palestinian residents of the occupied West Bank are still waiting for their first doses of the inoculation.

That disparity has set off a roiling debate about Israel’s responsibilities as an occupying power in one of the world’s most protracted territorial feuds.

To Israel’s critics, international law obligates Israel to give Palestinians access to vaccines comparable to what it offers its own citizens. But supporters of Israel’s policies contend that the Palestinians assumed responsibility for health services for their population when they signed the Oslo Accords in the 1990s.

While the Palestinians’ glaring vulnerability to the virus lessened somewhat this week — the Palestinian Authority officially launched a vaccination campaign by giving front-line medical workers doses received from Israel — the contrast with Israel remains striking. The disparity also reflects in part the stark inequality in access to vaccines between rich countries like Israel and other areas of the developing world.

The Palestinian vaccine campaign still lags far behind that of Israel, which with a population of about 9.2 million has already inoculated more than 3.3 million people with a first dose. They include a substantial percentage of the roughly 450,000 settlers living alongside Palestinians in the West Bank, who number between 2.5 million and 3 million.

It remains unclear precisely when the roughly 2 million Palestinians in the Gaza Strip, the blockaded enclave controlled by the militant anti-Israel group Hamas, will begin to receive vaccinations.

For the small number of Palestinian doctors and nurses who received vaccines Wednesday, it was a moment of relief.

“Praise God, I feel great,” said Ayman Abu Daoud, 49, a nurse based in Bethlehem who has been administering coronavirus tests over the past 11 months. “The vaccines are giving us hope we will overcome the pandemic, but we still have a long way to go.”

Abu Daoud was one of 100 front-line medical workers in the Bethlehem region — where the first Palestinian cases in the West Bank were discovered — to receive vaccines Wednesday and Thursday, local health officials said. Dozens of other front-line health workers in the Bethlehem area were still awaiting shots, they said.

Bassil Bawatneh, director of an eye hospital near Ramallah that has been transformed into a coronavirus treatment center, called the vaccination of medical teams “a very crucial step.”

The Palestinians received their first substantial shipment of vaccines Monday when Israel gave the Palestinian Authority 2,000 Moderna doses — a measure the Israeli government approved after public health experts had recommended it. Israeli officials said they intend to hand over an additional 3,000 doses.

On Tuesday, the Health Ministry of the Palestinian Authority said the vaccination campaign would initially target front-line health workers and then expand to people older than 60 as well as those who suffer chronic illnesses.

The Palestinians received 10,000 doses of Russia’s Sputnik V vaccine Thursday. They expect to receive 37,440 Pfizer doses in February and hundreds of thousands of AstraZeneca doses in either late February or early March through the global-sharing initiative COVAX, according to Gerald Rockenschaub, head of the World Health Organization’s mission to the Palestinians. An additional 2 million doses of AstraZeneca are slated to arrive throughout March, Palestinian officials said.

The Palestinian Authority’s health minister, Mai al-Kaila, had said vaccines would be transferred to Gaza on Wednesday, but Israeli security officials said that the Palestinians had not submitted a formal request for permission to send vaccines there. Any request would require Israeli government approval, the officials said.

The launch of the vaccination campaign in the West Bank followed a fiery disagreement between supporters of the Israelis and Palestinians about whether Israel bears responsibility to vaccinate Palestinians.

Human rights advocates have argued that Israel is obligated under international law to provide Palestinians with access to vaccines on par with what it makes available to its own citizens. Some also argue that Israel has a moral imperative to do so as a military occupier with the means to help.

Advocates have pointed to the Fourth Geneva Convention, which states occupying powers hold a duty to ensure the public health of people living under occupation to “the fullest extent” possible, especially with regard to combating epidemics and diseases.

“After 50 years of occupation with no end in sight, Israel’s duties go beyond offering spare doses,” said Omar Shakir, Human Rights Watch director for Israel and Palestine, referring to the vaccine vials Israel delivered to the Palestinians on Monday.

Shakir emphasized that Israel must provide vaccines to the Palestinians irrespective of efforts by the Palestinian Authority to secure them independently and said it was unjustified to afford settlers greater access to vaccines than their Palestinian neighbors.

But Israeli officials have said that while Israel has an interest in ensuring the vaccination of Palestinians, many of them laborers who frequently come into contact with Israelis, it has no legal responsibility to do so.

“We want everyone in the area to be vaccinated, but the Palestinian Authority is the party responsible for providing for the health of Palestinians,” said Yoav Kish, Israel’s deputy health minister. “Our responsibility is to vaccinate our own population,” he said, noting that Israeli health care providers were inoculating Arab citizens of Israel and Palestinian residents of East Jerusalem.

The Oslo Accords, interim agreements between Israel and the Palestine Liberation Organization, stated that the Palestinians would take on responsibilities for health in the West Bank and Gaza, but they also mentioned that Israel and the Palestinians should cooperate in fighting epidemics and contagious diseases.

Defenders of Israel’s policies have argued that Israeli officials moved more quickly than their Palestinian counterparts in securing deals for vaccines.

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The Palestinian Authority did not initially lead public calls for Israel to vaccinate Palestinians.

Ahmad Majdalani, the minister of social development, said the Palestinians did not publicly demand that Israel give them vaccines at first because they thought they would obtain what they needed through international donations, contacts with pharmaceutical companies and private discussions with Israeli officials.

When it became clear their strategy was not producing immediate results, Majdalani said they decided to start issuing statements demanding Israel fulfill its “international duty” by providing vaccines.

Last week, Nabil Abu Rudeineh, a spokesman for Palestinian Authority President Mahmoud Abbas, said international law requires Israel to provide vaccines to the Palestinians, but that Palestinians were still working “to find every path to find whatever vaccine possible — whether it is English or Russian or Chinese.”

Ghassan Khatib, a political scientist at Birzeit University, argued that the Palestinians initially refrained from publicly calling on Israel to give them vaccines because they were loath to sound “self-contradictory,” seeking to obtain them independently while simultaneously ceding responsibility to Israel.

Hussein al-Sheikh, the main Palestinian official in charge of coordinating with the Israelis, said the Palestinians asked Israel for up to 10,000 doses in late December.

Israeli officials said that in addition to the thousands of vaccines Israel transferred to the Palestinians this week, it also delivered 200 doses in January to the Palestinians, but al-Sheikh denied that.