Healthcare Inequity - Covid-19 Vaccine Distribution in Palestine and Israel
1st Year MBBS, Islamabad Medical and Dental College
How do we decide who deserves healthcare facilities ﬁrst? With the Covid-19 pandemic affecting every human life these past few years, a prominent issue was highlighted by experts worldwide. Who receives the Covid-19 vaccine and when? Vaccine distribution plans became one of the most discussed topics while the pandemic was at its prime, with experts criticizing the evident inequity in healthcare. While the development of the Covid-19 vaccine was a medical breakthrough, combining solid medical research skills and global collaboration, it also gave rise to political strife caused by the aforementioned healthcare inequity. In 2021, almost eighteen months into the pandemic, approximately 1.5 billion vaccine doses had been administered in the world, however, from this, 75% of the vaccine supply had been distributed in 10 major countries.With its extremely sophisticated vaccination program, Israel took the lead as countries throughout the world hurried to immunize their citizens against COVID-19. However, this was not the case with Palestine. Israeli occupation came under ﬁre from the international community for failing to uphold its public health obligations to Palestinians as the country's occupying force because OPT residents were not covered by Israel's vaccination program. The statistics raised concerns about the region's larger health disparities by highlighting the considerable difference between the proportion of Israelis and Palestinians who had received vaccinations. 1
Inequity between Israel and Palestine vaccine distribution
According to Matthias Kennes, MSF Medical Advisor for Palestine, “You are over 60 times more likely to have a vaccination in Israel than in Palestine.” Palestinian citizens of Israel and Arab Israelis make up around 21% of Israel's total population, and these individuals, coupled with Palestinian individuals living in East Jerusalem, were all eligible for the vaccine, regardless of their nationality.4 Israeli authorities declared the start of their COVID-19 vaccination campaign on December 20, 2020 and Israeli Ministry of Health Director-General Chezy Levy said, "It is important for me to stress that we will vaccinate everyone, and there is nothing to worry about.,"the day before the campaign started. Levy made it clear that Israel's vaccination objective was for everyone to receive a vaccine in an effort to allay concerns about vaccine access. However, it became evident that Levy's usage of the term everyone did not include Palestinians residing in Israel's occupied territories as thousands of dosages were provided by Israeli medical personnel over the course of the following few weeks. Israeli authorities provided 14 million immunizations to their nine million citizens, but they did not uphold their legal obligation to vaccinate the 5.3 million Palestinians.5 Moreover, the Covid-19 vaccine roll-out plan also came under scrutiny for leaving out more than 2.8 million people—particularly those in the West Bank—who live between the Jordan River and the Mediterranean Sea. It had been controversially determined that approximately 5 million Palestinians who reside in Gaza and the West Bank were ineligible for this vaccine. 2
Intervention from Global Organizations
Following the Oslo Accords' signing by the Israeli government and the Palestinian Liberal Organization, the Palestinian Authority came into existence. The Progressive Alliance granted the Palestinians the ability to exercise self-governance and assume control over primary healthcare in the West Bank and Gaza. Furthermore, some contended that the Palestinian Authority alone should have been responsible for administering this vaccine to Palestinians. Yet, the provision of immunizations in the West Bank and Gaza could not be independently funded by Palestinian authority. Israel was required by international law to fully support them while they waited for initiatives like COVAX, run by the World Health Organization (WHO), to be fully functioning. With Israel not adhering to these rules, several activists then cited Article 56 of the Fourth Geneva Convention, “The Occupying Power has the duty of ensuring and maintaining, with the cooperation of national and the local authorities, the medical and hospital establishments and services, public health and hygiene in the occupied territory, with particular reference to the adoption and application of the prophylactic and preventive measures necessary to combat the spread of contagious diseases and epidemics.6 Activists from all over the world, including the United Nations, Amnesty International, and others, pleaded with Israeli authorities to assist the Palestinian population in receiving both their basic human rights and the necessary vaccinations to stop additional virus mutations. As of 2023, 71% of Israeli individuals have been able to receive the Covid-19 vaccine, whereas, only 38% of Palestinian individuals have been vaccinated against the Covid-19 pandemic.7 These numbers indicate that there are still discrepancies between the quality and quantity of healthcare being provided between the two states, and it is of ample importance that these differences be reduced as soon as possible. 3
- Torreele E, Amon JJ. Equitable COVID-19 vaccine access. Health and Human Rights. 2021 Jun;23(1):273.
- Tayara H. To what extent is the Israeli-Palestinian COVID-19 Vaccination Gap a Result of Medical and Structural Racism Generated by the Israeli Occupation? Journal of Intersectional Social Justice [Internet]. 2022 Aug 28; Available from: https://jisj.pubpub.org/pub/tayara-2022
- Kennes, Matthias. “The Stark Inequality of COVID-19 Vaccination between Israel and Palestine | MSF.” Médecins Sans Frontières (MSF) International, Msf, 22 Feb. 2021, https://www.msf.org/stark-inequality-covid-19-vaccination-between-israel-and-palestine.
- Howard N, Schneider E. COVID-19 Vaccination in Palestine/Israel: Citizenship, Capitalism, and the Logic of Elimination. Health and Human Rights. 2022 Dec 1;24(2):265-79
- N, Schneider E. COVID-19 Vaccination in Palestine/Israel: Citizenship, Capitalism, and the Logic of Elimination. Health and Human Rights. 2022 Dec 1;24(2):265-79.
- Treaties, States Parties and Commentaries, Protocol Additional to the Geneva Conventions of 12 August 1949, and relating to the Protection of Victims of International Armed Conﬂicts (Protocol I), 8 June 1977., Article 56 - Protection of works and installations containing dangerous forces, https://ihl-databases.icrc.org/en/ihl-treaties/api-1977/article-56#
- Mathieu, E., Ritchie, H., Ortiz-Ospina, E. et al. Aglobal database of COVID-19 vaccinations. Nat Hum Behav (2021)
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