With infections surging, COVID-19 has exacerbated the Palestinian enclave’s already dire living conditions in 2020.
Ramallah, occupied West Bank – Prime Minister Benjamin Netanyahu received a coronavirus vaccine jab on December 19, kicking off a national roll-out that has made Israel the world’s COVID-19 vaccination drive leader.
But while Israel’s vaccination campaign even includes Jewish settlers living deep inside the illegally occupied West Bank, it will exclude the nearly five million Palestinians living under occupation there or in the blockaded Gaza Strip.
They will have to wait for the cash-strapped Palestinian Authority (PA), which administers parts of the West Bank under interim peace agreements signed in the 1990s, to provide the jabs.
The Palestinian health ministry expects the first batches of the AstraZeneca COVID-19 vaccine to arrive in the occupied West Bank and Gaza at the beginning of March, more than two months after Israel began its roll-out.
“We have just signed a deal with AstraZeneca to get two million doses,” May al-Kaila, the Palestinian health minister, told Al Jazeera.
The two million doses from Oxford-AstraZeneca would only be enough to inoculate one million people.
The vaccination is going to be free of charge and voluntary. Each dose will cost the PA about $5, making the deal worth about $10m.
More than 148,100 Palestinians have so far tested positive for 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 surging, many Palestinians living in the occupied territories cannot afford to wait until March. New daily infections in the West Bank and Gaza have consistently surpassed 1,000 in the past month. In the second half of December, the number of daily detected cases averaged almost 1,500 – a threefold increase from July 2020.
The PA is also expecting 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 “low and middle income” countries in response to the pandemic.
“COVAX is going to supply us with 20 percent of our vaccine requirements in increments,” Yaser Bouzieh, a senior official at the Palestinian health ministry, told Al Jazeera.
COVAX shipments are also expected in early March.
Though cash-strapped and competing for access with many countries, the Palestinian health ministry said it has also reached out to six vaccine manufacturers: Pfizer, Moderna, Oxford-AstraZeneca, the Russian Sputnik V, Johnson & Johnson, and China’s 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.
At the moment, health officials expect to vaccinate about two million Palestinians by May. Front-line workers and senior citizens will be a priority.
According to the Ministry of Health, nearly 40 percent of the Palestinian population is below 18. This large youth demographic should provide some relief to health officials since younger people are much less likely to suffer severely from COVID-19.
But if the vaccines are delayed, it would mean more deaths as well as more lockdowns and economic pain. The pandemic has brought the economy to a near standstill and put an already vulnerable health system under strain.
Numerous general and partial lockdowns have been imposed in the West Bank and Gaza since March of last year.
According to the Palestinian Central Bureau of Statistics, the unemployment rate in Palestine increased to 28.5 percent in the third quarter of 2020, up by nearly 4 percent from the same period in 2019.
Even under so much strain, the pandemic has forced the Palestinian health system to find a way to expand.
Since the onset of the pandemic, five new hospitals have been opened in the West Bank. These were slated to open as general hospitals but had to be redesignated to provide care for COVID-19 patients.
The Ministry of Health does not anticipate difficulties in rolling out the vaccine, especially with AstraZeneca as it only requires a storage temperature of 2-8 degrees Celsius (35.6-46.4 degrees Fahrenheit).
But there are doubts.
“The scale required for vaccinating people in a meaningful amount of time is huge,” Dr Robin Abu Ghazaleh, a virologist at the Palestine Polytechnic University, told Al Jazeera.
Acquiring the Pfizer vaccine would speed up vaccinations, but it would pose challenges as it must be stored at minus 80C (-112F), but the health ministry only has the capacity to stock about 150,000 doses at a time.
“We have only two [suitable] freezers in the whole of the [West Bank],” al-Kaila said.
Nearly 2,000 new healthcare workers have been trained and employed in the West Bank in the last year. They include lab technicians, doctors, and respiratory specialists, al-Kaila said.
But in Gaza, under an Israeli and Egyptian-imposed blockade since 2007, the situation is more critical.
“Each day without the 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 in December an average 240 patients a day were admitted to the ICU. “In January, the numbers are better, they dropped to 135 per day.”
He added Gaza has five freezers suitable to handle the Pfizer vaccine. “My hope is that donor and friendly countries supply us with the vaccine very soon because this is the lifeline for our people who are exhausted and under siege,” he said.
“The health infrastructure here is strained, the medical teams are under big pressure.”
Dheir said Israel is obliged to help the beleaguered enclave. “Israel has a responsibility to provide 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, the spokesman for the PA’s interior ministry, told Al Jazeera: “We always anticipate complications from the Israeli side. It is certainly possible, they control the borders.”
Israel began rolling out the Pfizer vaccine on December 23 and in less than three weeks managed to vaccinate more than 1.5 million of its citizens, including settlers in the West Bank. Palestinian East Jerusalem residents are also entitled to the vaccine.
Netanyahu recently said Israel expected to vaccinate all its citizens above 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 Israel’s coordinator of government activities in the occupied Palestinian territories, COGAT, told Al Jazeera that fighting COVID-19 in the West Bank and acquiring vaccines is the PA’s obligation under the Oslo Accords.
COGAT also said Israel had allowed the entry of medical equipment into the West Bank donated by the international community, including “thousands of test kits, protective items, face masks”, and even coordinated “joint training for Israeli and Palestinian medical teams”.
“It’s important to mention that Israel has not denied any request for medical assistance that has reached its doorstep.”
The Israeli public security minister, Amir Ohana, has instructed the Israel prison service not to vaccinate Palestinian prisoners inside Israeli jails.
According to prisoner rights group Addameer, there are 4,400 Palestinian prisoners in Israeli jails, including 160 child inmates, 440 in administrative detention, and 37 female prisoners.
The argument that the Oslo Accords exempt Israel from providing medical care to Palestinians is wrong, according to some human rights advocates.
“Sixty percent of the West Bank is under full Israeli control,” Francesca Albanese, an international lawyer and author, told Al Jazeera.
“Israel is under the obligation to protect the Palestinian population from the virus, this means planning for the Palestinians to be vaccinated without discrimination,” she added.
Amnesty International also called on Israel to “stop ignoring its obligations as an occupying power”.
“Israel’s COVID-19 vaccine programme highlights the institutionalised discrimination that defines the Israeli government’s policy towards Palestinians,” the rights group said in a statement.