Equal access to COVID-19 vaccines: Who is responsible in the occupied Palestinian territory?

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Today Medical Aid for Palestinians (MAP) has released a position paper calling for rapid, comprehensive and equitable access to vaccines in the occupied Palestinian territory (oPt).

position paper front coverWhile Israel is rolling out one of the fastest vaccination programmes in the world, almost five million Palestinians living under its 53-year military occupation are being left behind. The impact of perpetual military occupation and blockade mean that the local Palestinian health system does not have the financial or material resources required to sustain COVID-19 response long-term, nor to implement a rapid and comprehensive vaccination programme for the population.

MAP’s position paper, Equal access to COVID-19 vaccines: who is responsible in the occupied Palestinian territory?, provides an overview of the dire COVID-19 context in Palestine; an analysis of the international legal responsibilities of Israel, the Palestinian authorities and international community with regards to Palestinian access to COVID-19 vaccines; and recommendations for action from governments like the UK to address the situation.

The paper has been published amid news that Israel will deliver several thousand COVID-19 vaccines to the West Bank, but continues to refuse to accept its legal duty as an occupying power to ensure rapid, comprehensive and equitable vaccination coverage for the entire population of the oPt.  

Reacting to the news, MAP CEO Dr Aimee Shalan said:

“While these limited supplies will mean that vaccinations can finally begin in the West Bank and Gaza, they fall well short of meeting the needs of the millions of Palestinians whose lives continue to be devastated by the pandemic.

Reliance on donations and aid will inevitably lead to a Palestinian vaccination programme that is piecemeal, incoherent, and glacially slow. Israel’s duties extend far beyond humanitarian gestures: as the occupying power it is obligated to ensure that the entire population of occupied Palestine can access a vaccination programme that is rapid, equitable, and comprehensive.”

You can read a summary of our position paper below. You can also take action on this issue by signing our petition demanding fair access to COVID-19 vaccines for Palestinians. 

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Equal access to COVID-19 vaccines: Who is responsible in the occupied Palestinian territory?

Overview

The COVID-19 situation in the occupied Palestinian territory (oPt) is dire. The impact of perpetual military occupation and blockade mean that the local Palestinian health system does not have the financial or material resources it needs to sustain COVID-19 response long-term.

With the COVID-19 pandemic set to become a multi-year crisis, only a programme of mass vaccination can sustainably relieve the pressures on the Palestinian health system and prevent further avoidable loss of life, spiralling poverty and deeper health inequalities.

Israel leads the world in per-capita vaccinations, with more than a quarter of its population having received at least one dose by late January, including those residing in illegal settlements in the West Bank. Yet almost five million Palestinians living under Israel’s 53-year military occupation in the West Bank and Gaza are excluded.

The Palestinian Authority has applied to the global COVAX facility, though any such support will only cover up to 20% of its population and may take weeks or months to arrive. The Palestinian Ministry of Health has issued an interim national vaccination plan detailing how it intends to roll-out support from COVAX, though with further supplies yet to be agreed it remains unclear how a rapid and comprehensive  programme of vaccination for Palestinians can be realistically implemented in the oPt. The chronic financial crisis and resource and infrastructure limitations of the Palestinian Authority and de facto authorities in Gaza, caused in large part by decades of occupation and blockade, severely hamper their ability to purchase and administer vaccines for the population.

The ultimate responsibility for ensuring Palestinians in the West Bank and Gaza can access vaccines remains with Israel as an occupying power. Articles 55 and 56 of the Fourth Geneva Convention impose on Israel a duty to provide healthcare goods where local resources are insufficient, and to adopt “prophylactic and preventive measures necessary to combat the spread of contagious diseases and epidemics.” As UN human rights experts have recently outlined, the Oslo Interim Accords, signed in 1995, do not exempt Israel from these duties. Moreover, Israel’s responsibilities to uphold Palestinians’ right to health do not diminish with time; they are heightened by the prolonged nature of its military occupation.

Emerging disparities in vaccine access and resources are set to drive up existing health inequalities between Israelis – including settlers living in the West Bank – and Palestinians who live under Israel’s military control. The current situation with regards to vaccine access is indicative of decades of structural discrimination against Palestinians and the systematic neglect of their rights to health and dignity that has characterised the policies and practices of Israel’s military occupation. It also reflects a persistent failure on the part of the international community to hold Israel to account for its violations of Palestinians’ right to health.

A situation in which most Israelis are vaccinated but not their Palestinian neighbours would lead inevitably to deeper restrictions to Palestinians’ freedom of movement, further restricted access to work, healthcare and livelihoods, and a spiralling humanitarian crisis in the West Bank and Gaza. Palestinians must be ensured fair, rapid and equitable access to vaccines that meet the same standards as the Israeli population and the World Health Organization.

As WHO Chief Dr Tedros Adhanom Ghebreyesus has said, ensuring equitable vaccine access is “not just a moral imperative, but a strategic and economic imperative” and failure to do so will “only prolong the pandemic, the restrictions needed to contain it, and human and economic suffering.”

Recommendations

The international community, including the UK government, must play their part in enabling Palestinians to access a comprehensive coronavirus vaccination programme through the following actions:

1. Urgently take all necessary measures to guarantee Israel respects its duty as an occupying power to ensure Palestinians in the occupied Palestinian territory have fair, rapid and equitable access to coronavirus vaccines by:

a. Immediately offering financial or other resources required by the Palestinian Authority necessary to procure stocks of vaccines of sufficient quality and quantity to cover the population of the West Bank and Gaza, to the extent that local resources are insufficient

b. Immediately offering financial or other resources required by the Palestinian Authority necessary to implement safe and effective ‘cold chain’ transport, storage and administration of vaccines in the West Bank and Gaza, to the extent that local resources are insufficient

c. Ensuring the timely import of vaccines and all equipment needed to implement immunisation programmes and combat the COVID-19 pandemic in the occupied Palestinian territory

d. Immediately ending its violations of international law that undermine the capacity of the Palestinian healthcare system to respond to the COVID-19 pandemic, including the illegal closure of Gaza and blanket restrictions on the free movement of patients and health workers.

2. Publicly monitor Israel’s compliance with its obligations under international humanitarian and human rights law in this regard and support international initiatives to promote accountability where these are not met.

3. Urge the Palestinian Authority to take all feasible steps, insofar as it is able within the constraints and financial limitations created by the occupation, to enable all people across the West Bank and Gaza to access coronavirus vaccines by:

a. Working with Israel, the international community, COVAX and the de facto authorities in Gaza to continue to develop its National Deployment and Vaccination Plan, ensuring it is fair, rapid and comprehensive, and identifying gaps in financial and other necessary resources  for implementation

b. Coordinating the implementation of this vaccination programme across the West Bank and Gaza, without discrimination, and with prioritisation for the most vulnerable individuals

c. Providing accurate public health information relating to vaccines across the West Bank and Gaza, as outlined in the National Deployment and Vaccination Plan, and ensure that this is accessible to people with disabilities.

4. Support the Palestinian Ministry of Health to implement a fair, rapid and comprehensive vaccination programme, respond to humanitarian needs created by COVID-19, and build back better after the pandemic by:

a. Urgently providing technical, economic, and humanitarian cooperation and assistance to help address the direct and indirect humanitarian impacts of the pandemic in the occupied Palestinian territory

b. Immediately facilitating access to essential COVID-19 healthcare supplies, including vaccines

c. In the long term, placing the principle of self-determination at the core of foreign and aid policies regarding the Palestinian people by supporting the sustainable development of healthcare and other institutions; ensuring Palestinians are meaningfully consulted in the development of aid initiatives; and tackling chronic impunity for violations of international law in the occupied Palestinian territory.

Read MAP’s position paper

To read a joint statement from 29 Israeli, Palestinian and international health and human rights organisations – including MAP – calling for equitable access to vaccines in the oPt click here.

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