Israel is refusing to provide Palestinians with Covid-19 vaccine in the occupied territories where it controls every aspect of their lives. This is in addition to helping to destroy the Palestinian health sector, especially in the Gaza Strip, with bombs and blockades.
At least one vaccine dose is being provided to more than two million Israeli citizens, including the 600,000 settlers who live illegally on occupied Palestinian land. The Palestinians, though, are yet to receive any vaccine.
"Israel has a legal responsibility to provide us with the vaccine," insisted Dr Majdi Dheir, Deputy Director-General of Primary Health Care at the Ministry of Health in Gaza, when I spoke to him. "It is, after all, the occupying power in practice and according to international law."
The occupying state has, though, failed to support the Palestinians from the very start of the pandemic. "It is not helping or supporting the devastated healthcare system in Gaza in any way. Israel is nowhere to be found on the ground."
Except, that is, in tanks and other military vehicles enforcing the near 14-year siege on the territory. Not only does Israel place severe restrictions on medicines and medical equipment entering Gaze, but it also limits the amount of fuel allowed in for the sole power station. Israeli bombs destroyed the power station, and the materials needed for essential repairs are also blocked from entry. Hospitals have to rely on "emergency" generators, and they break down regularly from overuse. Even before the pandemic, the healthcare system was on the verge of collapse. It hasn't got any better.
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The Palestinian Ministry of Health in Gaza reported almost 47,000 Covid-19 cases and 464 deaths by the beginning of this month. "We are working hard and doing the best we can here," explained Dr Dheir, "but hundreds of workers are in self-isolation due to possible exposure, and pregnant workers and those with underlying health issues face extra difficulties."
In the early days of the pandemic, the authorities closed Gaza's borders. The limited number of people allowed to enter were required to isolate in specially-built quarantine centres for three weeks.
The latest lockdown with nightly curfews was announced from early December. Schools, universities, kindergartens and mosques remain closed.
"Even though we have implemented lockdowns for the past five weeks and closed supermarkets, schools and mosques after six in the evenings, the whole population is suffering," said the doctor.
On top of all of this, the oppressive siege has shattered Gaza's economy. Unemployment is at a record high. Poverty rates are rising, with 85 per cent of the Palestinians in the territory on or below the official poverty line. Seventy per cent of the people are food insecure. And, as the senior public health official confirmed, mental health is an additional issue for Gaza's already stretched healthcare sector to contend with.
More than two million Palestinians live in Gaza. The territory is overcrowded, so lockdowns and social distancing, even where possible, are never going to be effective. That's the simple reality. Without the vaccine, more Covid-19 cases will be recorded, and more lockdowns and restrictive measures will be necessary. It is a vicious, deadly cycle.
"Ultimately," Dr Dheir pointed out, "if Israel continues to deny us the vaccine, then it will be responsible for even more Palestinian deaths."
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The Netanyahu government has rejected a request by the World Health Organisation and the Palestinian Authority to provide up to 10,000 vaccine doses for Palestinian healthcare workers. There is no legal or moral justification for this decision. The Fourth Geneva Convention of 1949 asserts that an Occupying Power has the "duty of ensuring and maintaining the medical and hospital establishments and services" with "particular reference" to taking the "preventive measures necessary to combat the spread of contagious diseases and epidemics."
Having anticipated that Israel will not share its vaccine supply any time soon, the Palestinians are turning to a WHO-led partnership called Covax, aimed at helping poorer countries. Vaccine enough for 20 per cent of the Palestinians in the occupied territories has been pledged by the partnership.
"We are trying our best in coordination with the Palestinian Minister of Health in the West Bank to offer the vaccine doses," noted Dr Dheir. "We expect them to arrive from the WHO programme by the end of February." The Ministry also expects the first batches of the AstraZeneca Covid-19 vaccine to arrive at the beginning of March. A priority list is being prepared, with healthcare workers, the elderly and patients with chronic diseases at the top.
Dr Dheir, however, drew my attention to the potential for delay in the arrival of the vaccines. All, he said, will have to be reviewed by Israeli regulators, who have previously blocked the import of unapproved drugs. That as much as anything demonstrates that Israel is still the occupying power in control of the borders, and thus with a legal duty to provide healthcare for those living under its occupation.
At the end of our discussion, Dr Dheir made an appeal to the international community. "The world needs to understand that Gaza cannot continue like this. Gaza needs help." Ending the blockade and getting Israel to fulfil its legal obligations would be a good place to start.
The views expressed in this article belong to the author and do not necessarily reflect the editorial policy of Middle East Monitor.