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Inside StoryPandemic has hit new heights in West Bank and Gaza

As world scrambles for COVID-19 vaccines, Palestinians pin hopes on WHO program

UN-backed initiative Covax is set to provide 20% of Palestinians’ inoculations for free, but the timeline is uncertain — and the rest of the needed shots are up in the air

Palestinian students affiliated with the United Nations "UNRWA" wear face masks amid the coronavirus pandemic, in Rafah, in the south of the Gaza Strip, on November 25, 2020. (Abed Rahim Khatib/Flash90)
Palestinian students affiliated with the United Nations "UNRWA" wear face masks amid the coronavirus pandemic, in Rafah, in the south of the Gaza Strip, on November 25, 2020. (Abed Rahim Khatib/Flash90)

As countries compete for vaccines to combat the novel coronavirus, the Palestinian Authority have applied for a UN program that would provide and fund 20 percent of the total doses needed — but the delivery is likely months away, and no deals have been closed to secure the remaining doses.

Covax, a joint initiative of the World Health Organization and GAVI, an international vaccine organization, aims to deliver two billion doses of various coronavirus vaccines around the world by the end of 2021. The Palestinians are among some 90 applicants for the free shots.

“We’re going to get 20% of our vaccines for free, from Covax. We’ve signed an agreement with them, guaranteeing it, and everything’s in order,” Palestinian Authority Health Minister Mai al-Kaila said in an interview with Palestine TV on Tuesday.

But many other details about the Palestinian coronavirus response have not yet been made public, as the first vaccines are poised to arrive in Israel in the coming days and weeks, promising an end to the acute phase of the nearly year-long pandemic.

Palestinian Authority Health Minister Mai al-Kaila announces a surge in coronavirus cases in Hebron on June 17, 2020. (Courtesy: Wafa)

Prime Minister Benjamin Netanyahu said last month that Israel had signed a deal with Pfizer to purchase eight million doses of its vaccine, enough to inoculate four million Israelis. Israel has also signed an agreement with Moderna which would provide six million doses — enough for an additional three million Israelis.

The pandemic in both the West Bank and Gaza, meanwhile, has reached unprecedented levels of severity. Both Palestinian areas have put partial lockdowns in place as the number of cases has surged to record highs — with 10,091 active infections in Gaza and 14,894 in the West Bank.

Around 36.3% of coronavirus tests came back positive in the Gaza Strip on Sunday, indicating that large numbers of cases could be going undetected.

The Ramallah-based Palestinian Authority will be responsible for purchasing the vaccine for its citizens and distributing it to both the West Bank and Gaza. A Hamas health official contacted for comment on the subject said that Gaza health authorities were waiting for instructions from the PA going forward.

A woman walks past a mural encouraging the wearing of face masks amid the coronavirus pandemic, on the main road of Nusseirat refugee camp, central Gaza Strip, Tuesday, November 24, 2020. Arabic reads: “Protect yourself, together we protect the old.” (AP/Adel Hana)

But vaccines are expensive — despite international assistance, the World Bank expects the PA to run a $760 million deficit this year — and competition with wealthier nations is fierce. For Ramallah, one solution has been to apply for Covax, which seeks to provide free shots for low-income countries that would otherwise be unable to afford them.

But the distribution of those doses could still be months away. Covax’s selection of vaccines includes the AstraZenaca vaccine, but not the Pfizer vaccine, which is expected to arrive well in advance. Clinical errors have laid obstacles to the AstraZenaca vaccine’s approval.

Moreover, the Palestinians will not be the program’s priority. The Covax doses are expected to be distributed proportionally between all 91 participating countries as supplies become available. According to WHO documentation, each country will receive shipments in tranches: An initial 3% of vaccines so as to inoculate first responders, followed by additional stages as all countries –slowly — progress together toward the 20% limit.

After one-fifth of the population is inoculated, the free doses run out. Countries will be able to purchase subsidized doses through the program, depending on when and how many doses are available.

According to al-Kaila, medical responders will receive priority access to vaccines as they arrive, followed by members of the Palestinian security services and those deemed to be in at-risk groups.

“According to Covax guidelines, the first priority ought to go to medical first responders. We told them that we wanted to also prioritize the security services who work alongside us in the field, the elderly, pregnant women, and the chronically ill,” al-Kaila said.

Given that Israel controls almost every port of entry into and out of Palestinian areas, intensive coordination between all players will be essential to ensure that the vaccine can be transferred quickly and effectively to health providers in Gaza and the West Bank, said WHO envoy to the Palestinians Gerald Rockenschaub.

The Pfizer vaccines require storage at -70° C (-94° F) and doses must be used within five days of their removal from cold storage. Moderna’s candidate, on the other hand, can be kept at around -20° C (-4° F). The AstraZeneca vaccine — the preferred candidate of the world’s less-developed nations — can be kept at normal fridge temperatures.

“With the Israelis, we’re discussing a fast-track mechanism once a shipment arrives so that it can pass customs and clearance. Cooling facilities need to be available, at Ben Gurion Airport and in Israeli facilities, to make sure that we don’t run into substantial obstacles once a vaccine becomes available,” said Rockenschaub, listing some of the challenges.

Gerald Rockenschaub, the head of the World Health Organization’s mission to the Palestinians, addressing an event in the Gaza Strip on November 29, 2016. (Screenshot: World Health Organization)

While the Israeli government has announced several deals between Jerusalem and various companies, the PA has yet to articulate a public plan for how it hopes to acquire enough vaccines to inoculate the rest of its population against the virus.

Al-Kaila suggested that the PA could continue purchasing subsidized vaccines from Covax beyond the free ones they hope to receive, but that it was yet to be finalized.

“The price through Covax will be far lower and allow us to purchase enormous quantities and there have been calls between us and the World Health Organization. All this is under consideration, and it’s far better than going to purchase on one’s own,” al-Kaila said. “We’re not America, which can just cough up the money.”

According to al-Kaila, the PA seeks to provide enough vaccines to inoculate 70% of its population, which she said would be enough to create so-called “herd immunity.”

“We’re also in touch with Russia, as well, with regards to the Russian vaccine,” al-Kaila added, referring to a controversial, unproven vaccine championed by the Russian government.

PA President Mahmoud Abbas remarked in a televised speech late last Thursday night that Ramallah had come to agreements to purchase “vaccines in large quantities,” but no sources contacted by The Times of Israel had been given details of the purchase. It was unclear whether the president was referring to the Covax vaccines or to other sources of inoculation.

A spokesperson for the Palestinian presidency could not be reached for additional comment.

Palestinian students affiliated with the United Nations “UNRWA” wear face masks amid the coronavirus pandemic, in Rafah, south of the Gaza Strip, on November 25, 2020. (Abed Rahim Khatib/Flash90)

While rumors flew in the Israeli media that the Israeli government was planning on procuring millions of vaccines for the Palestinians, The Times of Israel could not find a single source who could confirm the report.

Israeli officials have repeatedly said that they see averting a public health disaster in the West Bank and Gaza as a key security interest. The Israeli security apparatus believes that an implosion of the Palestinian health sector could lead to rising tensions with Israel, The Times of Israel reported in November.

Israelis and Palestinians are also intertwined in their daily lives, with tens of thousands of people regularly moving between Israeli and PA areas. Both Israeli and Palestinian health officials have traded accusations that the other side was exporting cases into their territories since the beginning of the pandemic.

“If they do acquire vaccines for us, it won’t be out of love for the Palestinians or to preserve the health of the Palestinian people,” PA Health Ministry Executive Director Dr. Osama al-Najjar commented in a phone call. “They would do it because we both live in the same place. There’s an enormous degree of overlap in work, in daily life. Israel doesn’t want the pandemic to continue to rage in a place which overlaps with it.”

An Israeli security official indicated during a briefing with reporters last week that coordination on vaccines had been delayed due to a prolonged crisis between the PA and Israel. In May, Abbas announced that he was severing ties with Israel in protest of an Israeli plan to annex parts of the West Bank in accordance with US President Donald Trump’s controversial peace plan.

The annexation plan was officially shelved in mid-August due to Israel’s normalization accord with the United Arab Emirates, but Ramallah did not officially renew ties until US President-elect Joe Biden’s victory over Trump in the November elections.

“First we need to create a dialogue, and this is something which hasn’t happened,” the Israeli official told reporters last week, later adding: “We are still waiting for the Palestinian Authority to engage us in this matter. When they will engage us, we will start any process that will assist them.”

PA official Hussein al-Sheikh announced in late November that coordination between the two sides would resume from where it left off in May, with a situation approaching full coordination resuming at the end of last week.

Pressed on whether Israeli willingness to assist the Palestinians meant a willingness to sell some of the vaccines it acquired to the PA, the Israeli security official repeated, without elaborating: “No, willing to assist them [means] willing to have a dialogue with them.”

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