Earlier this week it was reported that the Israeli government had approved a campaign to vaccinate Palestinian laborers working in Israel and in West Bank settlements. This decision came days after reports that Israel had pledged at least twice as many doses of its surplus supply of vaccines to allied countries as it had to Palestinians living in Gaza and the West Bank.
The effort to vaccinate Palestinian laborers is welcome news, but it is not sufficient. As part of the public health community, we call on the Israeli government to take responsibility and assure the vaccination of all Palestinians. We demand that any excess supply of coronavirus vaccines is prioritized for Palestinians.
We do not argue this imperative on legal or political grounds (such arguments necessitating Israeli government to assume responsibility, as per the Geneva Convention and the Oslo Accords, have been argued elsewhere).
Instead, our demand is unequivocally justified by the urgency of the public health emergency in the West Bank and Gaza, as well by public health ethics.
COVID-19 cases are surging in Gaza and the West Bank with 2,236 fatalities in these regions (including East Jerusalem) and 16,000 active cases as of the beginning of this week. To combat the surge in COVID-19 cases and the current strain on intensive care units, the Palestinian Authority announced tighter lockdown restrictions in the West Bank including nightly curfews, a continued ban on social gatherings, and enforced movement restrictions.
However, the public health situation in Gaza and the West Bank is only getting worse. Providing Palestinians with vaccinations is thus a public health imperative.
Previous studies have demonstrated that Israel, Gaza, and the West Bank act as one epidemiological unit whereby infectious diseases in one region can result in cross-border infections and disease transmission. Trends in Covid-19 mortality and morbidity for Israel, Gaza, and the West Bank follow similar trajectories and appear to be influenced by each one’s closures with 2-3 weeks lags.
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Israeli government officials should not assume that Israel is safe despite its current success in vaccinating its own population.
Cross border transmission along with the emergence of new variants and continued high rates of infections in certain Israeli populations, ensure that the pandemic is not going to end in the immediate future without a joint public health response. Failing to respond to the crisis in Gaza and the West Bank will make it more difficult to return to normal in the entire area and stop the rise in infections.
Even prior to the pandemic, Palestinians experienced substantial health issues. A report by the Director-General for the World Health Organization found that Palestinians in Gaza and West Bank have higher rates of mental health disorders, noncommunicable diseases, infant mortality, and lower life expectancy. Palestinians are also exposed to higher rates of violence and injuries related to the Israeli occupation and conflict.
Lack of access to clean water and poor sanitation are particularly bad in Gaza and contribute to these inequities as does the high rate of poverty and economic deprivation along with crippling healthcare systems.
The pandemic has made these disparities even more visible, yet many will likely be exacerbated without a coordinated public health response.
Compared to Gaza and the West Bank, Israel has a well-resourced public health system, including COVID-19 testing services, epidemiological surveillance operations, and advanced healthcare delivery settings.
It is in Israel’s own best interest to deploy its public health infrastructure to address the pandemic in Gaza and the West Bank. Vaccine nationalism, as described by the World Health Organization, occurs when wealthy countries sign vaccine aggreements with pharmaceutical compaies for their own populations, often limiting the available vaccines for less wealthy nations.
This hurts everyone and threatens the international community's collective ability to suppress the virus worldwide: in the WHO’s words, "The virus will not be eliminated anywhere…if it is not eliminated everywhere."
The coronavirus does not respect international or political boundaries. While collaboration between the regions has been challenging, particularly following Israel’s talk of annexation, it remains achievable.
Israel is leading the world right now in vaccinating its population. There is no public health justification or moral argument for not providing vaccines to Palestinians. As this region continues to battle the pandemic as well as faces future public health emergencies, particularly those spawned by the effects of climate change, a joint public health response between Israel, Gaza, and the West Bank remains critical.
This starts with Israel providing vaccines to Palestinians. Yet this should not stop with just vaccination efforts. There is a long tradition of collaboration between Israelis and Palestinians, especially on public health issues.
Initiatives such as the Middle East Consortium on Infectious Disease Surveillance (MECIDS) were established to enhance the capabilities for early infectious disease detection, control, and response between its member countries of Israel, Jordan and the Palestinian Territory. Many Palestinian public health practitioners studied with Israeli colleagues.
While we need to enhance and revive these initiatives from the bottom-up, we also must address the social, economic, and political determinants of health embedded across Israel, Gaza, and the West Bank. This includes the effects that the occupation and conflict have on the population. Only then can we fully protect the health and wellbeing of all the people of this region.
Joseph Bruch is a Ph.D. candidate in Population Health Sciences at Harvard University. He studies social epidemiology and his research focuses on the effects of financial systems and policies on population health. Twitter: @Joe_Bruch
Professor Nadav Davidovitch is Director of the School of Public Health at Ben-Gurion University of the Negev. He serves on the Israel national COVID-19 advisory committee.