Pfizer CEO Albert Bourla does not update his Twitter account very often, but he sent out a celebratory tweet last week after inking a deal with Israel.

“Pfizer and governments around the world are working on longer-term pandemic preparedness. Today we signed our first 2022 government agreement with Israel to supply millions of doses of the Pfizer-BioNTech COVID-19 vaccine with the option to purchase millions of additional doses,” he tweeted.

Reactions were quick to come. Many of them focused on one issue – the Palestinians’ vaccine situation in comparison to that of Israel.

“‘Israel’ wants to ensure that all settlers are vaccinated while Palestinians have to wait;” “The Israeli occupation must provide the vaccine to the Palestinians in accordance with international law”;

“Although ‘Israel’ has been praised for its swift vaccine rollout, it has not provided Palestinians in the occupied West Bank access to the vaccine” were some of these responses.

These claims regarding Bourla and Israel should surprise no one.

Far removed from the discourse in Israel, the world is engaged in discussions about Israel’s legal and moral responsibility for vaccinating residents of the West Bank and Gaza Strip, particularly given the disparity between vaccinated Israelis and the dire situation of the Palestinians. Articles in the international press, social media posts and statements by senior figures such as Jordan’s King Abdullah – who spoke at the World Economic Forum in Davos about the gap between the two populations – all raise some pointed questions about Israel’s obligation to vaccinate its Palestinian neighbors.

Sharpening the tension is the fact that Israel is the most vaccinated country in the world. 62 percent of its population is vaccinated, including 90 percent of the at-risk population.

As a result, Israel has been almost completely unburdened of coronavirus restrictions for several weeks now. In contrast, only 3.3 percent of the Palestinian Authority’s population has been vaccinated.

In recent weeks, Palestinians have been afflicted by a large wave of infections and mortality. The epidemic is raging throughout the West Bank and Gaza, in a reality of poor infrastructure and scarce resources, despite a long list of restrictions on travel and gatherings as well as school closures.

While the Palestinians are struggling against the coronavirus wave and are unable to vaccinate a reasonable number of people, Israel is widely vaccinated and is holding surplus doses, including 10 million AstraZeneca doses which it has said it does not intend to use. Despite these facts, the recent public and media discourse in Israel revolves around India and Ben-Gurion Airport, rather than the goings-on across the border, with our Palestinian neighbors.

Not exactly an island nation

The issue of Israel’s obligation to vaccinate the Palestinians raises legal, moral and medical questions, some of which are extremely sensitive on a political and diplomatic level.

To date, Israel has vaccinated only Palestinian workers with an Israeli work permit (110,000 workers), in order to safeguard public health inside Israel. As for Palestinians who don’t enter the country on a daily basis, Israel has remained silent.

The words of Health Ministry Director General Prof. Chezy Levy during a visit to the vaccination center for Palestinian workers demonstrates the government’s attitude towards the rest of the Palestinians. Levy explained how important it is to vaccinate those who work shoulder-to-shoulder with Israelis, but when it comes to the others, he explained, “vaccinating Palestinians is a matter for the Palestinian health institutions, and we can help those in charge of the Palestinian Authority with experience and knowledge.”

To say that vaccinating the Palestinians is their own internal affair is controversial, to say the least. The argument is mainly a legal one, but it has far-reaching political implications. On the one hand, legal scholars claim that international law requires the occupier to take responsibility for the public health of the population under its control. On the other hand, Israel claims that in the context of the Oslo Accords, responsibility for various matters, including public health, was transferred to the PA.

Dr. Adi Niv-Yagoda, an expert on medical law at Tel Aviv University, says that

“The Oslo Accords determined that authority in a number of civilian areas, including health, was transferred to the PA.

But the Fourth Geneva Convention includes an article to the effect that an ‘occupying power’ is obligated to adopt protective and preventive measures to combat the spread of contagious diseases.

Another article maintains that the obligation of the occupying country cannot be reduced due to agreements with the occupied population. Here we’re already getting into an explosive question that is inevitably influenced by diplomatic and political opinions – is Israel an occupying power?

“In practice, for a variety of reasons, some of which depend on Israel and some do not, no significant, stable and comprehensive health care system has developed in the Palestinian territories – neither in Gaza nor in the West Bank,” Niv-Yagoda says. “In addition, the complex relationship between Israel and the Palestinians – and in particular Israel’s effective control and the fact that there is no full Palestinian sovereignty as defined in the Oslo Accords – imposes a great degree of responsibility on Israel, including in the area of health.”

Even if we set aside the legal and even moral debate, one thing is hard to ignore: The coronavirus is blind to borders and international law. Israel is not exactly an “island nation,” as it is often called, but a country that shares borders with the unvaccinated Palestinians, among whom the pandemic is rampant. In other words: While in Israel they talk day and night about the danger of coronavirus variants entering the country via Ben-Gurion Airport, the physical borders are neglected.

In January, the cabinet of experts, the leading professional and non-political organization advising the COVID-19 czar, said that “All those present agree that vaccinating the Palestinian population is a clear need, due to the fact that the Palestinian and Israeli populations are epidemiological ‘communicating vessels.’ We must take active steps, to the degree that the PA agrees to be assisted by Israel, to help this population be vaccinated.” The cabinet members included members of Israel’s national program for fighting the coronavirus and Health Ministry representatives.

A shared epidemiological fate

In March, a group of Israeli human rights organizations, including Physicians for Human Rights Israel, Adalah – The Legal Center for Arab Minority Rights in Israel and Rabbis for Human Rights, petitioned the High Court of Justice demanding that Israel “ensure the supply of COVID-19 vaccines to the entire Palestinian population in the West Bank and the Gaza Strip.” In addition to the legal and moral arguments spelled out in the petition, the petitioners discussed at length the health considerations of Israel’s citizens.

The petition cites a position paper of the Israeli Association of Public Health Physicians of the Israel Medical Association, to the effect that “In a situation in which the virus continues to spread among the unvaccinated, there is an increased risk of developing additional mutations and variants, which could be partially or entirely resistant to the vaccine. The immunity of a community requires defining the community as people living in close proximity.”

The position paper also claims that “According to accepted epidemiological standards, the Palestinian and Israeli communities are a single community for the purpose of communal immunity. If we don’t ensure that Palestinians in the PA are vaccinated, illness will continue among Israeli citizens as well, which even increases the risk of mutations. In effect, Israeli citizens and residents of the PA share the same epidemiological fate.”

The public health doctors also state that “Vaccinating only part of the population will undermine the long- and short-term effectiveness of the entire vaccination project, a campaign in which considerable resources are rightly being invested, in order to save lives and to try to restore the routine as much as possible after a long period of restrictions and lockdowns.” The government has yet to respond to the petition.

TheMarker sent a series of questions to the Health Ministry demanding to know whether they believe that Israel has a legal, moral and medical obligation to vaccinate Palestinians in the West Bank and Gaza, and who is supposed to pay for it.

The ministry made do with a laconic response that mentions the campaign to vaccinate the Palestinian workers who enter Israel, as well as several thousands of additional Palestinians considered “special populations” who live in Israel, such as Waqf (Muslim religious trust) employees or Palestinian women living in the south. They did not send a principled response to the issue itself.

“The moment that the subject of land borders is not sufficiently taken into account, we should remember that Israel also has a health-related interest, whether or not it has a legal or ethical obligation,” says Niv-Yagoda.

“The subject of vaccinating the Palestinian population must not become part of a political or legal battle. It’s a clear Israeli interest, even as part of self-defense.”

Source: Ronny Linder – HAARETZ