BNTX BioNTech SE

By Felicia Schwartz and Dov Lieber 

TEL AVIV -- As Israel leads the world in vaccinating against Covid-19, the neighboring West Bank and Gaza are grappling with the prospect of waiting months to inoculate their people, raising political and public-health questions about Israel's responsibilities to the Palestinians.

The contrast could hardly be more stark.

Israel's Prime Minister Benjamin Netanyahu said Thursday the country is receiving more of the vaccine developed by Pfizer Inc. and BioNTech SE beginning on Sunday and will be able to vaccinate its population by the end of March, or possibly before. The vaccine's makers say it takes two doses to be fully effective.

Israel -- a wealthy country that boasts of a technologically advanced health-care system -- has administered the first shot to more than 18% of its roughly nine-million population since paying a premium for early shipments and beginning its program on Dec. 20.

While other countries, including the U.S., have administered more doses, none has vaccinated a larger percentage of its population.

The West Bank and Gaza depend on aid to survive and have poor health and logistics infrastructure. They are expecting the World Health Organization's Covax program to provide vaccines for 60% of their combined five-million population, but only a portion of those will be free and it is unclear when the first batch will arrive. They have asked others, including Qatar and the European Union, for assistance, and are also speaking to some vaccine developers directly.

"I hope that our bad political situation won't affect the supply," said Alaa Shehada, 37, who runs a cafe in Gaza City but is struggling to stay in business amid the pandemic.

The WHO said it won't deliver any vaccines through the Covax program until March at the earliest.

For Israel, the differing pictures raise questions about its obligations to Palestinians living in the West Bank and Gaza -- which are partially self-governed territories but whose borders are effectively controlled by the Israelis. Israel has occupied the West Bank and Gaza since the 1967 Arab-Israeli war. Both Egypt and Israel imposed a blockade on Gaza when Hamas, an Islamist militant group considered by the U.S. and Israel to be a terrorist organization, seized control of the strip in 2007.

Israeli officials say the Palestinian Authority has responsibility for its citizens' health care, including procuring vaccines, under the terms of the 1990s Oslo Accords. Israel might provide excess vaccines to the Palestinians once its population is inoculated, they added.

But human rights organizations say that under the Geneva Conventions, Israel must provide vaccines to those living under its control.

Even if Israel succeeds in vaccinating much of its population, the coronavirus could still be a risk as long as it continues to spread in the West Bank and Gaza. Tens of thousands of Palestinians enter Israel and the Jewish settlements in the West Bank for work, mainly in the construction sector, every day.

"We will think how we can cooperate with the Palestinians on the issue of vaccination," said Yuli Edelstein, Israel's Minister of Health. "Not because we have some, you know, some responsibility or commitment, but because it's an Israeli interest."

Mr. Edelstein said Israel has assisted the Palestinians with medical equipment during the pandemic and would look for ways to cooperate with the Palestinians on vaccines once Israel's population is inoculated.

Through its state-run health-care system, Israel is providing vaccines to all Israeli citizens, including Jewish settlers who live in the West Bank, in addition to Palestinians who are residents of East Jerusalem.

There is also the question of whether the Palestinians would be able to use the same vaccines being rolled out in Israel.

Dr. Ahmad Majdalani, a close aide to Palestinian Authority President Mahmoud Abbas, said that the Palestinian Authority didn't ask Israel for vaccines because Israel is mainly relying on Pfizer's vaccine, which requires storage at ultralow temperatures. The Palestinians don't have the infrastructure to manage that properly.

Israel has purchased eight million doses from Pfizer. The government hasn't disclosed how many doses it has received so far, though health officials estimate the figure is around four million, for which it paid $62 a dose, an Israeli health-ministry official told public broadcaster Kan. Israel begins its second round of inoculations for people who have already received the first dose this weekend.

It has bought six million doses of the vaccine developed by Moderna Inc., which must also be kept at ultralow temperatures. It has also ordered 10 million doses of the vaccine developed by Oxford University and AstraZeneca PLC, which can be stored and transported more easily using normal refrigeration, making it easier to distribute in poorer countries with less sophisticated health-care infrastructure.

WHO officials said the Moderna and University of Oxford/AstraZeneca vaccines will be among those delivered to the West Bank and Gaza under its Covax program. But distribution could be complicated by the leadership split between the West Bank and Gaza. The Palestinian Authority controls the West Bank and Hamas controls the Gaza Strip, with relations between the two still tense after more than a decade of failed reconciliation efforts.

The Palestinian Authority will supply the vaccines, which will go through Israel's Erez border crossing. Dr. Majdi Dehair, deputy director of general care at Gaza's Ministry of Health, said health ministries in the two territories have agreed that the Palestinian Authority would then provide 40% of the Covax vaccines to Gaza and keep the rest for the West Bank.

"We are in Gaza, sure it will take a year, not a month," said Lina Mohammad Abu Daff, a 44-year-old Gaza City resident who works at the local health ministry.

She said coronavirus spread quickly among her friends, family and co-workers. Across the West Bank and Gaza, more than 144,000 cases have been reported since the beginning of the pandemic, and over 1,500 deaths.

Ms. Abu Daff said her 70-year-old father and young niece only recently recovered. "Of course, it will take time to get the vaccine," she said.

Meanwhile, Palestinian officials in the West Bank said they are also discussing purchasing vaccines directly from AstraZeneca in addition to those coming from the WHO. They expect deliveries by February if a deal is reached. Palestinian officials had been in discussions with Russia to purchase four million doses of its Sputnik vaccine but it isn't clear if or when that vaccine will arrive.

--Anas Baba in Gaza City contributed to this article.

Write to Felicia Schwartz at Felicia.Schwartz@wsj.com

(END) Dow Jones Newswires

January 07, 2021 15:16 ET (20:16 GMT)

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