Medical Apartheid

The​ Israeli defence minister, Benny Gantz, said on 25 February that Israel was suspending an initiative to provide nineteen countries with a hundred thousand surplus jabs from its stock of Covid-19 vaccines. The gesture by Benjamin Netanyahu had not been part of Covax, the global initiative to ensure more equitable access to inoculations. Rather, it was conceived as a bribe: a plan, as the Times of Israel put it, to ‘exchange vaccines for diplomatic support’. Identified beneficiaries included Guatemala, which followed the US in relocating its embassy to Jerusalem, in explicit violation of UN Security Council Resolution 478; the Czech Republic and Hungary, which have opened diplomatic missions in Jerusalem; and Mauritania, with which Israel is seeking to establish formal relations.

At the same time, Israel is withholding vaccines from the approximately five million stateless Palestinians living under its rule. As Nathan Thrall demonstrated in the LRB of 21 January, Israel and the occupied Palestinian territories are in effect governed by a single political regime: Israel is responsible for the residents of the West Bank and Gaza Strip, just as South Africa’s white minority regime was for the inhabitants of Transkei, Venda and the other Bantustans. On 14 January, the UN called on Israel to ‘ensure swift and equitable access to Covid-19 vaccines for the Palestinian people under occupation’. Yuli Edelstein, the Israeli health minister, rebuffed this with reference to the Oslo Accords, which give the Palestinian Authority oversight of public health. The result, in the words of the Palestinian doctor and activist Mustafa Barghouti, is ‘medical apartheid’.

Barghouti’s assessment would remain valid even if one were to maintain that Israel and the Occupied Territories are in fact governed by separate regimes. Article 56 of the Fourth Geneva Convention begins:

To the fullest extent of the means available to it, the Occupying Power has the duty of ensuring and maintaining, with the co-operation of national and local authorities, the medical and hospital establishments and services, public health and hygiene in the occupied territory, with particular reference to the adoption and application of the prophylactic and preventative measures necessary to combat the spread of contagious diseases and epidemics. Medical personnel of all categories shall be allowed to carry out their duties.

Speaking to the BBC’s Andrew Marr in late January, Edelstein claimed that Israel is no more responsible for the Palestinians than the Palestinians are for the ‘dolphins in the Mediterranean’. He insisted that it is not Israel’s ‘legal obligation’ to vaccinate Palestinians, although he admitted that it would be in ‘our interest’. Israel, he said, had to take care of its own first; getting vaccines to the Palestinians is the job of the Palestinians.

Yet just as the plan to reward foreign governments with surplus jabs gave the lie to the scarcity pretext, so Israel’s initial refusal to allow the transfer of two thousand vaccine doses to the Gaza Strip – the PA had independently acquired ten thousand doses of Russia’s Sputnik-V – made clear who holds ultimate power. It was the Israeli not the Palestinian parliament that spent two days last month debating the propriety of distributing vaccines to Gazans, with the Co-ordinator of Government Activities in the Territories (COGAT) informing journalists that a Palestinian request to transfer the desperately needed vaccines was ‘waiting for a political decision’ from Israel. No such deliberations were required when Israel decided to pay $1.2 million to purchase vaccines for Syria in order to secure the return of an Israeli woman who was being detained in Damascus.

Last December, after the Israeli Ministry of Health determined that prisoners as well as their guards were a priority group for vaccination, the public security minister, Amir Ohana, instructed the Israel Prisons Service to exclude ‘security prisoners’, of whom nearly all are Palestinian, from the inoculation campaign. Several weeks later, after a number of additional infections and a widespread outcry, Israel announced that they would be vaccinated after all. The hundreds of thousands of residents of Israel’s illegal settlements in the West Bank, including Jewish non-citizens, have full access to the Israeli government’s vaccination programme. It wouldn’t be quite accurate to say that West Bank Palestinians have none. On 28 February, Israel approved plans to inoculate the 130,000 or so Palestinians who have permits to work in Israel and the settlements (the plan has just been suspended until further notice). In a further act of noblesse oblige, just as Palestinian hospitals reported that intensive care units for Covid-19 patients had reached 95 per cent occupancy, Israel pledged a ‘symbolic quantity’ of five thousand doses for Palestinian medical personnel. Fewer than half that number have so far been delivered.

The Nieuw Israëlietisch Weekblad, the house organ of Dutch Zionism, recently ran an article by its editor-in-chief, Esther Voet, under the headline ‘Unique Offer: Vaccination Holiday in Israel’. ‘Thanks to our intimate co-operation with the Israeli authorities,’ she wrote, ‘we can proudly offer a unique vacation in April … choose the Pfizer vaccine and get a certificate for your second jab in the Netherlands, or the Johnson & Johnson vaccine that requires only a single dose.’ A ‘Druze lunch’ was also part of the package. When contacted by a journalist for clarification, the travel agency identified in the article dismissed the offer as a ‘Purim joke’.

No country has vaccinated a larger proportion of its citizens than Israel. Its compact size and relatively small population, its largely centralised and digitised health system, and its experience with logistics in times of crisis, tell only part of the story. Last year, Israel signed a deal with Pfizer for the BioNTech mRNA vaccine developed in Germany. In exchange for a guaranteed supply of ten million doses by the end of March, the Israeli government agreed not only to pay premium prices – reportedly double those paid by European buyers – but also to share vast troves of patient data. As any Palestinian could have predicted, Israel has also been the first state to introduce colour-coded identification documents to distinguish between those who have been vaccinated and those who haven’t.

As with other Israeli policies towards the Palestinians, the practice of medical apartheid is enabled by international support or indifference. It has been left to activists, and comedians, to expose its hypocrisy. On Saturday Night Live, Michael Che joked: ‘Israel is reporting they’ve vaccinated half of their population – and I’m going to guess it’s the Jewish half.’ In response, Jonathan Greenblatt, the CEO of the Anti-Defamation League, and others went into overdrive, pointing out that Israel is vaccinating Christian and Muslim Palestinians who are also Israeli citizens, but failing to mention the stateless Palestinians under its control. Accusations of anti-semitism against Che piled up.

Israel’s apologists also got the better of Anthony Fauci, who became a superstar for refusing to indulge Trump’s ravings about curing Covid-19 with anti-malaria drugs or lethal doses of bleach. Now Biden’s chief medical adviser, Fauci was asked during an interview with the Times of Israel whether Israel ‘should help’ vaccinate Palestinians. ‘You’re asking me a political question,’ he said, ‘and I don’t want to go there. That only gets me into trouble.’ He hailed Israel’s vaccination strategy as ‘a model for the rest of the world’.

5 March

Listen to Mouin Rabbani discuss this piece on the LRB Podcast.