The Middle East is a microcosm of this global problem.
The first Arab countries to start vaccinating their citizens and residents were also the richest: Saudi Arabia, the United Arab Emirates, Qatar, Kuwait, Bahrain and Oman.
The war-torn regional states have no concrete plans for the procurement and distribution of vaccines, even if international organizations intervene to help.
Arnaud Bernaert, head of the global health and healthcare industries at the World Economic Forum (WEF), said the world should not be “naive” about these inequities.
“High-income countries have political and legal reliability, which allows them to organize the fastest possible plans to protect their populations,” he said. “It will always be so.”
“[Gulf Arab] countries have smaller populations, larger funds and strong health systems, so they are in a better position to start launching earlier, and that is a fact, “said Dr. Yvan Hutin, director of communicable diseases. at the World Health Organization (WHO) Eastern Regional Office of the Mediterranean, he said.
“The Middle East is simply classified by substantial inequities.”
For Arab states outside the Gulf, full of poverty, endemic corruption or conflict, vaccination plans are complicated not only by poor administration, but by a deep distrust of political leadership.
“You have to have a clear vision for the plan [to vaccinate a population], which requires strong governance as well as the ability to pay, “Hutin told CNN.” Most countries in the region do not even have. “
In Lebanon, a ruling elite widely accused of corruption has bled the country’s resources for decades, culminating in a downward financial spiral last year. The medical system was not spared and was blocked in the absence of drugs and the exodus of health workers. The Beirut port explosion in August last year, which damaged some major hospitals, exacerbated what the country’s president called a full-fledged “state of health emergency”.
Despite having some of the lowest cases in the region in the first months of the pandemic, Lebanon now leads the Arab world in cases per million population.
Two million doses of Pfizer / BioNTech vaccine will arrive in early February, but are expected to cover only about 20% of the country’s population. On the streets of Lebanon, few people believe that the launch is imminent or that it will take place safely.
It is a similar story in Iraq and Jordan, countries suffering from economic unrest and where people have regularly protested to demand political reform.
Jordan’s free Pfizer / BioNTech vaccination program is already underway, but only a very small percentage of the population has signed up to receive it, citing a lack of confidence, according to health officials. In Iraq, only 1.5 million doses of the Pfizer / BioNTech vaccine will be available to its population of 40 million people, despite the fact that the country has struggled with repeated increases in Covid cases in the past year.
But where governments are faltering, the international community says it is trying to fill the gaps. WHO organizes distribution plans for middle- and low-income countries through programs such as the COVAX alliance, a global initiative with 190 participating countries that aims to work with manufacturers to give countries around the world equitable access to vaccines.
Bernaert says he expects a quick launch despite countless challenges. “Although there will be a gap in vaccinating lower-income countries against Covid-19, it will be much shorter than what we have seen in the past,” he said.
Iran and Egypt are the two most populous countries in the region, with Iran with almost 85 million people and Egypt with over 100 million – complicating the distribution for two states that have fought economically in recent years.
Egypt has begun vaccinating its people, starting with medical workers, with Sinopharm shot on January 24th. GAVI, the vaccine alliance that co-leads COVAX, will also provide inoculations to 20% of the population, while the Egyptian government said it has signed a grant of 20 million doses of AstraZeneca vaccine, covering another 10% of the population. the state of North Africa.
Flaming under sanctions imposed by former US President Donald Trump, Iran is the most affected country by the virus in the region. It has had over 1 million cases and over 50,000 deaths.
But Iran is the only regional state that says it intends to produce its own vaccine. Officials say the country also plans to import nearly 2 million doses from India, Russia and China by the end of the first quarter of 2021. Imported vaccines will barely cover 2% of the population.
Conflict areas with a vague prospect of vaccines
In conflict zones in the region, governments are unable to buy their own vaccines or even distribute them in cross-border territories with competing armed factions and spheres of political control. It must rely almost entirely on international organizations to do so.
COVAX provided nearly 2 billion doses of Covid-19 vaccines to be distributed in all 190 participating countries. But Hutin says it’s not enough.
“We really want to have more to offer,” he said. “We are working to ensure more doses, but it simply will not happen tomorrow.”
Syria, already on its knees after almost a decade of civil war, is facing an economic crisis. The country’s president, Bashar al-Assad, does not control his entire territory – much of it was snatched from his regime by opposition groups during the conflict. The Damascus government – repeatedly accused of war crimes and human rights abuses – will rely on GAVI, the vaccine alliance that co-leads COVAX. Opposition groups in northeastern Syria, mostly Kurds, and rebel-controlled northwests will do the same.
In war-torn Yemen, which is suffering from a devastating humanitarian crisis, rival governments in the south and north of the country seem to have only a vague idea of what the vaccine launch will look like.
In Israel and the Palestinian territories, vaccine disparities across the region are also coming to the fore. The world’s leading Israeli vaccination campaign, which is set to meet the government’s goal of inoculating the entire country by the end of March, leaves behind at least 4.5 million Palestinians living in the West Bank and Gaza.
According to United Nations experts, an immunization policy that differentiates between those with Israeli IDs and those without, is “unacceptable.”
A UN expert report, published by the UN High Commissioner for Human Rights in January, says Israel is the occupying power in and over Gaza and the West Bank and has been since 1967 and is therefore ultimately responsible for health care. those who live under occupation.
Israel disagrees, pointing to the Oslo Accords signed in the mid-1990s with the Palestine Liberation Organization, which led to the creation of the Palestinian Authority (PA). The first of these agreements includes a clause that teaches the PA responsibility for the health of all Palestinians under its civilian administration.
Israeli Health Minister Yuli Edelstein told CNN: “If we get to the point where everyone in the country who wants to be vaccinated is vaccinated, we will be more than ready to share the vaccines with our neighbors.”
Palestinian Authority Health Minister Dr. Mai Al-Kaileh says he expects to get the Covid-19 vaccine by the end of March, but that there is no specific date for their arrival. The ministry says it has contracts with four vaccine companies. These vaccines will cover 70 percent of the Palestinian population, and the WHO will provide doses for another 20 percent, the PA said in a Jan. 9 statement.
“The beginning of a new era”
According to Hutin, the WHO has addressed rich countries, including the Gulf nations, to share their doses and that they have complied, but that it is still a work in progress.
The Abu Dhabi Department of Health has launched a local collaboration called the Hope Consortium, which is to deliver 18 billion doses of vaccine globally by the end of 2021.
Undersecretary of the department Jamal Mohamed Al Kabbi told CNN’s Becky Anderson that the plan is a complete supply chain solution to address and facilitate the availability of vaccines worldwide.
Bernaert told CNN that despite the delay in vaccinations in lower-income countries, he is more optimistic than a few months ago.
“Will we be able to vaccinate everyone in 2021? No, I don’t think so. Will the story of vaccination continue in 2022 or even 2023? Yes, I think so. But what we have managed to do so far is a sign that we could be at the beginning. a new era. “
CNN’s Mostafa Salem in Abu Dhabi, Aqeel Najm in Baghdad, Eyad Kourdi in Gaziantep, Gul Tuysuz in Istanbul and Andrew Carey, Sam Kiley and Abeer Salman in Jerusalem contributed to the report.