Ramallah, Occupied West Bank – Prime Minister Benjamin Netanyahu received a coronavirus vaccine on December 19, which launched a national rollout that has made Israel the world’s leading provider of COVID-19 vaccines.

While Israel’s vaccination campaign even includes Jewish settlers deep in the illegally occupied West Bank, the nearly five million Palestinians living there or in the blocked Gaza Strip under occupation are excluded.

You’ll have to wait for the Palestinian Authority (PA), which administers parts of the West Bank under peace agreements signed in the 1990s, to deliver the shocks.

The Palestinian Ministry of Health expects the first batches of the AstraZeneca COVID-19 vaccine to arrive in the occupied West Bank and Gaza Strip in early March, more than two months after the start of Israel’s adoption.

“We just signed a contract with AstraZeneca to receive two million doses,” Palestinian health minister May al-Kaila told Al Jazeera.

The two million doses of Oxford-AstraZeneca would only be enough to vaccinate a million people.

Vaccination is free and voluntary. Each dose costs the PA about $ 5, which makes the deal worth about $ 10 million.

More than 148,100 Palestinians have tested positive for coronavirus to date, and more than 1,610 COVID-19-related deaths have been reported in the West Bank and Gaza Strip since the pandemic began.

Many Palestinians in the Occupied Territories cannot afford to wait until March as infections rise. New infections every day in the West Bank and Gaza Strip consistently exceeded 1,000 over the past month. In the second half of December, the average number of cases discovered each day was nearly 1,500 – tripling from July 2020.

“We are a poor country”

The PA is also awaiting vaccines from COVAX – a global collaboration between the World Health Organization, the European Commission and France – which has pledged to provide vaccines to 92 low and middle income countries in response to the COVID-19 pandemic.

“COVAX will gradually supply us with 20 percent of our vaccine needs,” Yaser Bouzieh, a senior official with the Palestinian Ministry of Health, told Al Jazeera.

COVAX deliveries are also expected in early March.

Although the Palestinian Ministry of Health is in dire straits and is competing with many countries for access, it has also reached six vaccine manufacturers: Pfizer, Moderna, Oxford-AstraZeneca, Russians Sputnik V, Johnson & Johnson, and China’s Sinovac.

The Ministry of Health requested the vaccine from all six but received only one response from AstraZeneca. “We are a poor country, but we try to protect the people by all means,” said al-Kaila.

Currently, health officials expect to vaccinate around two million Palestinians by May. Frontline workers and seniors will be a priority.

According to the Ministry of Health, almost 40 percent of the Palestinian population is under 18 years of age. This large youth demographics should bring some relief to health authorities, as younger people are much less likely to suffer badly from COVID-19.

However, if the vaccines are delayed, it would mean more deaths, as well as more lockdowns and economic pain. The pandemic has almost brought the economy to a standstill and put pressure on an already vulnerable health system.

Numerous general and partial bans have been imposed in the West Bank and Gaza Strip since March last year.

According to the Palestinian Central Statistical Office, the unemployment rate in Palestine rose to 28.5 percent in the third quarter of 2020, an increase of almost 4 percent over the same period in 2019.

Despite the great strain, the pandemic has forced the Palestinian health system to find a way to expand.

Five new hospitals have opened in the West Bank since the outbreak of the pandemic. These were to open as general hospitals but had to be renamed to care for COVID-19 patients.

The Department of Health does not anticipate any difficulty in introducing the vaccine, especially at AstraZeneca, as it only requires a storage temperature of 2 to 8 degrees Celsius (35.6 to 46.4 degrees Fahrenheit).

But there are doubts.

“The amount of time it takes to vaccinate people in a significant amount of time is enormous,” said Dr. Robin Abu Ghazaleh, a virologist at Palestine Polytechnic University, told Al Jazeera.

Acquiring the Pfizer vaccine would speed up vaccinations but would be challenging as it has to be stored at minus 80 ° C. However, the Ministry of Health can only store around 150,000 doses at a time.

“We only have two [suitable] Freezers throughout [West Bank]”Said Al-Kaila.

A Palestinian girl and her family are waiting to cross the Rafah border in the Gaza Strip into Egypt [Mohammed Saber/EPA-EFE]

Gaza’s challenges

Almost 2,000 new healthcare workers were trained and employed in the West Bank last year. This includes laboratory technicians, doctors and respiratory specialists, said al-Kaila.

In Gaza, where a blockade imposed by Israel and Egypt has been in place since 2007, the situation is more critical.

“Every day without a vaccine means more infections, more people admitted to hospitals, more deaths and high costs,” Majdi Dheir, a senior official at Gaza’s health ministry, told Al Jazeera.

Dheir said an average of 240 patients per day were being admitted to the intensive care unit in December. “In January the numbers are better, they have dropped to 135 a day.”

He added that Gaza has five freezers that are suitable for the Pfizer vaccine. “I hope that donor and friendly countries will provide us with the vaccine very soon as this is the lifeline for our people who are exhausted and under siege,” he said.

“The health infrastructure here is tense, the medical teams are under great pressure.”

Dheir said Israel was obliged to help the beleaguered enclave. “Israel has a responsibility to provide us with the vaccine, they are the occupying power.”

The vaccines will arrive at Israeli airports first before being taken to the Occupied Palestinian Territories, making delays a real possibility.

Ghassan Nimer, the PA’s interior ministry spokesman, told Al Jazeera: “We always expect complications from the Israeli side. It is entirely possible that they control the borders. “

Israel “ignores its commitments”

Israel began rolling out the Pfizer vaccine on December 23 and managed to vaccinate more than 1.5 million of its citizens, including settlers in the West Bank, in less than three weeks. The residents of Palestinian East Jerusalem are also entitled to the vaccine.

Netanyahu recently said Israel expects to vaccinate all of its citizens over the age of 16 by the end of March. “We will be the first country in the world to emerge from the coronavirus,” he boasted.

Israeli Coordinator of Government Activities in the Occupied Palestinian Territories, COGAT, told Al Jazeera that fighting COVID-19 in the West Bank and obtaining vaccines is the PA’s commitment under the Oslo Accords.

COGAT also said Israel allowed entry into the West Bank of medical devices donated by the international community, including “thousands of test kits, protective items, face masks” and even “joint training for Israeli and Palestinian medical teams”.

“It is important to note that Israel has not turned down a request for medical assistance that is on their doorstep.”

Israeli Public Security Minister Amir Ohana has directed the Israeli prison service not to vaccinate Palestinian prisoners in Israeli prisons.

According to the Addameer prisoner rights group, there are 4,400 Palestinian prisoners in Israeli prisons, including 160 child inmates, 440 in administrative detention and 37 female prisoners.

The argument that the Oslo Accords exclude Israel from medical care for the Palestinians is wrong, according to some human rights activists.

“60 percent of the West Bank is under full Israeli control,” Francesca Albanese, an international lawyer and writer, told Al Jazeera.

“Israel has a duty to protect the Palestinian people from the virus. This means planning that the Palestinians will be vaccinated without discrimination,” she added.

Amnesty International also urged Israel “no longer to ignore its obligations as an occupying power”.

“Israel’s COVID-19 vaccination program underscores the institutionalized discrimination that defines the Israeli government’s policy towards Palestinians,” the rights group said in a statement.

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