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.
War-torn regional states have no concrete plans to acquire and distribute vaccines, even when international organizations step in to help them.
Arnaud Bernaert, the head of the global health and healthcare industries at the World Economic Forum (WEF), said the world should not be “naive” about these inequalities.
“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 that way.”
“[Gulf Arab] countries have smaller populations, large amounts of funds and strong health systems, so they are in a better position to start deploying sooner, and that is a fact, ”said Dr. Yvan Hutin, director of communicable diseases of the World Health Organization (WHO) Regional Office for the Eastern Mediterranean, said.
“The Middle East is simply classified as a substantial inequity.”
For non-Gulf Arab states, full of poverty, endemic corruption or conflict, vaccination plans are complicated not only by mismanagement, but by deep distrust of political leadership.
“You need to have a clear view of the plan [to vaccinate a population], which requires sound governance and also the ability to pay, “Hutin told CNN.” Most countries in the region do not have them either. “
In Lebanon, a ruling elite widely accused of corruption has skimmed the country’s resources for decades, culminating in a downward economic spiral last year. The medical system has not been spared and has shrunk under the shortage of medicines and the exodus of health workers. Beirut’s port blast last August, which damaged some major hospitals, aggravated what the country’s president has described as a “state of health emergency” in its own right.
Despite having some of the lowest cases in the region in the early months of the pandemic, Lebanon now leads the Arab world in cases per million population.
Two million doses of the Pfizer / BioNTech vaccine are expected to arrive in early February, but they only cover about 20% of the country’s population. On the streets of Lebanon, few people believe that the deployment is imminent or that it will take place safely.
It is a similar story to Iraq and Jordan, countries suffering from economic turmoil and where people have periodically 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, alleging a lack of confidence, according to health officials. . In Iraq, there will be only 1.5 million doses of the Pfizer / BioNTech vaccine available to its population of 40 million, although the country has faced repeated rises in Covid cases during the last year.
But where governments are hesitant, the international community says it is trying to fill gaps. WHO organizes distribution plans for low- and middle-income countries through programs such as the COVAX alliance, a global initiative with 190 participating countries aimed at working with manufacturers to provide countries around the world with equitable access to vaccines .
Bernaert says he expects a quick launch despite countless challenges. “While there will be a delay in vaccinating lower-income countries against Covid-19, it will be much shorter than we have seen in the past,” he said.
Iran and Egypt are the two most populous countries in the region, with Iran close to 85 million people and Egypt more than 100 million, complicating the distribution of two states that have struggled economically in recent years.
Egypt began vaccinating its people, starting with medical workers, with the firing of Sinopharm on 24 January. GAVI, the vaccine alliance that co-directs COVAX, will also supply inoculations to 20% of the population, while the Egyptian government said it signed a treat 20 million doses of the AstraZeneca vaccine, covering an additional 10% of inhabitants of the North African state.
Under sanctions imposed by former U.S. President Donald Trump, Iran is the country most affected by the virus in the region. It has had more than a million cases and more than 50,000 deaths.
But Iran is the only regional state that says it plans to produce its own vaccine. Officials say the country also intends 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 vaccine outlook
In conflict zones in the region, governments are unable to buy their own vaccines or even distribute them in intersecting territories with armed factions and competent spheres of political control. They have to rely almost entirely on international organizations to do so.
COVAX has secured nearly 2 billion doses of Covid-19 vaccines to be distributed to all of its 190 participating countries. But Hutin says that’s not enough.
“We really wish we had more to give,” he said. “We’re working to get more doses, but it won’t happen tomorrow.”
Syria, on its knees after nearly 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 torn 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 co-led by COVAX. Opposition groups in the northeast of the Kurdish majority in Syria and in the rebel-controlled northwest 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 notion of what vaccine deployment will look like.
In Israel and the Palestinian territories, vaccine disparities across the region are also strongly concentrated. The world-leading vaccination campaign in Israel, which is about 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 UN experts, a vaccination policy that differentiates between those who have Israeli IDs and those who do not is “unacceptable.”
A UN expert report, released by the UN High Commissioner for Human Rights in January, says that Israel is the occupying power in Gaza and the West Bank and about it, that it is since of 1967 and is therefore the last responsible for the health of those living under occupation.
Israel disagrees, noting the Oslo Accords, signed in the mid-1990s with the Palestine Liberation Organization, which led to the creation of the Palestinian Authority (PA). Included in the first of these agreements is a clause attributing responsibility to the PA 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 get 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 they hope to get the Covid-19 vaccine by the end of March, but that no specific date has been set for its arrival yet. The ministry says it has contracts with four vaccine-producing companies. These vaccines will cover 70% of the Palestinian population and the WHO will provide doses for 20% more, the PA said in a January 9 statement.
“The beginning of a new era”
According to Hutin, the WHO has approached rich countries, including the Gulf nations, to share their doses and they have complied, but that is still a work in progress.
The Abu Dhabi Department of Health has launched a local collaboration called the Hope Consortium, which plans to deliver 18 billion doses of vaccine worldwide by the end of 2021.
Department Undersecretary Jamal Mohamed Al Kabbi told CNN’s Becky Anderson that the plan represents a complete supply chain solution to address and facilitate the availability of vaccines worldwide.
Bernaert told CNN, despite the delay in vaccinations in lower-income countries, that 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 have we managed to do? So far it’s a sign that we can be at the beginning. of 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 this report.