Vaccine Failure Spreads in Pandemic-Stricken Arab Region

Firas Al-Tawil, Hala Naser Al-Din, Abdullah Abu-Deif, Raddad Al-Qallab, Hana’a BuHaji

05/05/2021

Favoritism

Favoritism, nepotism and the absence of clear criteria and planning were the features that some Arab countries have in common in their way of handling vaccine provision to their people.

The scene in Lebanon was shocking as Members of Parliament received the vaccine and bypassed even the medical frontline staff, the elderly and those with chronic health issues. This created an uproar that prompted the World Bank to threaten to suspend vaccine deliveries to that country.

Akram Abu Hamdan is sixty-nine year old, he is annoyed and wondering why he has still not received a message from the health ministry platform to confirm the date for his vaccination, even though he had completed his registration on January 30, 2021. This is especially frustrating for him since Members of Parliament who are younger than him got the vaccine without officially registering for it or following the correct registration procedures.

Abu Hamdan’s turn still has not come even a month after the wide scale vaccination program began in Lebanon. Abu Hamdan suffers from a weakness in his heart muscle, hypertension, high cholesterol, and had endured heart attacks in the past. He exclaims, “This state does not offer help to the helpless” He adds, “It isn’t too hard for a state that has stolen our money, our souls and our future to rob us of the vaccines!”

The scene is not much different in the Palestinian territories where the humanitarian situation is in tatters due to the unprecedented outbreak of the virus. A young man called Fadi Abdullah lost his mother after she caught corona virus. As he cried over his mother’s grave, he directed his blame at the health authorities for the delay in providing the vaccine and for distributing the limited supplies among state officials and their relatives. He says, “We are second-class citizens, and there is no concern for the well-being of elderly people. If you do not “count as important” (or well connected) you won’t receive anything. My mother suffered from many chronic illnesses. If the ministry (of health) had provided the vaccinations early enough, (my mom’s) fate would have been different.”

The distribution of vaccines among state officials, and their cronies has led to some sharp criticism of the Palestinian government by civil society and activists. Calls for an official investigation to name and shame those involved fell on deaf ears.

Due to the increasing pressure and accusations, the Ministry of Health admitted to administering vaccines to certain groups. The ministry said those groups included officials and employees of the presidency, the cabinet office, members of the Executive Committee of the PLO who are over 65 years old; the Election Committee; employees working at embassies abroad, members of the national football team; in addition to around 100 students who needed the vaccine to travel to pursue their education.

In Egypt vaccination policy took another turn and was characterized by the absence of a clear plan to provide citizens with the vaccines. The government leaned towards imposing a fee for vaccination, then it demanded millions of people with limited income to apply for exemption from paying. According to Human Rights Watch, this reinforces inequality in accessing the vaccine.

Asma’a Ahmad an Egyptian from Cairo is not registered in the government’s “Takaful and Karama” (Solidarity and Dignity) program. She cannot receive the vaccine for free because she is not included in the government’s category of citizens eligible for free vaccination. Asma’a refuses to pay 200 Egyptian pounds to receive the vaccine and says, “If it is not free, I am not willing to pay for it.”

Human Rights Watch called on the Egyptian government to apply the measures it has taken to provide vaccines to everyone equitably. The organization sees that the “imposition of fees on the poor in Egypt to receive an essential vaccine is in conflict with the basic human right’s access to health, and it reveals distorted government priorities.”

In Jordan, people demanded to receive their share of the vaccine when these arrived in the country. This demand was voiced especially after the Jordanian authorities arrested the journalist Jamal Haddad last December for publishing an article entitled “What about the people? Has the Pfizer vaccine arrived in secret and was doled out to influential officials in the Jordanian government?”

Tha’er Shatnawi/ Shantawi is a thirty-three-year-old doctor. He registered himself on the government platform of the national vaccination initiative at the end of last December. He was shocked by procedures he described as unfair, and could have been avoided had the government followed medical protocols in the distribution process. Shatnawi/ Shantawi examines around 200 patients on a daily basis at the Hawara Health Center where he works, which is a clinic affiliated with the Ministry of Health in the province of Irbid north of the capital Amman. He lives in a state of panic for fear of contracting the virus due to his diabetes. He accused the health authorities of “slipping” vaccines to dozens of people with special access to some (high ranked) officials. This situation made his father lose his right to receive the vaccine, even though he is sick and is 65 years old.

Reluctance and Hesitation

In addition to governments’ mismanagement of the vaccine file, people in Arab countries have been reluctant to register for vaccination. Egypt’s case is an important example.

In the first week, only about 150,000 Egyptians registered for the vaccine on the website launched by the Egyptian government at the beginning of March. This is despite the fact that the target groups in the first phase make up about 20 million people.

This state of reluctance was not exclusive to the general public. Only10 thousand medical staff from Egyptian hospitals were vaccinated since the start of the process on January 24. However, according to the Egyptian Minister of Health Hala Zayid more than 30% of medical staff are reluctant to receive the vaccines due to the uncertainty (in their mind) of its safety.

Shireen Al-Muhandes, a member of the Council of Government Doctors Syndicate in Egypt, suggested that vaccination reluctance amongst Egyptians could also be due to side effects associated with the vaccines, as listed by the ministry of health’s protocol. She even revealed that she refused to take the Chinese vaccine (available in Egypt) in the hope of obtaining a different “safer” make of vaccine.

This is also the case of the mother of a young man from Ramallah called Ali Mahmoud. Ali had registered his elderly mother on the government platform to receive the vaccine without her knowledge. He has been trying without success to persuade her to take the vaccine. She refuses and tells him, “By God: whatever happens, I won’t let them inject me”.

Ali is not sure that he could persuade her, but he will persist while he is waiting for the Ministry of Health to contact him.

Similarly, sixty-four-year-old Safi Hassan from Ramallah was not among the 100,000 citizens who registered on the government platform within two weeks of its launch, even though he has several chronic health conditions. He believes that “the vaccine is not safe”. He decided instead to follow preventive measures instead of “venturing into the unknown”, as he explains his situation.

Seventy-five year old Ahmad Mustafa is from Al-Wehdat Camp in Jordan, who agrees with Safi Hassan’s attitude towards the vaccine. He would rather stay unvaccinated than submit to taking some type of protection with untested results. He explains, “I suffer from hypertension and diabetes. I wouldn’t know what would happen to me after the vaccine. I worry that my body may not handle it”.

A Different Type of Discrimination

The electronic registration mechanism followed in Bahrain excludes undocumented migrant workers. This sector constitutes 12.6% of the total work force in the country, and those workers are unable to provide the required information to complete the registration process either due to the expiration of their residency credentials or that the migrant worker no longer know the address of their local sponsors.

This is happening despite the fact that Bahrain was one of the first countries in the region to provide vaccinations for all citizens and residents at the start of the vaccination program in mid-December 2020 . As of April 5, 2021, about 20% of the Kingdom’s population have taken the two doses of one of four types of vaccines (available in Bahrain) while 35% of the population took the first dose.

According to the Ministry of Labour in Manama, the number of violators reached 67000. This equals 12.6% of the total number of workers and foreign employees authorized to work in the country. This means that 8.3% of foreigners residing in Bahrain will not be able to receive the vaccine. None of the undocumented workers has been able to speak openly about this discrimination. They prefer to remain silent and carry on working rather than demand a vaccine that might get them deported.