Vaccination: To each his own?


OF SUBSTANCE AND SPIRIT

Our column last week “Israel shows how to do things right” elicited several comments, admitting that while Israel also fouled up in the early days of the pandemic, it got things right towards the end of 2020. Israel’s government imposed lockdowns a few times and strengthened their surveillance system for monitoring mobility and establishing the basis for health protocols.

The problem was public ownership. Many citizens defied the lockdowns; schools remained open; and health protocols were violated — all leading to Israel’s perfect health storm.

But Israel bounced back by securing enough vaccines at a premium and planning to inoculate more than half of its over nine million population in a few months. Reopening the economy will follow mass vaccination and herd immunity. This sequencing is very critical.

But some readers questioned the integrity of Israel’s current policy limiting its vaccination program to only its citizens within its own and in occupied territories.

The Guardian reported that “Palestinians in the Israeli-occupied West Bank and Gaza can only watch and wait.” Pfizer-BioNTech vaccines had been delivered inside the West Bank and administered to Jewish settlers. Yet these vaccines remained beyond the arms of 2.7 million Palestinians living around them.

Indeed, vaccination per se is to be considered global public goods but there are not enough vaccines at this time and money is not exactly available to all countries and people. Priorities have to be set.

In the case of Israel, their government must have prioritized their own citizens. It could also be political. Under the Fourth Geneva Convention and relevant international human rights laws including the Hague Resolution of 1907, Israel is obligated to provide vaccines in a non-discriminatory manner to Palestinians under its control with the same benchmark applied to its citizens. Israel maintained, however, that under the Oslo accords, this responsibility falls on the Palestinian Authority.

Occupied by Israel for practically half a century, Gaza and West Bank should receive the jabs for practical reasons. Israel has virtually full control over borders, people and goods transport, security, taxation, and civil registry.

Israel also ought to look after the Arabs in the occupied territories for its own good. Discriminatory health policy “may have negative impact on Israel’s goal of herd immunity, as thousands of West Bank Palestinians work in Israel and the settlement, which could keep infection rates up.” Meaningful economic revival has a cost.

In the Philippines, President’s Duterte’s ire was needed to get things done. Without the vaccines, he would not allow the economy to reopen. We find it deplorable for some to continue believing that all it takes for the economy to grow is a simple migration from GCQ to MGCQ. Self-quarantine remains prevalent and economic scarring is yet to be fully felt in various economic sectors.

The President was even quoted to have said “COVID-19 vaccines should be treated as a global public good and made available to all, rich and poor alike…no one is safe until everyone is safe.”

True, vaccination benefits not only the inoculated person but also the whole community. Vaccination helps control the pandemic. But vaccines per se can only be made available to countries with the money to finalize the term sheets, get the final agreements signed, and pay for the vaccines. Unfortunately, the Philippines is now playing catch-up.

Budget-wise, we have allocated a sizeable sum of around P70 billion from unprogrammed appropriation for vaccine procurement this year on top of the P2.5 billion for the health department. Under Bayanihan 2, there is another P10 billion, all adding up to P82.5 billion. These might be funded from public revenues and from the $1.3-billion loans from multilateral lenders, including the ADB, World Bank, and the Asian Infrastructure Investment Bank. This amount includes the Philippines’ $84-million contribution to COVAX or COVID-19 Vaccines Global Access facility.

In his press statement last month, Finance Secretary Sonny Dominguez clarified that the government’s total funds for the vaccines should be sufficient to inoculate more than 70 million adults. Dominguez announced that the program is being pursued in partnership with the multilaterals, the private sector, and the local government units (LGUs).

For what was the Philippines’ contribution to COVAX?

COVAX is a global initiative to secure some initial batches of vaccines to poorer countries. With a goal to distribute 2 billion doses to the poorer nations, COVAX has to contend with a funding gap of nearly $800 million at end-2020 and some $6.4 billion this year.

This is the essence of the vaccination being a global public good. The US’ National Bureau of Economic Research, as quoted in the MIT Technology Review of January 26, 2021, recently found that the whole global economy actually depends on poorer countries’ getting residents vaccinated. Richer nations will have to fund some 49 percent of the costs of the pandemic even if they all achieved herd immunity.

In various accounts of COVID-19 and state of vaccination today, the virus continues to infect with all its mutations. It’s clearly a race between the virus and the vaccines. Rich countries have hogged most of the available vaccines. Within each jurisdiction, getting the jabs has become a function mostly of money and influence. Countries have started to vaccinate, with Israel leading the pack with some 38 percent of its population having received the full dosage as of February 27. The vaccines came from Pfizer-BioNTech which is being used in 70 countries. In the case of the Philippines, we started inoculation using donated Sinovac vaccines administered in six countries.

With very few choices, and not every single one is available, Filipinos are not faced with the paradox of choice. Somebody said that the best vaccine is the one that’s available. This makes sense because the alternative is getting the virus. The first best could have been one with several choices available. Efficacy, rather than availability, should guide our decision.

No, we cannot borrow Polonius’ “to each his own, to thine self be true” from Shakespeare’s Macbeth.