Imagine the coronavirus pandemic began in 1970, at the height of apartheid in South Africa. Imagine the South African government purchased vaccines but distributed them primarily to whites, under the pretext that Black South Africans are citizens of the Bantustans, so-called autonomous zones to which the South African government confined Blacks, and that it was up to Bantustan leaders to vaccinate "their" populations.
What responsibilities would pharmaceutical companies have, under those circumstances, to prevent discrimination in the distribution of the vaccines they sell?
Now let's return to 2021. Pfizer, Moderna-Biontech, and AstraZeneca have been contracted to sell the Israeli government 18 million doses of their life-saving vaccines. But the Israeli government is vaccinating only Israeli citizens and residents, including nearly seven million Jewish and two million Palestinian citizens of Israel, but excluding the nearly five million Palestinian residents of the West Bank and Gaza who also live under Israeli government control.
The drug companies should not support such discrimination. Like all businesses, pharmaceutical companies bear responsibility for preventing human rights violations in their business activities. They should engage the Israeli government to try to end the discrimination.
Israel captured the West Bank and Gaza Strip in 1967 and immediately began to settle them with Israeli civilians, in violation of international law. But although the Israeli government claims the land belongs to Israel, it disavows responsibility for the non-Jews who live there, perpetuating a regime of Jewish hegemony that a growing chorus of voices calls apartheid. The Israeli government says responsibility for Palestinian health lies with the Palestinian Authority – a semi-autonomous body that, similar to South Africa's Bantustan governments, exercises limited, local government functions, using tax revenues controlled by Israel.
The cash-strapped Palestinian Authority cannot even bring vaccines into the West Bank and Gaza without permission from Israel, which controls the borders, and it received its first shipment of 10,000 doses of a Russian vaccine, intended for health care workers, only last week. In contrast, the Israeli government has already partially or fully vaccinated more than a third of its citizens and residents and more than half of the adults among them, including 600,000 Jewish settlers living in the West Bank.
The result is that a 19-year-old Israeli living in the West Bank's Beit El settlement can get a vaccine, but her 85-year-old Palestinian neighbor, living across the street, cannot. United Nations human rights experts and civil society organizations have called on Israel to allocate vaccines according to health needs, not ethnic or religious identity, but the Israeli government has refused.
As the occupying power in the West Bank and Gaza, Israel is responsible, under international humanitarian law, for providing health services to Palestinians, especially "preventive measures necessary to combat the spread of contagious diseases and epidemics." After more than a half century of exercising sovereignty over all of Israel/Palestine, between the Jordan River and the Mediterranean Sea, the Israeli authorities must also respect the human rights of those whose lives they control, including their right to health. Allocating life-saving vaccines based on ethnic or religious identity is a particularly grave violation of the right to nondiscrimination.
While it is up to Israel to respect Palestinian rights, the drug companies are responsible for addressing rights abuses in distribution of their vaccines. Pharmaceutical companies wield tremendous power, especially during a global pandemic, and the widely accepted United Nations Guiding Principles on Business and Human Rights recognize their responsibility to use that power to mitigate or end rights abuses and violations of international humanitarian law. The principles require companies to "address adverse human rights impacts with which they are involved . . . even if they have not contributed to those impacts."
Pfizer, Moderna, and AstraZeneca should request assurances that Israel will abide by human rights law in its distribution of their vaccines and, if necessary, help Israel develop a plan to obtain additional vaccines, to cover all those living under its control, Israelis and Palestinians. The companies should insist that medical, not ethnic or religious criteria, determine who gets a vaccine first. Doing so is consistent with the human rights commitments that Pfizer and AstraZeneca have already promised to uphold, and that Moderna should also accept. The Palestinian human rights group Al-Haq has written to Pfizer to request such assurances, and Pfizer should promptly respond.
This kind of engagement can be effective – following loud protests by international organizations, the Israeli military agreed last week to provide 5,000 vaccine doses to Palestinian health workers, a concession that should be expanded.
Injustice in vaccine distribution is not limited to Israel/Palestine. The World Health Organization has decried the practice of rich countries monopolizing supply. The drug companies who developed these life-saving vaccines should take more responsibility for equity and racial justice in their distribution. That might not have been the expectation in 1970, but as of 2021, businesses are responsible for respecting human rights.