MANILA —The World Health Assembly ventured into the hotly contested arena of Middle East politics last week and weighed in on health conditions in the Palestinian territories.
With a vote of 78-14, the WHA adopted a deeply divisive decision asking the World Health Organization director-general to continue providing technical and programmatic support in the Palestinian territories, and report on progress regarding access to and provision of health care there.
The proposal, which was made by the delegations of Cuba, Iraq, Lebanon, Palestine, Qatar, Syrian Arab Republic, Tunisia, and Turkey, was viewed by some countries to contain an implicit attack on Israel — which occupies the Palestinian territories — and thus overly political for the health body to take on.
A total of 180 delegates were given the right to vote during the WHA’s virtual session last week, but 56 were absent, and 32 abstained. Norway and Iceland were two of the countries that made an abstention.
Explaining their vote, Norway, who was delivering a statement on behalf of Iceland too, said that while they found the report by the director-general outlining the health conditions in the territories to be “balanced and factual,” there is “no place for politics” at the WHA. The Norwegian official called on both Israelis and Palestinians to constructively engage and work with WHO to “reach a consensus in the future.” Despite this, Norway said it will continue to support the development of the health system in Palestine.
Canada said it could not support the decision, arguing that the WHA is a technical body and should focus on improving global health outcomes. The official from Canada added that the decision “does not advance the prospects for peace” between the Israelis and Palestinians.
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Canada, however, said it supports WHO’s role in providing support for strengthening health systems and medical assistance to Palestinians, particularly for children, girls, and women who are disproportionately affected by inadequate health care services and access to medicines — a situation exacerbated by COVID-19.
Prior to the vote, the United Kingdom said it could not support the decision, but noted that it has provided COVID-19-related support to the Palestinian territories, including through WHO and UNICEF.
The director-general’s report describes significant health inequities in the Palestinian territories, which include West Bank, east Jerusalem, and the Gaza Strip. It describes the difficulties by Palestinians in accessing health care given the restrictions in movement of people and goods — which sometimes extends to humanitarian groups working there — and the impact of years of blockade on Palestinians’ health.
In the Gaza Strip in 2019, 46% of people lived below the poverty line, and 62% experienced severe or moderate food insecurity. The unemployment rate was high, and 96% of the aquifer in the Gaza Strip “remains unfit for human consumption,” according to the report. Much of this is likely to have worsened amid the pandemic.
In addition, a ban on “dual use” items — those that can be used by civilians and military — has affected the supply of equipment like electric generators for hospitals and communications equipment for ambulances.
Previous decisions at the WHA have recommended Israeli authorities ensure access for all Palestinian patients requiring specialized health care outside the occupied territories, ensure health workers get unhindered access to their workplaces, and exempt medical goods from the trade restrictions under the Paris Protocol.
Reporting on progress of implementing those recommendations, WHO said in its director-general report that access remains a challenge, with approvals for patients requesting to exit the Gaza Strip at only 65% in 2019. The report recommends the Israel government review and ensure its permit system does not hinder access for patients and their companions — such as in the case of children — as well as medical practitioners.
However, temporary import restrictions for vaccines to the territories “have been fully resolved,” and Israel has indicated easing restrictions on entry of protective equipment, according to the report.
A ‘misused’ WHO?
The Israel delegation argued the decision shifts the focus of the WHA from tackling global health challenges to “a political attack’” and “does not reflect the reality on the ground.”
“Dear colleagues, what are we really talking about here? A decision that politicizes the WHO and allows it to be misused,” said Israeli Ambassador Meirav Eilon Shahar.
Shahar said Israel supports the work of WHO in assisting the Palestinian health system, and has “strengthened its cooperation” with the Palestinian Authority in mitigating the spread of COVID-19 in the region.
Syria, a co-sponsor of the proposed decision, is “a regime that uses chemical weapons on its own citizens, a regime that deliberately targets and destroys health centers, threatens WHO staff and prevents first aid care to be delivered,” she said.
Shahar said a field assessment by WHO experts in the Golan Heights in 2017 found that “there were no significant barriers” for residents to access health care there. However, WHO never published the report due to pressure from Syria, she said.
A copy of the unpublished report obtained by Devex does state: “Key informants in the occupied Syrian Golan consistently stated that there were no significant barriers for residents to access primary, secondary or tertiary care, even for the most vulnerable members of the community.” It further notes that there are “no physical barriers or checkpoints limiting travel or access, including to referral facilities in northern Israel” nor permit requirements.
But the unpublished report also underscores the challenges in accessing disaggregated demographic and health data for Syrians in the Golan. The experts noted the difficulty in obtaining independent information and reports on the health conditions in the Golan, where there was limited presence of international organizations. They were not able to do a formal review of the quality of available health services to the Syrian Arab community because of time constraints.
In its report last week, WHO said it offered to provide health-related technical support to strengthen the COVID-19 response capacity in the Golan, but that in early May 2020, it was informed that there were no active cases there, and that information on COVID-19 and health care were accessible to all residents.
In response to claims of politicization, the Palestinian representative said it was its own citizens health that had been politicized — such as by the 2018 U.S. decision to cut medical aid to hospitals in East Jerusalem catering to children and cancer patients.
The Palestinian representative also asked WHO to continue supporting its health sector, and for Israel to “respect its obligations as a member of the World Health Organization.”