JERUSALEM (AP) – After firing on the run to inoculate its population against the coronavirus, Israel struck a deal with Pfizer, promising to share a vast collection of medical data with the international drug giant in exchange for the continuous flow of to get the vaccine .
Supporters say the deal could allow Israel to become the first country to vaccinate most of its population, while providing valuable research that can help the rest of the world. But critics say the deal raises major ethical concerns, including possible breaches of privacy and a deepening of the global divide that allows rich countries to stockpile vaccines, as the poorest populations, including Palestinians in the Israeli-occupied West Bank and Gaza, have to wait longer to be inoculated.
Prime Minister Benjamin Netanyahu – who anticipates the country’s March elections as Israel’s chief vaccinator – said earlier this month that he reached an agreement with the chief executive of Pfizer to speed up vaccine deliveries to Israel.
“Israel will be a global model state,” he said. “Israel will share with Pfizer and the world the statistical data that will help develop strategies to defeat the coronavirus.”
Israeli Health Minister Yuli Edelstein told the Associated Press that the government will provide data to “see how it influences, in the first place, the level of the disease in Israel, the possibility of opening up the economy, different aspects of social life and if there are any effects of vaccination. “
The Pfizer vaccine, developed with the German partner BioNTech, has received emergency approval from the Food and Drug Administration and the European Union regulatory agency and is believed to provide up to 95% protection against COVID-19. But much remains unknown, including its long-term protection and whether it can prevent transmission of the virus.
Israel, where around 9.3 million people live, is considered an ideal place to study these issues. Its mandatory universal health care is provided by four publicly funded HMOs, with meticulously digitized medical records. This centralized system has helped Israel deliver more than 2 million doses of the vaccine in less than a month. Israel also bought doses of the Moderna and AstraZeneca vaccines.
The inoculation blitz is a matter of national pride. It is also at the heart of Netanyahu’s reelection campaign while he tries to divert attention from his ongoing corruption trial, Israel’s deep economic crisis and the latest virus outbreak.
The Ministry of Health has recorded more than 551,000 cases since the pandemic began and more than 4,000 deaths. Israeli officials say they intend to vaccinate most of the country by the end of March, close to election day.
But the exact quid pro quo between Israel and Pfizer is not clear, even after a written version of the agreement was launched by the Israeli Ministry of Health on Sunday.
Neither Israel nor Pfizer said how much Israel paid for vaccines, although Edelstein called it a “classic win-win” for both sides. Israeli media reported that Israel paid at least 50% more than other countries. The data is being shared with the World Health Organization, but the global body has not responded to repeated requests for comment.
Earlier this month, the WHO chief called on drug manufacturers and wealthier countries to “stop making bilateral agreements”, saying they undermine a UN-supported effort to expand access. Tedros Adhanom Ghebreyesus did not highlight any country or company.
Last week, Dr. Siddhartha Datta, WHO Europe program manager for vaccine-preventable diseases and immunization, said the agency is trying to collect “disaggregated” data – based on age, sex, local area, employment and other factors – and reports on any safety issues as vaccines are deployed.
Israel had already announced the acquisition of millions of doses of vaccines before the announcement of the agreement with Pfizer. It is not clear how the quantity or pace of deliveries has changed, or whether vaccines have been diverted from other countries.
The arrangement drew attention to the uneven distribution of vaccines between rich and poor nations. A recent estimate by the International Rescue Committee said that the WHO global COVAX campaign is likely to vaccinate only 20% of the world’s low-income countries by the end of 2021.
“This is an obscure and obscure agreement that gives preference to certain countries over others without any transparency,” said Lawrence Gostin, professor of global health law at Georgetown University in Washington. “In the end, it will be the low and middle income countries that will be left behind.”
Dr. Nadav Davidovitch, head of the public health school at Ben Gurion University in Israel and a government adviser on coronavirus policy, said the deal had raised worrying concerns about the widening disparity in vaccination efforts.
“To eradicate COVID-19 or at least control it efficiently, we need to see the big picture,” said Davidovitch.
This disparity is particularly noticeable in the case of Israel and Palestinians in the West Bank and the Gaza Strip, who live under varying degrees of Israeli control and have not yet received vaccines.
By vaccinating its own Arab citizens and Palestinian residents of East Jerusalem attached to Israel, Israel says it is not responsible for inoculating the Palestinians. Edelstein said Israel will consider helping as soon as it takes care of its own citizens.
But the Palestinians and the main human rights groups say that Israel remains an occupying power and is responsible for providing vaccines. Palestinian Prime Minister Mohammad Shtayyeh recently accused Israel of “racism”, but did not publicly request vaccines.
With tens of thousands of Palestinians in the West Bank working in Israel and in their West Bank settlements, experts say Israel should share vaccines for ethical and practical reasons.
“I really think we need to see how we get the vaccine for the Palestinian Authority,” said Davidovitch, acting chairman of Israel’s association of public health professionals. “We are talking about this with the Minister of Health, and I really hope that this will be resolved soon.”
It is also not known exactly what information is being shared with Pfizer. According to the written agreement, “no identifiable health information” must be shared and the research must be published in a recognized medical journal.
He said Israel will provide Pfizer with weekly data on various ages and demographic groups. The objective, he said, is “to analyze the epidemiological data resulting from the launch of the product, to determine if the herd’s immunity is achieved after reaching a certain percentage of vaccine coverage in Israel”.
The data, he added, are “designed to help end the global COVID-19 pandemic for the benefit of all patients inside and outside Israel.”
Privacy Israel, a defense group that has petitioned the government to publicize the agreement, welcomed its release, but said that certain questions remain unanswered, mainly about the handling and security of private information. It also hid some details, such as important dates and names of employees involved. Still, he said there is “a little more certainty” about sharing information with a global company.
Tehilla Shwartz Altshuler, a digital privacy expert at the Israel Institute of Democracy, questioned the ethics of a deal that could bring millions in profits for Pfizer. She also said that sharing large amounts of information could still put individuals’ privacy at risk, even if it is supposed to be anonymous.
“If, God forbid, the data set is going to be hacked, then the risk will be yours,” she said, referring to Israeli citizens.