Bethlehem, 19 January 2021. The novel virus has reinforced the situation of acute vulnerability experienced by Palestinian refugees. As the world is preparing for mass vaccination campaigns, the pandemic’s impact on Palestinian refugees is likely to persist. The COVID-19 vaccination process under the auspices of the United Nations Relief and Works Agency (UNRWA) remains uncertain due to the chronic lack of funding that the Agency is facing. In Lebanon, West Bank and Gaza Strip in particular, this uncertainty is exacerbated by host and/or responsible states’ intentional unwillingness to comply with their duties towards the protection of Palestinian refugees’ right to health as per international law.
Israel, formally the occupying power in the West Bank and Gaza Strip, has continued to pursue its systemic discriminatory policies towards the Palestinian people in the administration of COVID-19 vaccines. While Israel currently stands as the leading provider of COVID-19 vaccines, with 10 percent of the mostly Israeli-Jewish population vaccinated as of January 2021, Palestinians with Gaza and West Bank IDs were excluded from the immunization scheme, including Palestinian refugees which constitute 42 percent of the population in the occupied Palestinian territory. Although Commissioner-General of UNRWA Philip Lazzarini ensured that vaccination will be provided to Palestinian refugees by the Palestinian National Authority, with the support of the Agency, this should not detract attention from Israel’s duty to provide vaccines to Palestinians: as per Article 56 of the Fourth Geneva Convention, it is the occupying power’s duty to “[...] ensur[e] and maintain[...] the medical and hospital establishments and services, public health and hygiene in the occupied territory, with particular reference to combat the spread of contagious diseases and epidemics.”
Palestinian refugees residing in Lebanon, including those who were exposed to secondary displacement as a consequence of the Syrian conflict, have long been the target of systemic discriminatory policies on part of the Lebanese government. Ineligible for Lebanese citizenship, some 450,000 Palestinian UNRWA-registered refugees residing in Lebanon are deprived from access to the state’s social services, comprising health care. Health care is the responsibility of UNRWA or, alternatively, costly private facilities. The recent passing of legislation aimed at permitting deals for COVID-19 vaccines will only benefit the Lebanese national population, to the exclusion of Palestinian refugees. The entire charge of their immunization is likely to lay on UNRWA, within its shrinking financial margin of action.
UNRWA’s emergency mission to supply COVID-19 vaccines in all its fields of operation comes within the context of its gradual depletion of its financial capacities as a result of chronic defunding of its core programs by donor states. Donors’ withdrawal is particularly concerning and detrimental as UNRWA’s budget almost entirely relies on voluntary donations, making up to 95.34 percent of its overall budget. The biggest contributor to UNRWA's budget with $365 million in 2017, the United States has utterly ceased its donations in 2018. To face the COVID-19 pandemic, UNRWA has been compelled to submit several emergency appeals, the latest to date amounting to $94.6 million to allay the pandemic’s impact on health, cash assistance and education from September to December 2020. Within this context, it is essential to consider international responsibility for the protection of Palestinian refugees’ right to health as a result of the pandemic.
The obligation to provide for COVID-19 vaccination to Palestinian refugees is derived from two different sources. It first falls within the pursuance of their internationally recognized right to health, to which host states as well as an occupying power are obligated. It then falls within the purview of the UNRWA as part of its mandate to provide assistance to Palestinian refugees until a just and durable solution to their predicament is reached.
The United Nation General Assembly (UNGA) Resolution 302(III) of 8 December 1949 mandated UNRWA to provide “direct relief and works programmes” to Palestinian refugees with the support of states and other UN Agencies, in the present instance, the World Health Organization (WHO). Primary healthcare services constitute a fundamental pillar of UNRWA’s assistance that serves more than 3.1 million refugees, as well as one of the strategic outcomes of its medium term strategy 2016-2021. Considering this, vaccination campaigns have consistently been carried out by the Agency within the framework of host countries’ immunization program, with a coverage largely exceeding WHO’s target of 95 percent, to prevent preventable infectious diseases.
The UNRWA’s mission to perform vaccination campaigns does not absolve host states from their obligations towards their Palestinian refugee communities under international human rights law. The aforementioned UNGA Resolution 302(III) locates UNRWA’s work “in collaboration with local governments.” As per Article 12(2)(c) of the International Covenant for Economic, Social and Cultural Rights (ICESCR), the full realization of the right to health covers “the prevention, treatment and control of epidemic […] diseases.” Controlling epidemics constitutes a core obligation and notably entails “the implementation or enhancement of immunization programmes” by states. Access to immunization must be performed without discrimination based on national origin, in particular to refugees. Also pursuant to UNGA Resolution 302(III), governments are required to facilitate UNRWA’s completion of its mission. Facilitation implies that host states should in particular support “privileges, immunities, exemptions and facilities” to enable UNRWA’s vaccination mission.
Finally, third states are also expected to provide “disaster relief and humanitarian assistance in times of emergency, including assistance to refugees [...] to the maximum of their capacities,” and to assist, where necessary, access to healthcare in third states. Coupled with the collective responsibility to assist and find a just and durable solution to the Palestinian refugees’ plight, third states should uphold UNRWA’s undertakings through voluntary financial donations and support its COVID-19 immunization scheme.
The provision of COVID-19 vaccination to Palestinian refugees, under the umbrella of UNRWA, is legally protected under international human rights law. Host governments, notably Lebanon, are under the negative duty not to impede UNRWA’s mission through discriminatory health policies, and the positive duty to actively support the realization of UNRWA’s immunization scheme, whether by means of financial donations or technical aid. The Palestinian Liberation Organization, recognized as the representative of the Palestinian people as per UNGA Resolution 3210(XXIX), should actively demand that host states and third states comply with their obligations towards Palestinian refugees.
Therefore, BADIL calls upon:
- The international community, to exert pressure on Israel and bring it into compliance with its obligations as per occupation law, to provide and support COVID-19 immunization campaign in the oPt of the West Bank and Gaza Strip;
- The international community of UNRWA donors, including state donors, to assist and support UNRWA’s efforts to provide continuous and unimpeded services and assistance to Palestinian refugees, in particular by financing UNRWA’s emergency appeals to support the COVID-19 immunization of Palestinian refugees.
- Host states, in particular Lebanon, to uphold their obligations as per international human rights law, by first including Palestinian refugees in their campaigns for vaccination, and to secondly support, materially and financially, UNRWA’s provision of vaccination schemes to Palestinian refugees;
- The Palestinian Liberation Organization, as the internationally recognized representative of the Palestinian people, to demand that host states secure non-discriminatory access to COVID-19 vaccines, in coordination with UNRWA and other UN agencies such as WHO.
 UNGA, UNRWA Financial Report and Audited Financial Statements for the Year Ended 31 December 2019 and Report of the Board of Auditors, A/75/5/Add.4, 14, available at: https://www.un.org/en/auditors/board/auditors-reports.shtml [accessed 8 January 2021].
 UNRWA, 2017 Pledges to UNRWA’s Programmes (Cash and In-Kind) – Overall Donor Ranking as 31 December 2017 in USD, available at: https://www.unrwa.org/sites/default/files/overalldonor_ranking.pdf
UNRWA Health Department, Annual Report 2019, 23, available at: https://www.unrwa.org/sites/default/files/content/resources/health_department_annual_report_2019_-final.pdf.
 Committee on Economic, Social and Cultural Rights, General Comment No.14, The Right to the Highest Attainable Standard of Health, E/C.12/2000/4, 11 August 2000, paras.16 & 44.
 Committee on Economic, Social and Cultural Rights, General Comment No.14, The Right to the Highest Attainable Standard of Health, E/C.12/2000/4, 11 August 2000, paras.18 & 34.
 Committee on Economic, Social and Cultural Rights, General Comment No.14, The Right to the Highest Attainable Standard of Health, E/C.12/2000/4, 11 August 2000, paras.39-40.