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December 3, 2019

The Political Instability and the Health and Wellbeing of the Palestinian Territories

According to the Organization for Economic Cooperation and Development (OECD), Palestine or the Palestinian territories of Gaza and the West Bank are considered highly fragile. This fragility comes from the absence of territorial, economic and political sovereignty due to the ongoing Israeli-Palestinian conflict. The political conflict in the Palestinian territories as well as the territorial fragmentation of the West Bank make an integration of basic health care services a very difficult. In investigating the association between political instabilities/humanitarian crises and the re-emergence of infectious diseases I have seen how many historical epidemics have been associated with political conflicts. For instance, in 2016 there was a devastating cholera outbreak in Yemen as a result of the ongoing war and the Saudi Arabian-led intervention against the Houthi movement. Airstrikes targeted and damaged hospital infrastructure as well as water supply. Furthermore, I attended the 2017 Harvard National Model United Nations Conference, where I represented the Republic of Botswana at the Special Summit on Terrorism. During the conference, I learned about the re-emergence of wildtype poliovirus that occurred during the Syrian Civil War, which was declared a public health emergency by the World Health Organization (WHO). Another example is the recent outbreak of the Ebola virus in the Democratic Republic of the Congo, a country that has been affected by various political conflicts and the widest interstate war in modern African history.

As a fellow with the Georgetown Global Health Initiative, I am working as a research assistant with Dr. Wolfgang Rennert, MD, DMSc, DTM&H, at MedStar Health. The project focuses on the safety and immunogenicity of ROTAVAC, a rotavirus vaccine, in the Palestinian territories of Gaza and the West Bank. Rotavirus is considered the most common cause of severe diarrheal disease accounting for up to 45 percent of hospitalizations for children under the age of three. The high poverty rates and the limitation of movement of goods and people between the territories continue to worsen the status of the disease in Gaza and the West Bank. Furthermore, the Gaza strip is suffering from a devastating water crisis; 97 percent of drinking water is unfit for consumption by international standards. This collapse of water infrastructure has led to a sharp rise in various pathogens, among which are rotavirus, cholera and salmonella. "When you have political instability, public health always suffers," Jeremy Farrar, PhD, an infectious disease expert at the University of Oxford.

It is interesting to note that low-income countries often tend to have better access to vaccines than middle income countries. Low-income countries receive global support from organizations such as Gavi, the Vaccine Alliance.  While the Palestinian territories are very poor, they do not receive Gavi support. According to the United Nations Office for the Coordination of Humanitarian Affairs (OCHA), 53 percent of Palestinians in Gaza live in poverty. This means poverty has increased by 14 percent in a six-year period. “Palestine is very poor. But unfortunately, Palestine is not even seen as a country,” Dr. Rennert. Palestine can be safer and healthier if it is fully recognized as an independent state.

One of the main health challenges that poses global concerns is the fact that public health threats, health emergencies and infectious diseases do not recognize or respect political borders. The safety and well- being of the Palestinian territories are essential for the safety and well-being of the State of Israel as well as the Global community. 

Mohammed Jibriel (G’20) is a graduate student at the Department of Microbiology and Immunology studying Biohazardous Threat Agents and Emerging Infectious Diseases and a student fellow with the Global Health Initiative.