U.A.E. and Israel have world's fastest vaccination programs what can the West learn from them?

On Dec. 19, Israeli Prime Minister Benjamin Netanyahu grinned on live television as he received his first COVID-19 vaccine, signalling the start of what would become the world's fastest inoculation campaign.

But over in the United Arab Emirates, the country's health minister received his dose four months earlier after the Gulf country authorized the emergency use of the Chinese-made Sinopharm vaccine.

Since then, the U.A.E. has administered more than four million vaccine shots.

"The national campaign for the COVID-19 vaccination is one of the most-important initiatives that the U.A.E. has achieved," said Dr. Saif Al Dhaheri, spokesperson of the country's National Emergency Crisis and Disaster Management Authority, during a COVID-19 briefing last month.

According to Our World In Data numbers, Israel and U.A.E. lead the world in administered vaccinations. Both were swift to secure vaccines and begininoculating citizens, and they are now up to a rate of roughly 71 doses per 100 people in Israel and 48per 100 in the U.A.E., as of Friday.

Another Gulf country, Bahrain, ranks fifth in the world, with 13 doses administered per 100 people as of Wednesday. That is still more thanfour times the rate in Canada.

Canada has faced delays in vaccine delivery while the United States has struggled to speed up its lagging rollout. The United Kingdom ranks third worldwide in vaccination rate, but it is embroiled in a fierce feud with the European Union over vaccine exports.

While part of the vaccination success in Israel and the U.A.E. can be explained by the countries'small populations and relative wealth compared to other Middle East countries, medical experts say the West can still take some lessons from them and other countries in the region.

Vaccine diversity

According to Joan Barcel, assistant professor at New York University in Abu Dhabi and co-lead of the CoronaNet Project, a database of government responses to COVID-19, timely rollouts in some parts of the Middle East are due to a willingness to sourcevaccines outside the West.

While Israel and countries in the Gulf Co-operation Council (U.A.E., Bahrain, Saudi Arabia, Kuwait, Qatar and Oman) have relied heavily on the Pfizer-BioNTech vaccine, the U.A.E. was the first country to approve the Sinopharm vaccine for widespread use early in December, with Bahrain soon following suit.

When oil-rich U.A.E. was hit by the twin crises of COVID-19 and a drop in worldwide fossil fuel demand, the idea of a fast vaccination campaign helped foster hope of economic recovery, said Crystal Ennis, a lecturer in political economies of the Middle East at Leiden University andvice-president of the Association for Gulf and Arabian Peninsula Studies (AGAPS).

The U.A.E. became a trial site for Sinopharm, which started Phase 3 human trials early in the summer. In September, the government issued emergency approvals for front-line health-care workers. By December, social media coverage was rife with images of residents receiving doses.

"This positioned the U.A.E. well in the global vaccine rollout," Ennis said.

At that point, Canada had only just approved the Pfizer-BioNTech and Moderna vaccines.

The U.A.E. has since announced that it will start manufacturing the Sinopharm vaccine locally to speed up production and has secured its first shipment of the Oxford-AstraZeneca vaccine.

It is also running clinical trials of Russia's Sputnik V vaccine, which a recent study in the Lancet medical journal deemed "safe and effective."

"The West, and especially the EU, has been slow in authorizing new vaccines and have not been very open to authorize non-Western vaccines," said Barcel. "This meant that all eggs were put in one basket. The delays in the production and the distribution of the approved vaccines are leading to delays in the vaccine administration, and that is costing lives."

Several Mideast countries using Sinopharm

The most important lesson for the West, Barcel said, is to speed up the authorization processes for new vaccines and "avoid favouring some vaccines over others based on their origin rather than their medical data."

Western nations have been concerned, however, about the shortage of data on the Sinopharm vaccine. The company has not divulged much beyond the vaccine's 79 per cent efficacy rate, and medical professionals have expressed skepticism over the lack of published data during development and trials.

However, this was not a deterrent for the at least 17 countries that have already purchased the vaccine globally.

"Countries should prioritize vaccines that are effective, secure and that can be distributed massively to the entire population in a reasonable time frame without considering where a vaccine comes from," said Barcel.

Egypt, Jordan and Morocco are among the countries using Sinopharm. Meanwhile, Iran, which has been hardest hit in the Middle Eastby the coronavirus, with 1.5 million cases and close to 59,000 deaths, is currently developing its own vaccine.

Itkicked off its vaccination campaign earlier this week using Russia's Sputnik V. Oman, meanwhile, has committed to AstraZeneca vaccines manufactured in India.

As new variants of the virus spread across the globe, more Western nations are slowly turning to other vaccine options. Hungary became the first EU country to approve Sinopharm, and Switzerland is negotiating with Iran for its domestic vaccine.

Canada, which leads the world in terms of vaccine procurement per capita, secured millions of doses of the Moderna and Pfizer-BioNTech vaccines in December, but in light of recent delivery delays, just announced that it will produce the Novavax vaccine domestically, although it will take months to begin the manufacturing process.

More than 100 vaccine centres inU.A.E.

Another reason the U.A.E. was able to scale up its vaccination program is that it established more than 100 vaccine centres in its megacities, Abu Dhabi and Dubai, where more than 70 per cent of its population (nearly 10 million people) lives.

By comparison, the province of Ontario, which has about one and a half times the population, has only 23 vaccination hubs.

Meanwhile, Israel, which has already administered more than six million doses, may have gotten a jump on vaccinations because it agreed to share patient medical data during the rollout of the Pfizer-BioNTech vaccine.

"There is a diverse ethnic region in Israel, and it's a small country with a small population, so maybe this was an incentive [for] Pfizer to give us vaccination priority," said Hadas Ziv, head of policy and ethics at Physicians for Human Rights-Israel.

This incentive led to a bulk shipment of vaccines in early December. Once delivered, an efficient digitized system alerted priority groups when and where to go for their vaccines.

Israel recently agreed to transfer 5,000 doses to front-line Palestinian medical workers in the Palestinian Territories, where the Palestinian Authority last weekaccepted the first shipment of Sputnik V vaccines.

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Aid organizations are relying on COVAX, a project co-led by the World Health Organization, which helps countries lacking resources buy large quantities of vaccine for up to 20 per cent of the population.

The COVAX-dependent countries in the region include Iran, where U.S. sanctions have hobbled the ability to secure loans to fund a vaccine.

"There's a huge discrepancy. You have countries like Israel and the U.A.E. that were among the first countries to vaccinate their citizens, and you have on the other hand, extremes such as Yemen, Syria and Iran," said Dr. Souha Kanj, head of infectious diseases and chair of the infection control program at the American University of Beirut Medical Centre.

Similarly, while the vaccine is free and accessible in the U.A.E., Ennis stressed that migrant workers who are undocumented or lack residency or work status may be left out of the vaccination campaign.

She said tens of thousands of migrant workers have lost their jobs because of the pandemic and are stranded in countries spanning the Gulf, leaving them without access to medical insurance or residency status.

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