Palestine’s Ministry of Health Covid-2019 Vaccine Purchases

- The Diwan (the General Directorate for the Oversight of Social and Cultural Services) audited the compliance of (Ministry of Health) with the laws and regulations governing the procedures for obtaining the Covid-2019 vaccine during 2021, and the following are the main observations reached by the Diwan:

· Administrative procedures in the (vaccine exchange transaction)

- There is no confirmation that the Ministry obtained Cabinet approval regarding the exchange transaction for the "Pfizer" vaccine with the other party, as it was found that the item related to the transaction was not placed on the Cabinet's agenda for discussion according to the rules...!

- The necessary approvals for the exchange transaction were not obtained from the Cabinet in accordance with proper procedures and the law.....!

- There is no reasonable confirmation regarding the formation of a specialized technical delegation to follow up on managing the transaction, as the Ministry did not, when following up on the implementation of the exchange transaction, form a team to manage the transaction and supervise its implementation, and to provide the qualified personnel and the necessary logistical support for receipt and delivery in accordance with the terms of the agreement..!

· Receipt of the vaccine in the (exchange transaction)

- There is nothing to confirm that the Ministry of Health documented the procedures that took place with the other party and other parties related to the Pfizer vaccine exchange transaction..!

- There is no reasonable confirmation of the existence of specific guarantees regarding the safety of the procedures for receiving the vaccines related to the exchange transaction, as the Ministry of Health did not include clear clauses to ensure compliance with storage and transport conditions for the vaccine upon receipt...!

- The Ministry also did not form a committee for inspection.... and physical and technical receipt..., for the purposes of inspecting and receiving the quantities received..to ensure their conformity with the technical terms and specifications set out in the contract documents and the company's conditions..!

- Although the Ministry of Health's justification for conducting an exchange transaction for the "Pfizer" vaccine with the other party was based on health concerns about the spread of the pandemic and the fear that Pfizer would not deliver the vaccines in a timely manner, and it aimed to accelerate reaching herd immunity to work on reopening the economy and schools and universities... nevertheless ( Ministry of Health)... did not do the following:

1- Prepare the necessary studies about the epidemiological situation expected during the period in which a gap was expected..

2- It did not prepare a media plan that clarifies the importance of obtaining the vaccine

3- It did not prepare and implement measures that would increase citizens' willingness to receive the vaccine.....

4- There is no confirmation that the Ministry took other precautionary measures.... before resorting to the exchange option...., such as studying the effectiveness of lockdowns and resorting to a policy of mandating a particular vaccine type and the Ministry of Health taking the necessary precautions regarding vaccine efficacy..!

· Committees (Negotiation and procurement):

- Despite the fact that the Coronavirus pandemic is a global emergency, and despite the worldwide competition of all countries to obtain vaccines, the Ministry did not form a committee to negotiate and conclude agreements with vaccine manufacturers regarding prices and obtaining the vaccine,

- There is a shortcoming concerning the role of the special committee for purchasing the Covid-2019 vaccine... and the problem under Cabinet Decision 06/77/18/مو/م.أ for 2020, regarding its assigned role to set the necessary technical and legal procedures to introduce and use the vaccine safely..!

· (Vaccine type and vaccination)

- There is no clear and approved policy regarding mandatory vaccination, whether for the general public or for specific groups of citizens, nor regarding mandating (the type of vaccine available at the Ministry)....., in order to ensure reaching the targeted percentage of vaccinated citizens (70% of citizens),

- There is no media plan for health education to increase citizens' uptake of vaccination and raise their awareness of the risks of not being vaccinated....

- There is no confirmation regarding the effectiveness of the platform for enforcing registration to receive the vaccine, as the platform was created to register citizens wishing to obtain the vaccine, with the aim of enhancing transparency and citizens' confidence in the Ministry's procedures, but it was found that the number who received the vaccine, 490,309 citizens, received the first dose up to the date 2-8-2021 — far greater than the number registered on the platform, which amounted to 267,574 citizens registered on the platform up to the same date..... and therefore, there is no reasonable confirmation of the platform's added value..!

· (Receipt and storage)

- There are observations regarding the management of the (vaccine stock), where some vaccines are not kept in central warehouses, and it was found that 213,300 doses of Sputnik Light vaccine were kept in the blood bank refrigerators in Ramallah...., and it was also found that 38,050 doses of the AstraZeneca vaccine were nearing expiry...!!

- The emergency budget for purchasing vaccines was not allocated a financial amount in the 2021 fiscal year's budget for purchasing Covid vaccines, and a review of expenditures for vaccine purchases in 2021 shows that the Ministry of Finance made (transfers from the public expenditure responsibility center).... to the Ministry of Health in the amount of 22,471,418 dollars, to purchase Covid vaccines up to the date 15-8-2021,

- The Ministry of Health's response to the report was positive.... and agreed with the observations contained in the report..!!.. And I see no benefit from the positivity.., as long as accountability and محاسبة have not been applied…..? for all these observations, violations and negligence that raise questions, coming from a responsibility center the size of the Ministry of Health’s humanity…which is the essence of its responsibility and mission... to be a vigilant eye...to protect the citizens' health and prevent harm… and ward off all risks away from them….for their health ….., ...isn't the human being among us the dearest thing we own.....?!

· Date 24-8-2022