Even as infection rates spike again, the country’s small size and the efficiency of its decentralized public health system have made it an ideal place to carry out a program of mass inoculation. Prime Minister Benjamin Netanyahu, dogged by corruption charges and facing a fourth election since 2019, has yoked his political fortunes to the vaccination drive.

“I have my complaints about Israel and the government,” Rina Abadi, a Tel Aviv-based tech worker, told my colleagues recently after receiving the vaccine. “But I’ve never had a complaint about the health-care system.”

Still, around a third of the 14 million people living between the Jordan River and the Mediterranean Sea are not included in this vaccination campaign. Israel has distributed vaccines to Jewish settlers in the West Bank, but not to Palestinians there or in the crammed, impoverished Gaza Strip. Israeli officials contend that these Palestinians don’t fall under their jurisdiction under the terms of the Oslo accords and that it is the job of the Palestinian Authority to procure and distribute vaccines in the occupied territories.

“I don’t think that there’s anyone in this country, whatever his or her views might be, that can imagine that I would be taking a vaccine from the Israeli citizen, and, with all the goodwill, give it to our neighbors,” Israeli Health Minister Yuli Edelstein told Britain’s Sky News over the weekend.

“There could hardly be a better illustration of how Israeli lives are valued above Palestinian ones,” Saleh Higazi, deputy regional director for the Middle East and North Africa at Amnesty International, said in a statement.

On Monday, Palestinian officials announced plans to obtain and administer Britain’s AstraZeneca vaccine, as well as Russia’s Sputnik V shot. They also expect to receive assistance from the World Health Organization’s Covax initiative, which seeks to distribute vaccines to some of the world’s more disadvantaged countries. Those could be administered as early as next month.

That the Palestinians may not have formally requested assistance from Israel is not surprising, given how low an ebb ties between the two parties are. They also lack the super-cold storage facilities needed to house Pfizer’s vaccine, which has been the most widely distributed one in Israel.

Israel’s critics argue that the disparity in vaccine distribution underscores a starker reality. Whatever the political arrangement between the Israeli government and the Palestinian Authority — an institution intended only to be a transitional entity for a future Palestinian state that’s now impossible to imagine — they contend that, under the terms of Geneva Conventions, Israel as an occupying power has a responsibility for those living under its occupation.

In a statement this weekend, the Palestinian Foreign Ministry said “the search by the Palestinian leadership to secure the vaccines from various sources doesn’t exempt Israel from its responsibilities toward the Palestinian people in providing the vaccines.” It accused Israel of “ignoring its duties as an occupation power” and “committing racial discrimination against the Palestinian people.”

“Where budgetary shortages resulting from the long-term restrictions imposed by the occupation and blockade limit the ability of the Palestinian Authority to purchase and distribute vaccines, Israel must provide the necessary funds, as part of its legal obligations,” read a statement by a coalition of Israeli and Palestinian health and human rights organizations last month.

Human rights groups are also petitioning the Israeli High Court over the government’s decision to withhold vaccines from Palestinian prisoners in Israeli detention, even though conditions in these facilities make inmates particularly vulnerable to contracting the virus.

Israeli security concerns shape every dimension of Palestinian life. Israeli control is also likely to influence the ability to effectively distribute vaccines to Palestinians, especially in Gaza, which is under blockade and run by the Islamist political movement Hamas.

“We are in Gaza, sure it will take a year, not a month,” Lina Mohammad Abu Daff, a 44-year-old Gaza City resident who works at the local health ministry, told the Wall Street Journal, conveying her cynicism over current plans.

“Places like the occupied territories, where the health infrastructure is weak and it is difficult to maintain basic social distancing or hygiene requirements, should be prioritized in vaccination efforts,” wrote Yara Hawari, a fellow at Al-Shabaka, the Palestinian Policy Network. “And yet, because of prevailing structures of oppression, they won’t be.”

“There’s a basic moral obligation,” Hagai El-Ad, executive director of B’Tselem, an Israeli human rights group, told Today’s WorldView. “There’s one government, one regime, that basically controls everything from the river to the sea. We decide what comes in and out, who comes in and out.” He added that there should be no legal or administrative argument for Israelis “to hide behind not addressing something as basic as the health of the people under your control.”

The depth of that control has only grown more glaring in recent years. Under Netanyahu’s rule, demolitions of Palestinian homes and expansion of Israeli settlements continue apace. With the blessing of the Trump administration, Israel’s right-wing government has also seemingly foreclosed the possibility of a fully sovereign Palestinian state and is still mulling annexation of parts of the West Bank.

On Tuesday, B’Tselem published a new position paper making the case that the prevailing status quo ought to be seen as that of an “apartheid” regime.

“A regime that uses laws, practices and organized violence to cement the supremacy of one group over another is an apartheid regime,” read the report. “Israeli apartheid, which promotes the supremacy of Jews over Palestinians, was not born in one day or of a single speech. It is a process that has gradually grown more institutionalized and explicit, with mechanisms introduced over time in law and practice to promote Jewish supremacy.”

It concluded: “As painful as it may be to look reality in the eye, it is more painful to live under a boot.”