So how exactly has Israel pulled off this unlikely feat? The answer traces back decades to the embryonic health infrastructure created before the State of Israel even existed. That, in turn, should serve as a sobering reminder for Americans: Nations faring well against the virus are drawing on preexisting strengths, not flexing muscles suddenly conjured amid the crisis or, say, a change in administrations.
The countries that have performed best against COVID-19 have been those “that in general have good public-health infrastructures—and we [in the United States] just don’t,” Helene Gayle, the head of the Chicago Community Trust and a veteran of the CDC, told me.
“There’s a big lesson from this, which is: You’re not going to be ready for a pandemic if you don’t have your data systems in place, your surveillance systems, your state-level funding for the infrastructure, so that you can distribute [vaccines] effectively and fast,” argued Gayle, a co-chair of a recent study on how to equitably allocate COVID-19 vaccines.
And as the world shifts from focusing solely on containing the virus to rolling out vaccines as well, the key determinant of success is morphing from the credibility of the government to the credibility of the health-care system. As the scholars Jeremy A. Greene and Dora Vargha have observed, vaccines are at least in part “technologies of trust” that rely on people “maintaining confidence in national and international structures through which vaccines are delivered.”
The apparent paradox of Israel being both a “vaccine champ” and a “contagion chump,” as the Israeli journalist David Horovitz memorably put it, becomes less mystifying on closer inspection. Whereas some countries that did better in flattening the curve of coronavirus cases, such as Australia and South Korea, at first proceeded cautiously with plans to approve and procure vaccines, because they felt they had the virus under control, pandemic-battered Israel didn’t have that luxury. What the Israeli government felt instead was urgency.
Ahead of elections this March, Israeli Prime Minister Benjamin Netanyahu has cast himself as the face of the country’s vaccination campaign (he got Israel’s first COVID-19 shot) and its dealmaker in chief, negotiating directly with Pfizer’s CEO and reportedly paying Pfizer-BioNTech and Moderna top dollar to receive doses quickly and at scale when global supplies are tight.
Netanyahu recently announced an agreement with Pfizer that will send hundreds of thousands of vaccine doses to Israel per week. Israel, in turn, will serve as something of a national clinical trial—or, in the prime minister’s words, a “global model state for the rapid vaccination of an entire country.” It will send Pfizer anonymized medical information about the effects of the vaccine on the population and on curbing the epidemic. The statistical data could yield lessons not only for Pfizer and other pharmaceutical companies as they continue to develop COVID-19 vaccines, but also for other countries and international organizations working on their own vaccination campaigns.