Tunisian authorities must accelerate fair access to vaccines, as Covid-19 cases soar

Tunisian authorities must urgently expedite fair access to vaccines for all, Amnesty International said in a detailed analysis published today, as Covid-19 infections in the country rapidly escalate amid a fourth wave. Public hospitals are already exceeding their maximum capacity, with intensive care units more than 90% full. 

Tunisia’s healthcare system is in danger of collapsing as cases skyrocket, bringing into sharp focus how woefully insufficient the government’s vaccine rollout is
Amna Guellali, Deputy Director for the Middle East and North Africa

Tunisia’s vaccine rollout began in March 2021 but has been undermined by a lack of transparency, political interference, delays in vaccine shipments and a failure to take into consideration human rights vulnerabilities in selection of priority groups. The vast majority of Tunisians remain unvaccinated, with only 13% of the population having received one dose and less than 6% fully vaccinated with two doses as of 13 July.  

“Tunisia’s healthcare system is in danger of collapsing as cases skyrocket, bringing into sharp focus how woefully insufficient the government’s vaccine rollout is,” said Amna Guellali, Deputy Director for the Middle East and North Africa at Amnesty International. 

"The authorities have failed to prioritize younger people with chronic health conditions and other vulnerable groups; meanwhile politicians have jumped the queue. The Tunisian government must immediately prioritize the right to health and ensure that those most vulnerable have access to vaccines.”  

Second highest daily confirmed death rate

At least 16,000 deaths related to Covid-19 have been recorded in Tunisia, one of the highest death tolls for Covid-19 in Africa as of 13 July 2021. At the moment, Tunisia’s rate of daily confirmed deaths per million people is the second highest in the world, second only to Namibia. 

While authorities have followed some of the recommendations from the World Health Organization (WHO), by prioritizing health workers and those over the age of 60, people with chronic illnesses and other vulnerable groups have not been prioritized. These include people with disabilities, people who live in poverty, prisoners and people experiencing homelessness. These groups often do not have access to health care services, and so are disproportionately affected by Covid-19 and have a higher risk of experiencing severe illness and death as a result of contracting the virus. 

Tunisia’s government published its national vaccination plan in January 2021, with the goal of vaccinating 50% of the Tunisian population by the end of the year. Six months on, it is lagging significantly behind schedule, due to delays in deliveries as a result of the global shortage of vaccines and the instability of the government. Tunisia has changed health minister four times since the start of the pandemic, and an ongoing political standoff between the head of the government and the president of the republic is also believed to have played a role in delaying the pre-order of vaccines. 

In April 2021 it emerged that several government ministers had skipped the queue to be vaccinated before they were eligible, eroding public trust in the government’s commitment to fair and equitable vaccine distribution and their willingness to prioritize those most at-risk. 

In May and June 2021, the government prioritized vaccinating workers in primary and high education, tourism, and justice, following negotiations with these sectors’ influential labour unions. However, the rationale used to determine eligibility has not been published, despite the fact that the Minister of Health has referenced the existence of a government regulation defining the eligibility of each priority list. 

This lack of transparency has raised key questions about the rationale for eligibility criteria and how decisions are made about which groups are prioritized to receive vaccinations. To date, the Tunisian government has not prioritized essential workers at high risk such as transportation and food workers. 

“Tunisia’s authorities must urgently present a revised national plan to ensure fair and non-discriminatory access for all," said Amna Guellali.

"They must take into consideration social and health vulnerabilities that heighten individual or community risks to Covid-19, in particular for marginalized groups."