AP report reveals Houthis blocked shipment of cholera vaccines for almost a year

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In July 2017, a UN chartered plane carrying half a million doses of cholera vaccine to Yemen was not given permission to land by the Houthi militias until almost a year later, an AP report revealed.

Meanwhile, the outbreak continued to get worse, producing more than one million suspected cases.

UN officials believed they had the go-ahead to bring in cholera vaccines. Half a million doses were loaded onto a plane in the African republic of Djibouti.

At the last minute, hard-liners in the Houthi-controlled Health Ministry told the UN they would not allow the plane to land.

UN officials blamed the canceled flight on the difficulties in distributing vaccines during an armed conflict. But officials with knowledge of the episode told the AP that the real reason was that the Houthi militias who control northern Yemen refused to allow the vaccines to be delivered, after spending months demanding that the UN send ambulances and other medical equipment for their military forces as a condition for accepting the shipment.

A spokesman for the UN’s World Health Organization said at the time that delivering vaccines “has to make sense” in terms of the conditions on the ground, adding that the vaccine doses intended for Yemen would likely be re-routed to places that “might need them more urgently.”

UN officials sent the shipment to South Sudan in central Africa, where the disease had recently erupted. The cholera outbreak in South Sudan left 436 dead but was declared over by early 2018, largely due to the introduction of vaccines during the outbreak’s early stages.

The outbreak in Yemen went on unabated.

The cancellation of the shipment was just one of the setbacks that aid agencies faced in battling the cholera epidemic, which has killed nearly 3,000 Yemenis.

Yemen cholera. (AP)
Yemen cholera. (AP)

Relief workers and government officials said they have seen repeated indications that insiders in the Houthi-controlled north have skimmed off money and supplies for cholera vaccines and treatment and sold them on the black market. In some cases, treatment centers for people who had contracted cholera existed only on paper even though the UN had disbursed money to bankroll their operations, according to two aid officials familiar with the centers.

The AP’s examination of the efforts to fight the disease in Yemen drew on confidential documents and interviews with 29 people, including aid officials previously based in the country and officials from health ministries run by both the Houthi rebels and the internationally recognized government in the south. Almost all of these individuals—including six relief and health officials who say the Houthis were responsible for cancellation of the 2017 vaccine shipment—spoke on condition of anonymity because of fear of retaliation.

“The Houthis are taking advantage of UN weakness,” the official said. “Corruption or aid diversion and all of this are because of the UN’s weak position.” Relief workers know that if the UN speaks out, the official said, “their visas will be denied and they would not be allowed back in the country.”

When UN officials tried to rush in oral vaccines to halt the spread, some Houthi officials claimed vaccines were ineffective. A few messages circulated on social media asserting that vaccines could be harmful to children. Four aid officials and a former Houthi health official said that some rebel leaders suggested that the vaccination plan was a plot by the US and Israel to use Yemenis as guinea pigs.

A former senior official in the Houthi Health Ministry said the concerns over the vaccines’ safety were a pretext. Militia leaders had a list of demands and tried to bargain with UN officials for money and equipment, he said.

During weeks of negotiations over the vaccine program, the militiamen demanded that UN officials send X-ray machines and other items they could use to treat their wounded fighters on the front lines, according to the former health ministry official and three aid officials.

Cholera spread across Yemen in late 2016 and throughout much of 2017 and 2018. It ebbed late last year, but has again picked up in 2019. A new surge in the disease has produced roughly 150,000 reported cholera cases and nearly 300 deaths since the start of this year. The first cholera vaccine drives in Yemen didn’t start until May 2018 in the south, aid and health officials told the AP.

Yemen cholera. (AP)
Yemen cholera. (AP)

Ali al-Walidi, the deputy health minister in southern Yemen, and Youssef al-Hadri, the spokesman of the Houthi-run Health Ministry in the north, both deny there were delays in getting cholera vaccines into Yemen at the start of the outbreak.

Al-Hadri said claims that the Houthis blocked the shipment of vaccines into Yemen are false.

“This is all baseless, and I challenge the agencies to say this officially,” he said.

Discussing importance of vaccines

In that timeframe, Houthi officials held a succession of meetings throughout much of 2017 and into 2018 to consider the science and policy questions relating to vaccines. In the spring of 2018, after science panels approved bringing cholera vaccines into rebel territory, Health Minister Mohammed Salem Bin Hafez gave UN officials the go-ahead to bring in nearly 900,000 doses of cholera vaccine, according to documents obtained by the AP.

Then two of his deputies, both of them well-connected within the Houthi leadership, said the shipment couldn’t proceed, asserting that there were still more bureaucratic hurdles before the vaccines’ “safety and security” could be assured, according to the documents.

As a non-Houthi, Bin Hafez didn’t have the power to overrule the decisions of the two deputies who supposedly were working under him. He wrote a letter to the prime minister of the Houthi-controlled government, Abdel-Aziz Bin Habtour, detailing how the delivery of vaccines had been once again been put off.

“I am washing my hands of the consequences of these irresponsible actions,” Bin Hafez’s letter said. He told the prime minister that he was “putting the matter between your hands” in the hope the government would “take the necessary measures to use aid in a proper way and create proper work conditions for international and local aid agencies.”

A month later, Bin Hafez left his post and fled Houthi territory.
Abdel-Aziz al-Daylami, one of the Health Ministry deputies that Bin Hafez blamed for holding up the delivery of vaccines, denied that he had stopped the shipment.

“No, there was no rejection, but we had reservations,” he told the AP. “We thought that the vaccines would be useless” if they were deployed without more efforts to ensure clean water and reliable sanitation systems.

“We worried that if the vaccine campaigns failed, people would turn against the use of vaccines and that would be disastrous,” he said.

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