As part of LIFO’s “LIFO Politics” podcast series, Dr. Apostolos Veizis, Executive Director of INTERSOS Hellas recently spoke with the journalist Vasiliki Siouti focusing on the need to vaccinate refugees and migrants in our country.
He stated that:
«The issue of access, accessibility to diagnostics, vaccines and drugs worldwide is something that for over than twenty-five years of my course I and other colleagues have systematically identified and appropriately analyzed why it exists and what kind of obstacles we must overcome as a society in order to ensure that public health is destined for all the people.
Regarding people on the move or trapped, asylum seekers, refugees and undocumented people, the effects of Covid-19 were more serious compared with the general population, and this has been reported in other European countries.
As far as Greece is concerned, we do not have systematic data with which we can prove it. There are some data that were mentioned at some point by POEDIN referring to people who were in intensive care units but there more than the half of people were asylum seekers, immigrants and refugees who came either from accommodation facilities or from the center of Athens. But for our part, as INTERSOS, in collaboration with other academics, we conducted a study which we announced to the Lancet and which had been published in the Greek press.
This study was relevant with the analysis of the data of asylum seekers and refugees living in accommodation facilities on the islands or on the mainland based on data already provided by NPHO (EODY), covering the period from February 2020, when we had the first Covid breakout in Greece until November 2020. These data show us that the impact on people living in facilities on the islands is 3 times higher than the general population, and the impact was two and a half times higher for people living in facilities on the mainland.
The reason was clearly the way these people remain in these particular places which are the definition of overcrowding. They were excluded, it was the first population group in Greece that was excluded from the movements and we had the lockdowns from March 17th in comparison with what happened to the general population where there were movements. People mentioned above, still endure this mechanism of marginalization. So, in fact, we may not have had a large number of deaths in these facilities but the effects of the disease were more serious.
The not-so-huge number of cases with covid in these facilities is probably due to the arrival of new people, so as scientific research has shown so far the impact on young people has gone a little better.
Nevertheless, the serious effects of the disease itself were something unacceptable and I think it could have been avoided because as a Civil Society having the data at our disposal, we had asked the Greek government and there was the initial commitment that 2400 people who belonged to vulnerable groups or were older, they would be transferred from the islands, the facilities from the mainland to structures which were more secure for them. This move was never completed in their entirety.
So in fact there were possibilities towards the end of November 2020 where the Minister of Health, Mr. Kikilias that was in charge then, had stated that the group of refugees and migrants living in facilities is a priority group in the national planning and that vaccination will begin from the NPHO groups, a process which started only in June 2021. With the data we have at our disposal since December 26, 36% of the people in the facilities have been vaccinated, 39% of the people living in apartments of ESTIA have been vaccinated and only 6.5% have taken the booster dose, let alone that we have not mentioned what applies to undocumented people.
In May 2021 there was a circular which allowed people with identification and not legalization documents through the Citizens’ Service Centres to be able to get PAMKA for their own vaccination. Later, after the pressure of the Civil Society, we as INTERSOS started a campaign from the 1st of August 2021 which is in progress and is called “Vaccines for All” and we have been collaborated with the Greek Forum of Migrants and the Greek Forum of Refugees to reach all communities. The issue of vaccinating the population of people whether they are asylum seekers, migrants or refugees had to do first of all with how these people were included or not in the planning of the Greek State.
The result of all these actions we have achieved so far, at the moment is the possibility to have an institutional framework which was voted at the end of September that allows the issuance of PAMKA by both the Municipalities and the Migrant Integration Centers. Second, it allows CSOs to take part in the vaccination process of these groups. So, it’s an institutional framework that improves things a bit and for the first time it referred to not being arrested, not being deported during vaccination or while someone is going to get the vaccination certificate.
We do not know the exact number of people without papers. The percentage that has been vaccinated is very small because the one who has been vaccinated is in the context of the actions taken by the Civil Society organizations to issue them the PAMKA, trying to communicate with the Citizens’ Service Centres and respond to various procedures.
I hope that this will happen from next month, because now that we are going through February, and the two Civil Society organizations, Doctors of the World with which we are collaborating, and PRAXIS, have already asked the Ministry of Health to give them the opportunity to go to Manolada, Evrotas and other areas of Greece to start this vaccination as well as the vaccination of undocumented people living in big cities such as Athens and Thessaloniki.
Regarding the part of access to Health, according to the legal framework of 2016 all people who were uninsured were allowed to have access, then there were over 3 million people who were Greek citizens, but also the asylum seekers, the refugees were given the opportunity to access the Health system and the opportunity to issue AMKA. The decision of the Greek government in July 2019 no longer allowed asylum seekers to access the AMKA. After many struggles and many months it was possible to get PAAYPA, a temporary insurance number, and the process today still remains like that. Only a patient with an emergency issue can have access to Health. Emergency in medicine as commonly known, is when a person dies or has a serious accident.
However, when we have to do with public health issues, the emergency can also mean what happens when it comes to a pandemic. Current conditions prove to us that emergency is not always described in terms of the symptoms that a person may have, because this does not help to respond to any public health issue. And in this case as well as in the case of malaria epidemic in 2011, Covid means that the public health problem has quite a huge impact due to the lack of access of these people.
There are studies by the EU and the European Commission, in one of which I also participated myself, conducted in three countries Greece, Germany and Sweden focusing on the effects and costs of the national health system on the access or not of people without papers. So, it turns out that in the long run the cost of accessing a person without papers is less than the cost of not accessing.By including these people in the national health system, it turns out that they help the situation with their contributions in this case. Their legitimacy and integration into these societies will be a great advantage for them and for the societies that welcome them.
Of course, there are people in the accommodation facilities who refused to be vaccinated, but the majority wants to be vaccinated and cannot. So, it really has to do with a message that we have asked to disseminate at a national level as it exists in other countries in all languages in order to be explained in the best way, so that we can have more people who will get vaccinated.
Thanks to our campaign “Vaccines for All” and in collaboration with the communities we realized that many people when the message was translated in their language, it answered various questions they had about the disease, and increased the number of those who were vaccinated. Global experience shows when the message, either it’ s about a medicine or a vaccine, is studied, adapted, and conveyed in the best way, then it is explained properly to people in their own language (some watch this kind of messages on TV, on the radio, on WhatsApp etc.). I think in this way you achieve higher percentages of people who will engage in this and get vaccinated.
At the beginning of the pandemic as Civil Society we had stated again that Covid reminded us once more that access to medicines, vaccines and public health issues should not be patented. Unfortunately, the West and the world community are trapped in the patents of the companies we pay for, and we need to know that 83% of research and development for medicines and vaccines is achieved thanks to public money.
EU governments and the USA were the first, as well as Japan and Australia, to oppose the initiative from countries such as South Africa and India that demanded there be no patent and proposed to find a way to mass-produce vaccines which would allow more population to be vaccinated worldwide, a solution that would have better results in combating the pandemic.
The denial of Europe, of the USA and richer countries are to be blamed for these effects that we deal with now and they will be in the long run. And be aware that donations made by Western countries do not solve the problem that is permanent for these populations. When we talk about the 4th dose in Europe, we have to think about people in Africa. There at the moment 10% have not even got the first dose that should save them. Imagine that there are millions of colleagues in the health sector who are currently fighting in the front line without having been vaccinated themselves. It is unacceptable that in the year 2022 we still talk about charity in health issues. The world community and people do not need charity.
As a Civil Society, what we are asking is to have a transparency on how the citizens’ money is used for research and development, and to know the price that we pay because it is very high, while in the meantime the companies present themselves as saviors which is not true! Vaccines belong to the people, they pay them, they literally belong to the people.
The point is, people need to ask governments to take responsibility for our public health. So, asking for medicines, vaccines and access is not a luxury, it is our right! The cost of non-access will affect us as well. We are not far from this day. The issue of access to health, quality of health services and accessibility to health systems is what matters most. And we need strategies that in the West it was proven many times to be non-existent.
Considering vaccination worldwide, two major initiatives have been recognized, GAVI, which aims at access to the basic vaccines that all children in the world receive, and COVAX, in which we as INTEROS participate in the implementation of programs whether in Iraq, Nigeria, etc., therefore there was a result to some extent. Nevertheless, the participation of the countries is too low and although the governments have agreed with the implementation of these initiatives, they do not have the resources. So, these initiatives remain half-finished or do not have the result they should have.
If we do not change the way we produce medicines, meaning that they should not be considered as a trade, we will face the same situation. If we overcome the barriers of patent and high prices, I think that things can change. Human access to vaccines, diagnostics and medicines is not a luxury. It is a right that we as a society should allow by overcoming existing obstacles, and governments should take responsibility for public health which is a duty and obligation of their own, not of pharmaceutical companies. And as people we should care about ourselves, the others, each and everyone else. Public health concerns us all!».