22 Apr Is the Mauritian COVID-19 vaccine rollout based on a human rights approach?
Tanveer Jeewa is the Legal and Communications Officer at the International Commission of Jurists, Africa Regional Programme. She works mainly on issues of international human rights law and constitutional law. She has recently completed her LLM in Public Law at the University of Cape Town and was previously a law clerk at the South African Constitutional Court for Justice Theron.
During 2020, Mauritius was internationally hailed as a country with among the most effective COVID-19 responses. By June 2020, the strict lockdown imposed in Mauritius had been completely lifted and Mauritius was effectively declared a “COVID-free” zone. The announcement was met with much skepticism and, as predicted and as in much of the world, the proclaimed eradication of COVID-19 in the country did not last.
At the beginning of March 2021, cases of COVID-19 re-emerged in the country, and towards the end of the following month Mauritius registered a total number of 1,203 cases of COVID-19. While this a relatively low reported transmission rate (0.09%) for countries with larger populations, the Mauritian government did not take these new infections lightly. As of 10 March 2021, Mauritius had gone into strict lockdown again and amped up its ongoing rollout of COVID-19 vaccines.
Mauritius’ economy relies heavily on tourism, and the Mauritian government has made it clear that the goal is to reach “herd immunity” as soon as possible so that travel restrictions could be eased. While some experts have put that rate at around 75% of the population, the World Health Organization (WHO) emphasizes that the number of vaccinations to reach herd immunity for COVID-19 is not yet known. On 24 March 2021, the Mauritius Tourism Promotion Authority (MTPA) predicted that by June 2021 the country would achieve herd immunity by having vaccinated a threshold of 700,000 persons. At the time that this statement was made, 17% of the targeted population (117, 323 persons) had been vaccinated with the first dose of the AstraZeneca vaccine. According to a government spokesperson, Dr Zouberr Joomaye, “Mauritius has secured an adequate supply of vaccines for the authorities to maintain the pace of vaccination.”
By 3 April 2021 it was projected that Mauritius was expecting a total of 1 907 630 vaccine doses, with 507 200 doses expected from COVAX and other doses obtained through bilateral agreements with India and China. In addition to these expected doses, Mauritius had already received 530 950 doses of a variety of COVID-19 vaccines. Based on these predictions and the current pace of vaccination, Mauritius is well on its way to vaccinating 55% percent of its population by July 2021. As of 10 April 2021, the administration of the second dose of the AstraZeneca vaccine had commenced for persons who had received the first dose. On 15 April, the Minister of Health put forward a detailed plan for the administration of the second dose.
Not everyone is being catered for by the vaccine rollout
Interestingly, while there seems to be a lot of information available as to when members of the public will be vaccinated, there is not much transparency when it comes to whom among the population will be prioritized, nor to many other key aspects of the government’s vaccine acquisition and distribution plan. In fact, the information that has been made available to the public is sparse and opaque. At the January 2021 start of the vaccination campaign, the Health Ministry announced that the vaccines would first be administered to frontline health workers as well as tourism workers, including hotel employees, staff of the national airline, airport staff and other front line tourism staff. This seems to be in line with the Mauritian government’s goal of reviving its hard-hit tourism sector. Senior citizens, meaning those aged 60 years or older, as well as people suffering from chronic diseases, appear to receive priority for the Health Ministry’s COVID-19 vaccination programme. The Mauritian government also invited business operators to register an interest for vaccination, if they fell under specific categories which can be described as “operators who are in contact with the general population”.
There is no publicly available information as to when prisoners will be vaccinated. This is despite the fact that prisoners should be prioritized for vaccine access as they are not only at a higher risk of contracting COVID-19, but the prison environment creates a high risk of transmission to prison employees and prison health workers. Prisons are potential hot spots and global research shows that in some places positivity rates in prisons may be four times higher than that of the general population. This is for reasons of overcrowding, poor ventilation and little ability for inmates to social distance.
Mauritius also appears to be prioritizing the vaccination of its citizens only, as opposed to other inhabitants. This is observed in the requirement to present a national identity card in order to access the vaccination. While the country has started a “Mauritius Premium Visa” program which would allow for international visitors to get free COVID-19 vaccinations, and seems to signal that non-citizens lawfully in the country will be vaccinated, it remains unclear whether every inhabitant – regardless of their immigration status – will be eligible for vaccination. This is particularly concerning given the fact that Mauritius has for decades faced a labour shortage in various sectors of the economy and has relied on migrant workers to bridge this deficit. Unfortunately, many of these workers have an irregular immigration status and may not access the vaccines as a result.
“The vaccine should be provided without discrimination”
The history of the right to health in Mauritius is complicated as the right is not directly protected under the Mauritian Constitution, despite the existence of a strong social welfare system with free health service from primary to tertiary care. With regard to constitutional protections, section 3(a) of the Mauritian Constitution guarantees “the right of the individual to life, …and the protection of the law.” This provision serves effectively to implement the State’s obligation under Article 6 of the International Covenant on Civil and Political Rights (ICCPR), which the Human Rights Committee has affirmed protects aspects of the right to health. Mauritius is a party to the ICCPR, as well as the International Covenant on Economic, Social and Cultural Rights, and African Charter on Human and Peoples’ Rights, both of which protect the right to health. Mauritius is therefore bound to respect its inhabitants’ right to the highest attainable standard of health, which includes the duty to allocate COVID-19 vaccines in an equitable and non-discriminatory manner.
In March 2020, a group of United Nations experts had already established that “[w]hen the vaccine for COVID-19 comes, it should be provided without discrimination.” From the factions of society which Mauritius has prioritized for the administration of COVID-19 vaccines, it is clear that while the country is focusing on capturing the clinical vulnerability to infection, it is failing to address its human rights obligations and the social determinants of health which are embedded in the current social structure. For example, many migrant workers are employed in overcrowded factories and live-in dormitories behind said factories, making it difficult for the workers to socially distance. Mauritius fails to take into account these 45, 000 individuals and subsequently, to give effect to their right to health, as it should, given its accession to the International Convention on the Protection of the Rights of All Migrant Workers and Members of Their Families.
Under a human rights-based approach to COVID-19 vaccination, migrant workers and prisoners would not only be considered, but also be among those prioritized. Instead, the government of Mauritius seems to prioritize vaccination of even less vulnerable Mauritian citizens indiscriminately and non-citizen tourists with the aim of re-opening its borders and saving the tourism sector. States fail to learn from their mistakes when they entertain such shortsighted economic calculations. History has shown us time and time again, that when faced with this seemingly tough decision, States often choose the economy over human health and wellbeing. Public health emergencies have clearly illustrated that no-one is protected until everyone is protected. Mauritius cannot afford to make this mistake again: we must prioritize human health and well-being over the short-term economic benefits, which themselves are likely to be illusory. We cannot leave anyone behind.