CAIRO — A dramatic coronavirus surge in Tunisia has prompted other Arab countries to step in with supplies of vaccines and medical aid, as regional leaders flex their diplomatic muscles and try to earn goodwill.
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The response, which comes as Tunisia’s health system shows signs of collapse, reflects a rare degree of regional solidarity but also allows some Middle Eastern powers to show off their capabilities, analysts said.
“You have the proxy battle of the Arab world playing out within vaccine diplomacy but also in the general arena of foreign assistance in Tunisia,” said Sarah Yerkes, a senior fellow at the Carnegie Endowment for International Peace.
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No country in the region has responded with more vaccine doses than Saudi Arabia, which announced this past week that it would send 1 million to Tunisia, in addition to medical supplies. The United Arab Emirates, which started manufacturing vaccines earlier this year, has sent 500,000 doses, and Tunisia’s neighbor Algeria has sent aid and 250,000 doses. Turkey also stepped in with 50,000 doses. Several other countries in the region, including Egypt, Morocco and Qatar, are sending medical supplies, including field hospitals.
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The full array of vaccine doses pledged has not been announced, but they probably will come from several manufacturers, depending on each donor country’s supply.
Until recently, countries that have developed their own vaccines — including China, Russia and the United States — were the ones most easily able to use them as a diplomatic tool.
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“Now the problem is not producing the vaccine, it’s having the ability to buy the vaccine. And Saudi Arabia is able to do that,” said Oussama Helal, an independent Tunisian analyst. “It’s kind of to show off.”
For Saudi Arabia, the crisis in Tunisia offers an opportunity “to reassert its role, particularly in the charity aid sector, which it always has been traditionally proud of,” said Elham Fakhro, a senior analyst on Persian Gulf states at the International Crisis Group. Now that Saudi Arabia has made progress vaccinating its own population, “I think we can see it expanding its aid into more covid diplomacy,” she said.
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Youssef Cherif, a political analyst and director of Columbia Global Centers in Tunis, said Saudi Arabia’s significant aid in the midst of Tunisia’s crisis could also help the kingdom repaint its image abroad. Saudi Arabia has been sharply criticized in recent years for the killing of journalist Jamal Khashoggi by Saudi agents and for the human toll of its involvement in the war in Yemen.
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“Now there is this massive vaccine diplomacy that is actually making all of a sudden the Saudis and Emiratis quite popular in Tunisia, which is not always the case,” Cherif said, adding that it is too early to tell what kind of long-term impact the vaccine donations will have on public opinion or relations with Tunisia. Regardless, he said, “It’s a great PR move by the Saudis.”
The kingdom is sending the doses although most of its own population has not yet received two doses of vaccine. The UAE, by contrast, has fully vaccinated two-thirds of its population.
Tunisia has been recording one of the highest mortality rates in Africa and illustrates the enormous threat countries face when they cannot provide enough vaccine doses, especially as the delta variant continues to spread. Just 6 percent of Tunisia’s more than 11？million people had been fully inoculated as of mid-July.
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But as of last week, Tunisia had been promised a total of nearly 4？million doses of vaccine, “thanks to international solidarity and aid from friendly and brotherly countries,” Health Minister Faouzi Mehdi told parliament.
Tunisia has also secured vaccine doses from its former colonial ruler France, with which it still maintains close ties. France has pledged to deliver about 800,000 doses, plus more than 300,000 AstraZeneca doses secured through Covax, a World Health Organization-backed initiative. The United States will also deliver 500,000 doses through Covax, a White House official confirmed.
The World Bank approved $100？million in financing in March to support Tunisia’s efforts to acquire and administer vaccines. Tunisia said earlier this month that it would buy 3.5？million doses directly from Johnson & Johnson; it has also purchased some doses of the Pfizer vaccine.
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The country is seeing “a whole solidarity movement” from across the region, said Tunisia analyst Mohamed-Dhia Hammami.
“None of the Arab countries have an important strategic interest in Tunisia, but they don’t want to be seen as the ones that aren’t helping,” he said.
Tunisia is currently embroiled in a political crisis — with the country’s president and prime minister “basically at war with each other,” said Yerkes — and the rival camps have typically turned to different foreign powers for help.
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Tunisia’s main Islamist party, Ennahda, which backs the prime minister and makes up the largest bloc in parliament, has sought support from Qatar and its ally, Turkey. Anti-Islamist factions, meanwhile, have previously worked to block Qatari assistance in other realms.
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Tunisia’s non-Islamist presidents have been more willing to pursue support from Saudi Arabia, Qatar’s regional rival, which granted Tunisia a $500？million loan in 2019.
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In addition to confronting challenges shared across much of the developing world, including a weak health system and widespread vaccine hesitancy, the Tunisian government has “basically failed to operate effectively” in managing the pandemic, Yerkes added.
Even as life is returning to normal in some parts of the world where vaccines are easily available, doctors in Tunisia are describing nightmarish conditions in recent weeks.
One 26-year-old doctor working in the Mongi Slim hospital in the capital, Tunis, said dozens of people have at times been waiting in the emergency room, sitting in chairs they brought from home. At one point, a patient’s daughter flagged down the doctor to say she thought her dad had died while lying among several other patients. He had.
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“It’s traumatic for patients but also for doctors too,” said the doctor, who spoke on the condition of anonymity out of fear of retaliation from health officials.
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A 25-year-old doctor treating coronavirus patients at another hospital said his hospital had to turn some sick people away on a recent weekend because of a shortage of oxygen and ration the supply among admitted patients. He expects the outbreak will get even worse. Even with large vaccine donations, he said, it will take time for the population to feel the impact.
With the country in crisis and medical systems overwhelmed, any political motivations behind vaccine donations are irrelevant to him. “Where the vaccines are coming from is the least of our concerns,” he said.
Parker reported from Washington. Massinissa Benlakehal in Tunis contributed to this report.