For weeks, Nawal* has been hopping from one pharmacy to another in search of medicines for her husband, who is suffering from a heart condition and is on life-long medication, but to no avail.
She finally managed to buy the medicine she needed in Turkey, thanks to a relative who was abroad.
“These products are not available in Lebanon because they are subsidized” by Banque du Liban (BDL), Nawal said.
BDL, which has been financing the import of certain medicines and products sold in pharmacies since the beginning of the economic crisis in late 2019, has sharply reduced state subsidies since 2021 after its reserves reached a critical threshold.
This has caused a shortage of medicines, illegal stockpiling and smuggling of pharmaceutical products on the black market in Lebanon and Syria.
In Turkey, where drugs are cheaper than in other countries in the region, Nawal purchased “enough boxes for six months of treatment.”
She even admits to having resorted to the Lebanese black market when her husband needed anti-inflammatory injections a few months ago. “We paid for everything in dollars," she said.
Like Nawal, many Lebanese are forced to buy their medicines abroad, especially when they suffer from chronic diseases.
Three years into the economic crisis, Lebanon’s drug market is still in a state of stalemate, despite a series of measures put in place by the Health Ministry, which removed subsidies on many products in an attempt to curb smuggling and end shortages.
The ministry however continues to subsidize drugs for cancer patients and those suffering from chronic illnesses.
‘My mother ended up in the emergency room’
In this context of persistent shortages, the risks are high for patients. Liliane’s* mother, who suffers from hypertension and cardiac arrhythmia, almost died after missing her medication for several days.
“My mother has a serious illness and ended up in the emergency room because she had not taken her medication,” said Liliane, who finally managed to obtain the pharmaceuticals that her mother needs thanks to relatives in Paris and Qatar.
Although the Health Ministry has tried many times to rationalize the use of the monthly budget allocated by BDL for the purchase of subsidized drugs, it admits that it is still at a standstill, three years after the onset of the crisis.
“We are not able to buy sufficient quantities of subsidized drugs, because we do not have the financial means to do so,” caretaker Health Minister Firass Abiad said during a meeting with the press at the ministry on Tuesday. “We can only cover 70 to 80 percent of the market’s needs.”
“But these quantities are not sufficient either because of smuggling or our inability to control this traffic,” Abiad added.
In an attempt to regulate the situation, two weeks ago, the Health Ministry launched MediTrack, a computerized tracking system for drugs used in the treatment of cancer and incurable diseases.
The system includes some 40 subsidized drugs administered in hospitals and 11 drugs sold in pharmacies. It aims to prevent stockpiling or smuggling.
Pharmacists, however, denounce unscrupulous distributors who refrain from delivering drugs “every time the lira-to-dollar rate fluctuates.”
“Medicines are indeed available in Lebanon, especially generics, but we are victims of the goodwill of distributors,” a pharmacist in Beirut said, requesting anonymity.
He also said he advises patients to “always keep an extra box of medicines at home, because nobody knows when the deliveries might stop.”
In addition to turning to family or friends abroad, some people are now resorting to drug sales networks operating in Lebanon outside the legal channels.
According to several sources contacted by L’Orient-Le Jour, these networks, which normally obtain their supplies from Turkey, certainly make up for certain shortages, but they are not without risks.
“Many medicines bought abroad and sold on the black market in Lebanon are counterfeit,” Karim Gebara, president of the syndicate of drug importers, told L’Orient-Le Jour.
This was discovered when some patients bought their treatments abroad, at the request of hospitals that were out of stock.
“The lab assistants were surprised by packaging or textures different from those they are used to. They wrote to the manufacturer to check the serial numbers of the boxes, only to discover that they were counterfeit,” Gebara said.
“Many people say that these drugs come from Turkey, but we have no way of verifying this,” he added.
According to Gebara, unsubsidized drugs can easily be found in Lebanon. The situation is more complicated when it comes to subsidized products.
“In some cases, imports cover only 50 percent of medicine needs, because there are not enough funds to finance more imports,” he explained.
For his part, Joe Salloum, the president of the Order of Pharmacists of Lebanon, said. “The health sector and the drug industry is in danger unless we put in place a rescue government.”
He also warned against “the medical bill that could result from the use of smuggled drugs,” stressing that “some people have even bought placebos.”
“Any solution to this predicament must come from the authorities,” Salloum said. “It is necessary to be able to access certified drugs approved by the Health Ministry.”
*Names have been changed
This article was originally published in French in L'Orient-Le Jour. Translation by Sahar Ghoussoub.