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Beirut, Lebanon – For the past six months, Rafik Hariri University Hospital in Beirut has struggled with the wave of medical workers who emigrate to get power cuts, drug shortages and better job opportunities.
But now, even with the partial withdrawal of drug subsidies, doctors at facilities run by the Lebanese capital’s government are fearing the worst.
“We can expect a rise in the death toll,” Dr. Mahmoud Hassoun, the hospital’s director of operations, told Al Jazeera.
“How can you treat a patient when there are expensive medications you can’t give?”
Health Minister Firas Abiad announced earlier this month that he would partially withdraw the subsidies, including on some medicines for chronic diseases. The movement raised the prices of these medicines and exacerbated the medical crisis that has crippled Lebanon’s fragile health care system.
The price of a hypertension medication has risen ninefold. Other drugs, such as those prescribed for mental health conditions such as depression and schizophrenia, are costing three times as much, according to the Lebanese non-profit organization Embrace.
Hassoun said the hospital should continue to rely on the support of supply NGOs and that some patients should be given priority over others.
Lawmaker Bilal Abdullah, who is also a member of the parliamentary health committee, told Al Jazeera that the Central Bank “provided about $ 120 million in medical grants each month.” “Now it can only allocate $ 35 million.”
Lebanon is already experiencing a devastating economic crisis that has pushed about three-quarters of the population into poverty. The Lebanese pound, in just over two years, has lost about 90 percent of its value against the U.S. dollar, and ongoing political paralysis has halted hopes of economic recovery in the near future.
The country’s health sector has been particularly hard hit. Hospitals already struggling with a shortage of medical supplies and staff – Rafik Hariri University Hospital, the epicenter of Lebanon’s COVID-19 response, has only operated at half its capacity – also unable to ensure enough fuel to turn on the lights and keep the machines running. . Meanwhile, authorities have been unable to stop suppliers from accumulating drug depots, nor to reduce their smuggling and unusual rates of trade on the black market.
“Our pharmacies are already empty without medicine,” pharmacist Joe Salloum told Al Jazeera. “Pharmacists no longer have the capital to buy medicines, and citizens have less access.”
In May, the Central Bank refused to dive into foreign currency reserves to cover drug subsidies. Two months later, as reserves dwindled, the crisis-hit country partially cut subsidies on products such as vitamins and analgesics worth 12,000 pounds or less in Lebanon, along with expensive subsidies on wheat and fuel.
In an interview on Thursday, Abiad, the health minister, described this month’s move to address drugs for chronic diseases as a “necessary step” and sought to alleviate fears that drug subsidies would be completely removed.
Abiad said people “have the right to express their grief” and said he wanted to encourage the local production of about 500 medicines for chronic diseases.
“Bad politics but a rescue”
Experts say Lebanon’s entire subsidy program, including medicines, has benefited the rich more than the poor. Several studies show that because it is not aimed at the most vulnerable schemes, but as it is generally applied, people with higher incomes are more likely to benefit from it because they have greater spending power. A study by the International Labor Organization shows that less than half of all beneficiaries of grants are among the poorest 80 percent.
Leila Dagher, an associate professor of economics at the American University of Beirut, said Lebanon has spent billions of dollars to maintain the program.
“It was bad politics from the beginning,” said Dagher, a senior member of the Le Jazeera Center for Lebanese Policy Studies. “However, we have repeatedly warned that given the rapidly deteriorating economic situation, the removal of Lebanese homes would have a significant impact and should therefore be offset by a subsidy program.”
The government has long promised to implement a rationing card program to provide assistance to some 500,000 vulnerable families and to mitigate the impact of the removal of subsidies. But it has failed to secure funding from the international community amid ongoing political turmoil and the Central Bank’s refusal to use its reserves to help fund the $ 556 million program.
“There’s still a long-awaited‘ ration card ’when it will be launched and I haven’t heard a single valid justification for it,” Dagher said.
“Togo, like Lebanon, does not have a comprehensive social record. It was still able to expand an emergency funding program to more than half a million people in less than four weeks.”
Meanwhile, Olivier De Schutter, the UN special rapporteur on extreme poverty and human rights, recently met with Lebanese officials and struggling families, said the authorities were aware of the negative consequences, but said the removal of the aid was “inevitable”.
“You can’t raise subsidies – bread or wheat or medicines – without strengthening the purchasing power of people in poverty, raising the minimum wage and improving social protection, which is currently very poor,” De Schutter told Al Jazeera.
“I think we should be very careful about sequencing.”
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