Lebanese patients with chronic diseases now suffer more than ever before, with their prescription drugs being unavailable at state health centres, a shortage that affects some 25,000 citizens.
Health Minister Ghassan Hasbani warned that funds allocated for chronic disease supplies will run out within weeks, meaning that the country is well on its way to a major medical crisis.
Despite the complaints of patients, Hasbani confirmed that medicine stockpiles for those with chronic health conditions are currently available thanks to cooperation of pharmaceuticals, and he explained that reported shortages were caused by delayed shipment and transfer processes.
The Health Committee in the Lebanese Parliament believes crisis will be resolved soon, he added.
For Lebanon, this is not the first time scarcity has affected vital treatments for patients with chronic conditions. Last year a similar low stock situation emerged. Back in 2016, some key drugs were completely cut by the ministry.
But today’s shortage is actually caused by pharmaceutical companies withholding the delivery of their products to ministry clinics due to an outstanding bill of LBP75 billion ($ 50 million), an instalment that first needs to first be approved by parliament.
In an effort to resolve the crisis, Parliament Speaker Nabih Berri has pledged to convene a parliamentary session to tackle the issue at hand, the head of the parliamentary Public Health, Labour and Social Affairs Committee, Assem Araji, told 7Dnews.
Medicines likely to go missing from shelves in public health centres are cancer drugs, considered the most expensive for citizens to afford independently. This is a horrifying scenario knowing that cancer cases witnessed a 5.5% increase in Lebanon between 2005 and 2016 alone.
Lebanon also tops the list of Middle Eastern countries in terms of cancer frequency per population.
According to a recent report by the World Health Organization (WHO), there are over 17,000 new cancer cases expected in 2018, averaging 242 cancer patients every 100,000 Lebanese.
The Lebanese health ministry has justified its shortcomings by claiming to be the victim of a prolonged budget crunch, and that its burdens became overwhelmingly worse with the listing of new and pricy drugs without a corresponding increase in the budget.
Health Minister adviser George al-Akouri told 7D News that Hasbani assumed his position with the department already suffering from an LBP 85 billion deficit. This has dropped to LBP 38 billion since Hasbani took office as a result of a series of measures he put into effect, Akouri said.
Exceptional treatment was better regulated, which reduced the deficit by 63% in a single year, in addition to the rationalisation of drug orders.
Hasbani reformed the way the health ministry ordered its supplies from pharmaceuticals. It now places orders on a quarterly basis rather than annually, which has prevented the wasteful build-up of certain stocks.
The ministry also updated health sector protocols, adopting the UK National Institute for Health and Care Excellence (NICE) guidelines that ensure patient-tailored prescriptions and avoid excessive medication.
Akouri explained that the drug crisis did not happen overnight and is the fallout of parliament failing to include credit transfers in its agenda despite Hasbani making the request in writing four times. The delay later snowballed into a crisis which demands rapid action.
Some observers reject the justifications presented by Hasbani, but choose to place the blame only partly on his management. Head of the National Social Health Association and former member of parliament Ismail Sukariya said that the problem is the result of accumulated administrative misconduct by successive health ministries.
For example, Lebanon contracts drug traders to import medication for chronic diseases and cancer treatment rather than signing state-to-state purchases, allowing brokers to tamper with and control drug rates as they please, Sukariya explained.
The Swedish Health Ministry recently made a special offer to Lebanon, but this was refused because there was no benefit to anyone apart from patients, Sukariya added, hinting at elites dominating the country’s health market.
Many drugs ordered are too expensive, despite the availability of cheaper substitutes. Lebanon is also buying medicines that are still under trial at astronomical prices, he added.
Other than mismanagement incurring billions of Lebanese pounds in losses, Sukariya drew attention to corruption made possible by the chaotic distribution of drugs, with some stocks being smuggled into pharmacies for later sale.