Killer profits in Lebanon’s medicine trade reveal the dystopia faced by its people

Hoarding and profiteering at pharmacies is only part of the country’s problems

Majalla

Killer profits in Lebanon’s medicine trade reveal the dystopia faced by its people

Lina Khatib

last update on 02 Dec 2023

Searching for medicines in Lebanon is like being in a dystopian movie.

Last year, a family member of mine there was diagnosed with a degenerative disease. The shock was soon overridden with the realisation that the medication my relative needed was not available in the country.

This coincided with a research project I was doing on Lebanon’s illicit economy. The first-hand experience of trying to find the medication merged seamlessly with my research, providing a live illustration of the depth and breadth of corruption permeating Lebanon, a country where most people are living in despair.

Searching for medication here often feels like engaging in criminal activity. Going from one pharmacy to another in greater Beirut asking for what was needed yielded no results. A relative called, suggesting a particular pharmacy, and gave the first name of someone, for me to mention as an introduction.

I rushed there. As soon as I mentioned the medicine I was looking for, the staff replied: “Who told you to come here?”.

On hearing the name my relative gave me, they asked me to wait “while we go to the back and put price tags on the medicine boxes for you”.

The reason why medicine boxes were available – but hidden and unlabelled – was that pharmacies were expecting government subsidies on medicines to be lifted. The stock was bought at subsidised wholesale prices. Selling it on after the end of the subsidies means a much bigger mark-up in price.

Killer profits

Part of the reason why so many medicines disappeared from the market is because traders and pharmacies were hoarding stock in the hope of making killer profits. And they did, in more than one sense of this chilling term: Their greed meant people unable to source supplies of vital drugs actually died.

Lebanon’s medicine shortage has opened the way for profiteers. The last pharmacy I went to turned out not to have the actual medicine I was after. Later that day, an acquaintance mentioned that he knows someone who brings medicine to Lebanon from Turkey “in his suitcase”.

Over the next few days, this acquaintance acted as a go-between. He was soon changing his story, claiming the man told him that the airport authorities in Istanbul did not allow him to fly and that he will need to “send the medicine by courier”. This meant I would need to pay several times the amount originally quoted.

Obvious scams are prevalent in Lebanon, with people ending up paying over the odds out of despair, unless they happen to have relatives or friends who could buy them needed medicines from abroad.

Such obvious scams are prevalent in Lebanon, with people ending up paying over the odds out of despair, unless they happen to have relatives or friends who could buy them needed medicines from abroad.

People in Lebanon have figured out that in the absence of official social safety nets and basic services, they need to help one another to survive. Complete strangers frequently volunteer to carry medicines from abroad bought by people they don't know to deliver to other people's relatives in Lebanon. But even then, there have been cases of travellers being stopped by customs at Beirut airport and the medicines confiscated.

Reuters — Lebanese people queuing for medication at a Beirut pharmacy

After the dead end reached by my acquaintance, I continued asking around. A friend gave me the number of a pharmacy owner who had confirmed they had only one box of the medicine in stock. After going there a few times and being told it wasn't ready, a supply appeared. But it turned out to consist of only ten pills instead of the expected 100.

I decided I was going to ask everyone I could if they knew anyone who might help. One person gave me the number and name of a contact I suspected was connected to Hezbollah. I decided not to pursue that lead, choosing instead to rely on the kindness of friends and strangers abroad.

Corruption and impunity

I am one of the lucky few. Those without networks abroad are destined to a life of agony and ailment. This includes not just physical ailments but also mental illness. Whole sections of Lebanese society are suffering unnecessarily because of the medicine crisis in the country and its connection to the larger picture of political interests, corruption, and impunity.

Many people in Lebanon are so desperate they have no choice but accept to buy medicine from networks connected with Hezbollah. But even then, there is no guarantee that the medicine is genuine.

Hezbollah is reportedly involved in the smuggling of a wide range of goods. Contraband medicine – like the rest of the wider illicit trade – enters with no state oversight. But even treatments brought in legally get only patchy regulation, if any. When the Ministry of Health was led by administrators affiliated with Hezbollah, Iranian medicines were given an exemption and put on sale in Lebanon without being tested.

And the national pharmaceutical laboratory, which had the job of testing imported drugs, was shut down in 2007 on the pretext that is was too close to the residence of the Speaker of the House in Beirut and therefore posed a security risk.

Smuggling means loss of customs revenue. A bankrupt state does not have the needed resources to control its borders. And so Lebanon is trapped in a vicious circle.

Proposals to relocate it fell on deaf ears. There are periodical reports in the Lebanese media about fake medicines on the market. There is no accountability when things go wrong. And there have been several cases where even after being arrested and charged for selling fake medicines, accused criminals are let off due to their political connections.

Politicians from across the spectrum are accused of benefitting from the medicine crisis. Hezbollah generates profit from the sale of imported Iranian medicines. Being able to sell these medicines to its supporters at cheap prices is a method that Hezbollah uses to maintain loyalty.

Vicious circle

Politicians are themselves involved in the pharmaceutical trade and have sometimes got medicine to those in need.

While some of their assistance may be motivated by humanitarian concerns, there is no denying that such interventions feed the wider system of political patronage at work throughout Lebanon. Acts of individual philanthropy do not address the problem at the heart of the country: systemic corruption.

It is not just resulting in the exploitation of people but is also further eroding the finances of Lebanese state. Smuggling means loss of customs revenue. A bankrupt state does not have the needed resources to control its borders. And so Lebanon is trapped in a vicious circle.

The story of the medicine crisis in Lebanon is a reflection of the country's wider social, political, and economic dynamics.

Vulnerable people are subjected to manipulation and are pushed towards maintaining client relationships with political patrons out of despair. Politicians benefit from this situation and are unlikely to want the status quo to change for as long as it is profitable for them.

Hezbollah and other political actors continue to act without fear of any form of formal accountability. Victims of scams have no recourse to the courts as the judicial system is politicised. The gap between the haves and have nots in Lebanon has never been wider.

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