The head of the Barbara Nassar Association for Cancer Patients Support, Hani Nassar, was surprised that the medicine he had bought for a patient from a person in Turkey was counterfeit, as after he received it, it appeared that the amount of liquid it contained was less than it usually is, except for the yellowing of the inside of the box.
The official price of the medicine that Nassar bought from Turkey is 1500 dollars, but the merchant tempts the patient, as he says, “by making a discount for him, as the patient paid for it 1200 dollars, while its price in Lebanon if available is 7 million pounds, which is equivalent to about 240 dollars on the market.” black market exchange rate. He continued, “The merchant denied sending a forged medicine, and therefore refused to return the amount, only to then appear that an organized gang was behind the matter.”
Not only did the patient lose the money she paid, but she also lost a valuable time that delayed her reaching her goal of defeating her disease, and these incidents are repeated with patients in Lebanon, and are not limited to cancer drugs.
Smuggling networks took advantage of the inability of the Lebanese drug-importing companies to meet the needs of the market, to play their role, not caring about the results of patients taking counterfeit medicines or incorrectly preserved medicines, which prompted the Pharmacists Syndicate to raise its voice, launching an awareness campaign, which included a leaflet bearing the slogan “Not all medicine is medicine”, to warn citizens of smuggled medicines that may be counterfeit.
The economic crisis afflicting Lebanon affected the pharmaceutical sector, and after the loss of medicines from pharmacies due to the lack of dollars at the Central Bank, the Lebanese government last November lifted the subsidy completely and partially from most of them, to limit the support to intractable medicines and some chronic medicines, yet the amount allocated to them is not enough, Which led to the continuation of the crisis.
Last December, Amnesty International commented on the Lebanese government’s decision, saying, “The subsidy has been raised and the prices of medicines in Lebanon have increased four times compared to 2019 at the beginning of the economic crisis, and the shortage of medicines is still severe, although the government was aware of the need to lift the subsidy, At least since last year, but it has failed to put in place a social protection plan to ensure the continued availability of essential medicines.”
Poison and mother!
From everywhere, smuggled medicines enter Lebanon, especially, according to Joe Salloum, head of the Pharmacists Syndicate, from “Turkey, Syria and Iran, some of them are counterfeit and the other part is not preserved in a proper way, meaning that it turns into a deadly poison. Rather, some cancer drugs were discovered to be water.” In an interview with Al-Hurra, he added, “We have reached a stage where medicine has become more available outside pharmacies than inside, and the main problem lies in the inability to verify medicines that are not entered by legal means and are not registered with the Ministry of Health.”
There is no accountability or control over smuggled drug dealers, to the extent that they sell them openly, as they take advantage of the patients’ need to secure their treatment by any means and from any source, without the patient having the ability to verify its quality and how to preserve it. He thought that there are those who trade their lives for profit.
Organized networks are behind the drug smuggling operations, as Salloum asserts, “which sell them at double prices, and because we are entrusted with the health of patients, we refuse to be subjected to fraud and deception by bag dealers, and at the same time we cannot blame the patient who seeks his medicine, knowing that Thousands of medical errors have occurred because of those who replace the medicine with another person who is not a specialist,” stressing, “As long as medicines are not available by legitimate means, counterfeit and smuggled medicines will continue to enter the country.”
The main reason for the boom of this trade in Lebanon is that the amount allocated to subsidize medicines for incurable diseases and a number of chronic diseases, suffices at most two-thirds of patients,” according to what Karim Jbara, head of the Syndicate of Drug Importers, told Al-Hurra: “From here, the remaining third of them are forced to resort to To secure their medicines, and some of these medicines are counterfeit, knowing that the original medicines require precise conditions for preservation and transportation, especially refrigerated ones, and if these conditions are not observed, especially in light of the current situation in Lebanon, they can lose their effectiveness.
With regard to the medicines for which the subsidy has been lifted, he replied, “In principle, there should be no problem in securing them on Lebanese territory, and if there is a problem for any reason, there are many alternative medicines. This does not mean that smuggling networks do not bring these medicines into Lebanon.” But there is no shortage of it for the patient to resort to.” The Head of the Pharmacy Department at the Ministry of Health, Dr. Colette Raidy, emphasized that “drug smuggling is not limited to cancer drugs, although the focus is on expensive drugs.”
Jabara’s words were previously confirmed by the head of the Parliamentary Health Committee, Representative Bilal Abdullah, last month, when he pointed out that “there is a need for at least 10 million additional dollars per month, so that every patient in Lebanon who suffers from an incurable disease can find his medicine, wishing The government must take this national and humanitarian decision by asking the Banque du Liban to provide this coverage so that the Minister of Health and his assistant team can schedule the purchase of these medicines.”
Recalling the $400 million owed by Lebanon as a result of previous debts, Abdullah asked the importing companies to try as much as possible to reduce their profits, and as he said, “It is no longer permissible, in the dangerous atmosphere we live in, for there to remain smuggling of subsidized medicine, everyone, Every party and every organization that works to facilitate or turn a blind eye to smuggling must be in prison, as the suffering of cancer patients is much greater than making profits, and what they earned from smuggling fuel and food suffices them.”
Discovering the disaster
The discovery of the presence of counterfeit cancer drugs in Lebanon is due, as Jabara confirms, to “a number of hospitals noticing things that are not identical with the original drug in the medicines brought by patients, whether it is the writing on the box or tube and even the color and quantity of the liquid, international companies were contacted to inquire.” Regarding the batch number of the medicine, to ascertain whether it was original or not, the answer was no, which necessitated informing the Ministry of Health, which took the necessary measures.
Nassar also said that “some medicines are discovered to be counterfeit by not matching the version number to the number issued by the original company, and others may have the correct version number, but the colors of the box are different or the font used to print on it, and the matter can also be discovered through the amount of liquid that may be taken.” It is less or more than it is in the original drug, and it is up to the university hospital laboratories to confirm the matter by examining the drug.”
While the counterfeit medicines infiltrated the pharmacies, Raidy denied this, explaining that until now, “the matter was limited to medicines that were illegally brought into Lebanon through people coming from abroad,” noting that “the import of medicines from abroad exceeded personal use, that is, to trade them.” Then those who did this will be prosecuted before the competent court.”
Regarding the pharmacies of “Hezbollah” that it allocates to its members, and whether the Iranian medicines sold there are registered with the Ministry of Health, Raidi replied, “There are a lot of Iranian medicines registered in Lebanon, so Iran is like other countries with regard to importing medicine.”
A few days ago, the Minister of Health, Dr. Firas Abyad, reassured cancer patients that there is a solution to their medications, pointing out at the same time that “international drug companies had taken a decision to stop sending medicines to Lebanon before transferring money to them,” which he discussed during his visit to the states. United States of America.
Abyad presented last month the results of his visit to Washington during a press conference, during which he confirmed that he had held an important meeting in the Chamber of Commerce with international companies that were reluctant to export medicines to Lebanon after their debts exceeded $400 million, which led to the disruption of medicine in the Lebanese market.
He pointed out that “the direct meeting with representatives of pharmaceutical companies was an occasion to recall the recent decision taken by the government, related to securing drug financing from the Special Drawing Rights in the next four months, and before the extensive explanation, the companies expressed their understanding of the new mechanism, confirming their decision to re-export medicines.”
The Minister of Health indicated that “accordingly, the quantities of medicines that Lebanon will import for three consecutive months have been prepared instead of for one month, which will ensure greater continuity of securing medicine for the Lebanese patient,” pointing to “a meeting held at the Banque du Liban to confirm coverage of the agreement and start.” transfer of funds.
death penalty
The UN Special Rapporteur on extreme poverty and human rights, Olivier de Schutter, has criticized decades of underinvestment in the public health care system and the government’s “disgraceful” partial abolition of subsidies on essential medicines. The prices of medicines for chronic diseases have increased at least fourfold, and it is a near-guaranteed death penalty for those who need it most.”
The UN expert called on the next government to commit to improving its human rights record in all fields, including building strong and flexible social and educational protection systems and health care, and placing the public interest above the private interest.
Not only is the treatment of cancer patients delayed when they discover that the medicine they have been waiting for is counterfeit, but, Nassar says, that “their lives are at risk, and if they are not harmed, at a minimum they think that they are receiving treatment. In fact, what is given to them is nothing more than water and salt.” “.
According to the legal description, smuggling counterfeit medicines is a felony, as Article 92 of the Law on the Practice of the Pharmacy Profession in Lebanon No. 367 punishes anyone who is tempted to cheat in all aspects related to medicine, as it states, “He shall be punished with a fine of ten million to fifty million Lebanese pounds, And with imprisonment from one to three years, or one of these two penalties, in addition to confiscating the drug for the account of the Ministry of Public Health, whoever commits fraud in pharmaceutical substances, or sells counterfeit, smuggled, expired, unregistered, or prohibited drugs.”
And it adds, “Every pharmacist who is convicted of a felony or a heinous misdemeanor, or who commits fraud in pharmaceutical materials, or who sells secret medicines or drugs, or for illegally practicing the profession of medicine, shall lose the right to practice the profession of pharmacy.”
In order to avoid falling victim to the “drug mafia,” Nassar advises patients to buy their medicine only from the pharmacy, wishing the Lebanese state to secure medicines by legal means so that the patient does not have to endanger his life. As for the steps taken by the Ministry of Health to curb smuggling operations, Raidy explained: “We are trying as much as possible to warn citizens and issue decisions to prevent circulation, in addition to educating patients about the need not to purchase medicine from an unlicensed pharmaceutical institution, and to review the ministry if they want to verify any medicine.”
As for Jbara, he believes that the solution requires “bridging the gap by securing subsidized drugs for incurable and chronic diseases, by increasing the amount available for support, which now stands at $25 million, in addition to mechanizing drug delivery to the patient in order not to exploit the support.”
He stresses, “As long as there is a gap, someone will come to fill it. Nature does not like a vacuum. Hence, it is necessary to work with the Ministry of Health to pressure officials in order to secure an additional amount that meets the needs of all patients. In this case, there is no longer a need for the patient to buy his medicines from a smuggler or from outside the country.” Then the security authorities are asked to be strict with anyone who enters medicine illegally.