by Fady Noun

The central bank governor has suggested the end of subsidies for basic necessities, including medicines. Frightened citizens have emptied shelves in an unprecedented rush on pharmacies. For experts, the cuts to an already impoverished population could have "catastrophic" effects. The "In aid of devastated Beirut" campaign.

Beirut (AsiaNews) - Like everything else, this story too has developed in a brutal, empirical way, without warning and without the slightest source of communication with those concerned. With a few short lines entrusted to the press, the governor of the Bank of Lebanon, Riad Salamé, announced that the policy of subsidizing wheat, fuels and medicines cannot continue beyond the next three months. Of course, the fact that he sounded the alarm bell is positive, as is having announced that the strategic reserve threshold of 17.5 billion dollars is about to be reached.

However, could the modalities of this announcement to public opinion not have been better managed perhaps? The announcement by the Central Bank has in fact sown a wave of panic among patients and an unprecedented, frantic rush to pharmacies, some of which were emptied in a short time. About a month has passed since then, but the race to buy continues today. Pharmacies continue to be besieged by customers who fear both a shortage of stocks and a surge in prices if subsidies run out.

And the race happens every day. In a well-known pharmacy in the Metn district, yesterday a man insisted that the expiration date of the medicines he was buying "be far off", so that they will still be usable once stocks are exhausted. "It is not uncommon, in fact, to observe in these moments patients buy drugs for a requirement of at least 10, if not 12 months", reports to L'Orient-Le Jour Karim Gebara, president of the drug importers union, taken by surprise as all from the decision.

Other buyers, mostly women, are rightly worried on this hot September morning about the prolonged disappearance of some medicines and the risk of seeing their prices rise excessively when they return to the shelves and counters. Every day the phrase "we have no trust" resounds, underlines a pharmacist on duty, who tries - in vain - to reassure his customers.

Consultations between importers, pharmacists and doctors

This urgent situation prompted the president of the doctors’ association Charaf Abou Charaf, his counterpart of the pharmacists Ghassan el-Amine and the president of the importers union to meet. The three parties have reached an agreement to calm the frenetic sale of medicines, so as to ensure patients' needs for at least a month. This rationing in distribution, they agree, operates on two levels: distribution in pharmacies, calculated according to need, and retail sale.

However, having been decided overnight, this rationing caused a panic among customers. Left to fend for themselves and having lost faith in the state, they have developed a habit of bypassing rationing by turning four or five pharmacies to accumulate personal supplies. “The drugs targeted are mainly those used for chronic diseases: heart, diabetes, nervous system,” says Gebara. These drugs are currently out of stock, knowing that delivery times, after new orders and approval by the Lebanese Central Bank, can take up to a month.

“Certainly - he adds - at a microeconomic level the system put into practice cannot be fair and imposes constraints on pharmacists, who cannot predict in advance the quantities of drugs they sell, because they fluctuate. They also don't necessarily need to know their customers. On the macroeconomic level, however, it rationalizes the distribution system and establishes a certain equity between the regions. This gives us time to place new orders. It's just inventory management ".

So the announcement of the decline in the reserves of the Bdl was a mistake? “I can't put myself in the governor's shoes, - admits Gebara -  but I know it was already too late to react”. "The monthly supply of medicines distributed to pharmacies ran out in ten days" after the announcement by Riad Salamé. The president of the order of pharmacists, for his part, protested against the incident, saying that "greater coordination between the governor of the Bdl and the government" was needed before this announcement. "Unfortunately - complains Ghassan el-Amine - this coordination was lacking and the population paid the price".

Confusion and phobia of a hole in the stocks

In direct contact with the population, unlike importers, pharmacists are more sensitive to the confusion of their customers, confirms the president of the Order. "The phobia of a lack of supplies in patients suffering from chronic diseases is very common" underlines Charaf Abou Charaf. These are very vulnerable people, for whom continuity in the availability of their medicine is vital. This can give rise to situations of great anxiety”. "Whatever we do - Gebara continues - is badly seen, and this is also normal, especially when people live in a state of anxiety". He is also keen to defend his colleagues from those accusing them of responsibility in fuelling black market smuggling or selling subsidized medicines abroad.

 “The figures are there to prove the contrary. The sale of medicines between January and June 2020 decreased by 10% compared to the same period in 2019, proof of the fact that the medicines are sold only in Lebanon”.

Doubts in the long run

While defending the position of the importers, the manager shows concern for the long term. “We are gaining time - he admits - but in the long run we have to find a solution. We cannot last from eight months to a year without a new government, a stimulus package and the entry of new capital ".

"The end of the drug subsidy policy - warns the importer - would be fatal for the entire health system". He shows his appreciation for the choice of the Bdl governor and observes that 65% of the total of medicines in a year - equal to one billion dollars - is paid for by third parties (social security, public employee cooperatives, army and security forces) and 35% from private individuals. Given the percentage of the population living below the poverty line today, withdrawing support would be catastrophic.

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