How political dysfunction precipitated Lebanon’s healthcare collapse

The damaged Wardieh hospital is pictured in the aftermath of the Beirut blast that tore through Lebanon's capital in August, 2020. (AFP/File Photo)
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Updated 20 February 2022
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How political dysfunction precipitated Lebanon’s healthcare collapse

  • Study says sector is in decay thanks to the problems that led to the 2019 economic collapse
  • International aid community needs to be incentivized to pour resources into the health system

LONDON: Lebanon’s health system is in a precarious state following wave upon wave of political and economic crisis. As the country reels from medical supply shortages, COVID-19 case surges and an exodus of skilled medical professionals, the urgency of the sector’s need for outside help is no longer a matter of debate.

In most countries, it might seem reasonable to look to the government to implement reforms to rescue the health system from collapse. But in Lebanon, where it is arguably politics itself that is making the nation sick, the embattled state is unlikely to offer solutions.

A new study led by King’s College London and the American University of Beirut suggests Lebanon’s health system is in decline thanks in large part to the same disastrous political decisions and systemic problems that led to the country’s 2019 economic collapse.

The study, “How politics made a nation sick,” conducted by the Research for Health in Conflict–MENA project (R4HC-MENA), shows how a series of politically driven disasters has created a crisis state that is unprepared to deal with a deepening public-health emergency.

Dr. Adam Coutts, one of the R4HC-MENA project leads, describes the health situation in Lebanon as “a slow moving trainwreck, which sped up in the pre-pandemic period when the economy collapsed in 2019.”

Ever since the end of Lebanon’s civil war in 1990, sectarianism, clientelism and corruption have dominated political life and driven the country into successive bouts of unrest and instability.

Corruption, hyperinflation and the 2019 banking sector collapse have plunged Lebanon into the worst economic crisis in its modern history. The arrival of millions of refugees from neighboring Syria has only compounded the strain on its creaking infrastructure.

About 19.5 percent of Lebanon’s population of 7 million are refugees from neighboring countries. Already living precariously in impoverished communities, few of them have the means or the connections to obtain vital medications at a time of scarcity.




Protesting pharmacists (above) hold signs saying “no gasoline = no ambulance,” denouncing the critical condition facing the country’s hospitals while grappling with dire fuel shortages. (AFP)

Meanwhile, the drastic devaluation of the currency has made health insurance unaffordable for many Lebanese.

“The social and economic situation in Lebanon right now is dire,” said Dr. Coutts. “We have been working on health, economic and social issues in Lebanon for ten years and have never seen it this bad.”

The steady depletion of foreign-currency reserves has made it difficult for Lebanese traders to import essential goods, including basic medicines, and has led banks to curtail credit lines — a disaster for a nation that depends so heavily on imports.

Furthermore, patients have been left struggling to access appointments and surgeries as medical staff flee the country in droves.

According to the R4HC-MENA study, about 400 doctors and 500 nurses out of the country’s 15,000 registered doctors and 16,800 registered nurses have emigrated since the onset of the crisis.

To make matters worse, Lebanon’s chronic electricity shortages have forced hospitals to rely on private generators to keep the lights on and their life-sustaining equipment functioning. But generators run on fuel, which is also perennially in short supply.

Despite the severity of the health care emergency, the Lebanese government has been unable to respond, lacking both the financial means and the willpower amid a multitude of overlapping crises.

“Health always seems to be viewed as the poor relation in development and early recovery compared to economic stabilization, education and security,” said Dr. Coutts. “The problem is if we continue to neglect health and health systems this leads to even bigger problems in the future.”

The COVID-19 pandemic arrived at the worst possible moment for Lebanon, further exposing the health system’s weakness and placing additional strain on the country’s battered economy.




A combination of images showing shuttered doors of pharmacies in Lebanon during a nationwide strike to protest against a severe shortage of medicine during 2021. (AFP/File Photo)

“As the COVID-19 pandemic shows, if you neglect health systems you cannot respond to health emergencies,” Dr. Coutts said. “Health is a top concern among people. It’s the street-level issue which affects everything in people’s day-to-day lives. Development needs to be about lives and livelihoods.”

While COVID-19 infections are currently falling in Lebanon, successive waves of the virus have exacted a devastating toll on Lebanon’s health system. In December 2020, for instance, about 200 doctors who lacked sufficient protective equipment to avoid infection were placed in quarantine.

The R4HC-MENA study found that successive peaks of the virus overwhelmed hospital capacity and resources, exacerbating shortage of staff, to say nothing of equipment such as ventilators and pharmaceuticals.

“Many private hospitals were reluctant to undertake COVID-19 care for fear of ‘losing’ income from more lucrative services, losing their physician and nursing staff, and lack of trust that they would actually be reimbursed by the government,” Dr. Fouad M. Fouad, R4HC-MENA project lead in Beirut, told Arab News.

Just when it seemed things could not get any worse for Lebanon’s health sector, the Beirut port blast of Aug. 4, 2020 leveled a whole city district.




The damaged Saint George hospital (left) in Beirut more than a week after the port blast of Aug. 4, 2020. Some 43,000 Lebanese emigrated in the first 12 days after the explosion, including skilled workers such as medical staff. (AFP/File Photo)

More than 220 people were killed in the blast, about 7,000 injured, and some 300,000 left homeless. Within hours of the explosion, people began to pour into the city’s hospitals with all kinds of trauma, disfiguring burns and wounds caused by flying glass and masonry.

However, the blast also shattered the city’s health infrastructure. According to a WHO assessment, four hospitals were heavily affected and 20 primary care facilities, serving about 160,000 patients, were either damaged or destroyed.

“The explosion generated multiple health and rehabilitation needs among survivors,” Rasha Kaloti, research associate on the R4HC-MENA project, told Arab News.

“It also caused many patients to miss routine care for a variety of conditions, including critical care therapy such as cancer treatments, with many having to move to other hospitals, which led to delays and a lack of continuity of care.”




Doctors have warned that Lebanon is losing its best and brightest medical staff amid the crisis. (AFP/File Photo)

Meanwhile, the mental health impacts of the blast have only now started to become apparent, with survivors experiencing anxiety, depression and post-traumatic stress disorder.

Embrace, a mental health awareness NGO in Lebanon, surveyed about 1,000 people aged 18 to 65-plus in the first 10 days after the blast. It found that 83 percent of respondents reported feeling sad almost every day, while 78 percent reported feeling very anxious and worried every day.

The blast has also accelerated the brain drain of skilled workers, including health staff. According to the R4HC-MENA study, 43,764 Lebanese emigrated in the first 12 days after the blast.

R4HC-MENA outlined several recommendations to help Lebanon salvage its health system. “The first thing that needs to happen is that clear political commitments are given to securing the health and wellbeing of the Lebanese and refugees,” said Dr. Fouad.




Despite the severity of the health care emergency, the Lebanese government has been unable to respond, lacking both the financial means and the willpower amid a multitude of overlapping crises. (AFP/File Photo)

“A new social contract needs to be created. Just signing a WHO declaration on Universal Health Care is not enough.”

Indeed, the causes of Lebanon’s health care collapse are largely political. For Dr. Coutts, a good first step might be to redefine the definition of “state failure” to incentivize the international aid community to pour resources into the health system.

“It is hard to see how Lebanon is not a failed state when the health system is on its last legs, half the population cannot afford to access the health system, three quarters of the population are on the World Bank poverty line, and a massive man-made explosion occurred in the middle of the capital city for which no one has been held accountable,” he said.

“If that is not state failure, then state failure needs redefining.”


Trump says two weeks is ‘maximum’ for Iran decision

Updated 5 sec ago
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Trump says two weeks is ‘maximum’ for Iran decision

MORRISTOWN, United States: President Donald Trump said Friday that Iran had a “maximum” of two weeks to avoid possible US air strikes, indicating he could take a decision before the fortnight deadline he set a day earlier.
Trump added that Iran “doesn’t want to talk to Europe,” dismissing the chance of success in talks between European powers and Iran in Geneva on resolving the conflict between Israel and Iran.
Trump also played down the possibility of asking Israel to halt its attacks, after Iranian Foreign Minister Abbas Araghchi said Tehran would not resume talks with the United States until Israel relented.
“I’m giving them a period of time, and I would say two weeks would be the maximum,” Trump told reporters when asked if he could decide to strike Iran before that.
He added that the aim was to “see whether or not people come to their senses.”
Trump had said in a statement on Thursday that he would “make my decision whether or not to go within the next two weeks” because there was a “substantial chance of negotiations” with Iran.
Those comments had been widely seen as opening a two-week window for negotiations to end the war between Israel and Iran, with the European powers rushing to talks with Tehran.
But his latest remarks indicated that Trump could still make his decision before that if he feels that there has been no progress toward dismantling Iran’s nuclear program.
Trump dismissed the chances of Europe making a difference, saying the talks between Britain, France, Germany and EU diplomats and Tehran’s foreign minister “didn’t help.”
“Iran doesn’t want to speak to Europe. They want to speak to us. Europe is not going to be able to help in this,” Trump told reporters as he arrived in Morristown, New Jersey.
Asked if he would ask Israel to stop its attacks as Iran had asked, Trump said it was “very hard to make that request right now.”
“If somebody’s winning, it’s a little bit harder to do than if somebody’s losing, but we’re ready, willing and able, and we’ve been speaking to Iran, and we’ll see what happens.”

In Istanbul, top Arab League diplomats discuss Iran-Israel war

Updated 33 min 19 sec ago
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In Istanbul, top Arab League diplomats discuss Iran-Israel war

  • The ministers were in Turkiye’s largest city on the eve of weekend gathering of the OIC
  • Some 40 top diplomats are slated to join the weekend gathering

ISTANBUL: Arab League foreign ministers gathered in Istanbul late Friday to discuss the escalating war between Iran and Israel, Turkish state news agency Anadolu said, quoting diplomatic sources.

The ministers were in Turkiye’s largest city on the eve of weekend gathering of the Organization of Islamic Cooperation (OIC), which was also slated to discuss the air war launched a week ago.

Israel began its assault in the early hours of June 13, saying Iran was on the verge of developing nuclear weapons, triggering an immediate immediate retaliation from Tehran in the worst-ever confrontation between the two arch-rivals.

Some 40 top diplomats are slated to join the weekend gathering of the OIC which will also have a session dedicated to discussing the Iran-Israel crisis, the Turkish foreign ministry said.

Iranian Foreign Minister Abbas Araghchi, who met with his counterparts from Britain, France and Germany in Geneva on Friday, will also attend and address the diplomats, the ministry said.

Earlier on Friday, Araghchi said Tehran was ready to “consider diplomacy” again only if Israel’s “aggression is stopped.”

The Arab League ministers were expected to release a statement following their meeting, Anadolu said.


US to move third aircraft carrier closer to Mideast conflict

Updated 35 min 4 sec ago
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US to move third aircraft carrier closer to Mideast conflict

  • Navy official confirms USS Gerald R. Ford will depart for Europe next week
  • USS Carl Vinson carrier strike group already in Middle East, soon to be joined by USS Nimitz

WASHINGTON: The USS Gerald R. Ford will depart for Europe next week, a Navy official said Friday, placing a third American aircraft carrier in closer proximity to the Middle East as Israel and Iran trade strikes.
Israel launched an unprecedented air campaign against Iran last week, and US President Donald Trump has said he is weighing whether to join Israel in the fight.
“The Gerald Ford carrier strike group will depart Norfolk (Virginia) the morning of June 24 for a regularly scheduled deployment to the US European Command area of responsibility,” the Navy official said.
The USS Carl Vinson carrier strike group has been operating in the Middle East since earlier this year, taking part in an air campaign against Yemen’s Iran-backed Houthi rebels.
And a US defense official has confirmed that Pentagon chief Pete Hegseth ordered the Nimitz carrier strike group to the Middle East, saying it was “to sustain our defensive posture and safeguard American personnel.”
Trump said Thursday he will decide whether to join Israel’s strikes on Iran within the next two weeks, citing a chance of negotiations to end the conflict.
That deadline comes after a tense few days in which the US president publicly mulled hitting Iran and said that Tehran’s supreme leader Ayatollah Ali Khamenei was an “easy target.”
Trump had spent weeks pursuing a diplomatic path toward a deal to replace the nuclear deal with Iran that he tore up in his first term in 2018, but has since backed Israel’s attacks on Iran’s nuclear facilities and military top brass.
A key issue is that the United States is the only country with the huge “bunker buster” bombs that could destroy Iran’s crucial Fordo nuclear enrichment plant.
A number of key figures in his “Make America Great Again” movement have vocally opposed US strikes on Iran, and Trump’s promise to extract the United States from its “forever wars” in the Middle East played a role in his 2016 and 2024 election wins.


GCC chief hails UN adoption of landmark resolution on strategic cooperation

Updated 20 June 2025
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GCC chief hails UN adoption of landmark resolution on strategic cooperation

  • Jasem Albudaiwi describes agreement between the organizations as a major step forward in deepening regional and international collaboration
  • Its adoption reflects the respected status of the GCC as a proactive regional partner in efforts to support global peace and security, he adds

RIYADH: The secretary-general of the Gulf Cooperation Council, Jasem Albudaiwi, on Friday welcomed the adoption by the UN General Assembly of a landmark resolution on collaboration between the organizations.

He described the agreement, formally titled “Cooperation between the United Nations and the Gulf Cooperation Council” and the first of its kind, as a major step forward in deepening regional and international collaboration, the Saudi Press Agency reported.

The resolution, adopted on Monday, was submitted to the UN on behalf of GCC member states by Kuwait, which currently holds the presidency of the regional organization.

Albudaiwi said its adoption reflects the respected status of the GCC as a proactive regional partner in efforts to support global peace and security. It signifies a new phase of strategic partnership between the organizations, he added, underscored by concrete plans and activities to enhance cooperation.

He praised Kuwait for the diplomatic efforts of the nation’s mission to the UN in New York, and said the success of the resolution embodies the spirit of unity within the GCC and its commitment to working constructively with international partners across multilateral platforms.


19 injured in Israeli port after Iran missile barrage

Updated 20 June 2025
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19 injured in Israeli port after Iran missile barrage

  • Projectile slammed into an area by the docks in Haifa on Friday afternoon

JERUSALEM: At least 19 people were injured in the northern Israeli port city of Haifa as Iran fired a fresh barrage of missiles on Friday afternoon, authorities said.
Iran has been launching daily missile salvos at Israel for the past week since a wide-ranging Israeli attack on its nuclear and military facilities triggered war.
One projectile slammed into an area by the docks in Haifa on Friday afternoon where it damaged a building and blew out windows, littering the ground with rubble, AFP images showed.
Israel’s foreign ministry said it struck “next to” the Al-Jarina mosque.
The locations of missile strikes in Israel are subject to strict military censorship rules and are not always provided in detail to the public.
A spokesman for Haifa’s Rambam hospital said 19 people had been injured in the city, with one in a serious condition.
A military official said that “approximately 20 missiles were launched toward Israel” in the latest Iranian salvo.
More than 450 missiles have been fired at the country so far, along with about 400 drones, according to Israel’s National Public Diplomacy Directorate.
The directorate added that the country’s tax authority had received over 25,000 claims linked to damage caused to buildings during the war.
Israel launched a massive wave of strikes on June 13, triggering an immediate retaliation from Tehran.
Residential areas in both countries have suffered, while Israel and Iran have traded accusations of targeting civilians.
At least 25 people have been killed in Israel by Iranian missile strikes, according to authorities.
Iran said on Sunday that Israeli strikes had killed at least 224 people, including military commanders, nuclear scientists and civilians. It has not updated the toll since.