Syrians Suffer as Assad Profits from Medicine Black Market

The health conditions of many Syrians living in areas controlled by the Bashar al-Assad regime are deteriorating day by day. Patients cannot afford the escalating prices of medicine on the black market, from which the regime and its supporters profit.

The inability to secure or refuse to purchase essential medication due to the soaring prices has made patients victims of the Syrian government’s policies, which have left drug prices subject to the fluctuations of the dollar and the plummeting lira, without stabilizing the price to protect public health.

 

Inability to Secure Medication

Many patients with chronic illnesses are no longer able to secure necessary medication in areas under the control of the Assad regime, where there are 70 active pharmaceutical factories across several provinces producing around 8,000 types of medicine.

The current pharmaceutical labs meet around 93% of the local market’s needs but with the Syrian pound collapsing to 7,500 to the US dollar and salaries remaining stagnant.

Demand for medicine has decreased due to the price hike. Sales have dropped by around 40%, according to the head of the Damascus Pharmacists Syndicate, Hasan Derawan, speaking to local Melody FM radio on April 5, 2023. National medicines have recently seen price hikes, making them unaffordable for many Syrians due to declining living standards and purchasing power.

Many people are forced to choose between “medicine or food” due to the high prices of the former and the Syrian government’s inability to control prices and keep them within reasonable rates in proportion to citizens’ monthly incomes and unaffected by the rising dollar exchange rate.

The salary of an employee in the Assad regime-controlled areas is 25 dollars per month, and the inflation rate in Syria for 2022 exceeded 130%, ranking high on the list of the world’s most inflationary economies, after Venezuela, Sudan, and Lebanon, according to Trending Economy.

Food prices in the Assad regime-controlled areas rose by more than 150% in 2022, and locals admit through local media outlets to their daily food shortages.

During 2023, the average cost of living for a family of four living in a house they own in Damascus increased to two million Syrian pounds ($270) to be able to secure their basic needs in a month.

 

'Significant Price Hike'

On the other hand, drug prices in areas controlled by the Syrian government have skyrocketed since 2021, from hundreds to thousands of Syrian pounds, causing a major shortage of medication for patients with chronic diseases such as high blood pressure, diabetes, and prostate problems.

This has also made it difficult to obtain emergency medications for periodic illnesses such as diarrhea, vomiting, various infections, allergies, cramps, antibiotics, eye drops, skin creams, and vitamins.

For example, a box of Augmentin costs 19,000 Syrian pounds, while it should be sold at its fixed price of 11,000 Syrian pounds in pharmacies.

Moreover, areas controlled by the Syrian government are experiencing a severe shortage of baby formula boxes, with the price of each box reaching 15,000 Syrian pounds ($2) which may be enough for a baby for a week, exceeding the citizens’ ability to afford them in the first place.

The reality also indicates a shortage of medication for chronic diseases, especially in public health centers and government hospitals, as well as other types of drugs.

This makes healthcare expensive for patients and forces them to neglect it due to high prices.

Rima Murad, who heads the Endocrinology Association in the Syrian Medical Syndicate, stated in an interview with the pro-government newspaper Al-Watan on April 4, 2023, that the prevalence rate of diabetes in Syria has surpassed 18%. Murad also expressed her concern that treating these cases places a significant burden on the state’s resources.

 

Mass Death

The Syrian Corruption page commented on the high prices of certain medications, which range from 70 to 500%.

“It is a collective death that threatens the poor in Syria; the gap between income and prices has become significant, it stated.

The page, which comments on the Syrian reality, added in a post on January 18, 2023: “Many people will stop taking their medication for a long period because they cannot afford it, and this will have a negative impact on their health. We will witness mass deaths and health conditions that are out of control.”

According to the head of the Syrian Pharmacists’ Syndicate, Mahmoud al-Hasan, local medicine is currently exported to about 16 countries, mentioning only Iraq, however, insiders confirm that it is also exported to Russia, Jordan, Lebanon, Sudan, Mauritania, and Yemen.

The Assad government has abandoned its citizens to their health fate, rendering the phrase “no health without medicine” meaningless. With a lack of pharmaceutical oversight over pharmacies and pressure from drug companies and warehouses, prices are imposed at their discretion under the pretext of the high cost of active substances used in drug formulations.

India and China are the countries most relied upon by Syrian pharmaceutical companies to secure raw materials, while European companies continue to refrain from selling their drugs for fear of violating the Caesar Act imposed on the Syrian regime in June 2020.

The Western sanctions imposed on the Assad regime since 2011 aim to force it to engage in a real political solution in accordance with UN resolutions, which has pushed its stubbornness to become paralyzed and unable to achieve any new economic recovery in its controlled areas.

Syria achieved self-sufficiency in pharmaceutical production, exceeding 90% of the local market’s needs before 2011.

It also ranked third in the Arab world in exporting drugs to more than 50 countries worldwide, with its exports in that year reaching $305 million.

The pharmaceutical industries in Syria are mostly owned by the private sector, as until 2010, there were about 64 private companies alongside the two state-owned companies, Tamiko and Al-Dimas.

Therefore, the imposition of European and Western sanctions on the Assad regime has affected the ability of those companies to import raw materials for manufacturing, packaging, and equipment and inspection devices from the countries of origin, as well as the increase in shipping fees and carriers’ wages.

In addition, customs and port fees have increased, as well as the destruction of most of those factories due to the bombing and battles between Assad forces and opposition factions.

The current factories located in areas controlled by the Assad regime produce all medical products except cancer drugs and hormones, as well as injection products, creams, sanitizers, capsules, preservatives, coated tablets, solutions, and drops.

They also produce dry suspensions and liquid drugs that treat chronic diseases such as diabetes, pressure, heart, allergies, inflammation, cortisone, and anesthetics.

 

Government Excuses

In parallel, the Assad government’s raise of fuel prices is used as a justification for the owners of pharmaceutical factories to increase their prices under the pretext of high costs.

This makes some types of medication unavailable or limited in quantity at pharmacies, exceeding the patient’s ability to afford them, even if it is the type that people with chronic diseases are required to take continuously.

Pharmaceutical factories in Syria also suffer from a shortage of medical and primary logistics supplies, as they are imported from abroad.

In December 2022, the Assad government raised the prices of 1,277 types of medications by 30%, creating additional suffering for those suffering from chronic diseases that require ongoing medication.

The Assad government gives priority to exporting local medications abroad, as Syrian medication is known for its quality worldwide, and its export provides foreign currency to the regime’s depleted treasury.

However, any decision to increase the prices of locally produced medication means an increase in treatment costs and healthcare expenses for citizens.

Therefore, the Central Bank of Syria is unable to finance the purchase of primary materials needed by pharmaceutical factories with foreign currency, which has led private-sector factories to increase their exports to provide the necessary foreign currency for imports. This leaves the citizens, who are the weakest link, struggling with their illnesses alone.

According to local media reports, the number of countries importing Syrian medicine has decreased from 44 countries in 2010 to 10 countries in 2019.

 

A New Buying Culture

In this context, pharmacist Omar Nahhas confirms to Al-Estiklal that “there is a new purchasing culture for medication that has emerged among chronic disease patients in Syria, which is saving the price of medication in dollars from financial transfers coming from the patients’ relatives abroad, in order to cope with the fluctuation of the Syrian pound exchange rate and the continuous rise in the price of medication.”

Nahhas added: “The government claims that it raises drug prices to prevent smuggling to Lebanon, Iraq, or northern Syrian regions.”

However, this justification is not valid as drug smuggling networks have become evident, and the repeated government steps to tighten restrictions on pharmaceutical factories create a crisis in medicine and cause its price to rise, such as “the Syrian government’s efforts to link tax warehouses to the Ministry of Finance.”

This has led to the disappearance of medicines from warehouses due to fear of tax increases, which was not previously the case. This will open the door to further expansion of the black market, according to the pharmacist.

Nahhas did not deny that “the black market is currently the tyrant and controller of the pharmaceutical sector in Damascus, given the high prices, the variation in prices of different companies and suppliers, as well as the smuggling of drugs through its sale in hard currency in neighboring countries.”

Nahhas pointed out, saying: “The government is not interested in the citizen’s illness; it is fundamentally abandoning their living conditions. What matters to the government is to keep private pharmaceutical factories operating at full capacity to achieve profitable returns from them through foreign sales of drugs.”

He concluded by saying: “Citizens have lost hope in government solutions and have become dependent on their own pockets to obtain medication from the black market at reasonable prices, as it has become a popular trade in government-controlled areas.”