The crises that riddle Lebanon’s pharmaceutical industry date back to 1943, and the first post-independence government under Riyadh Solh. Countless promises and plans have since been made to provide all social classes with medicinal drugs of the highest quality and at the most affordable prices but none of them has ever materialized. To date, the concerned parties continue to commercialize medicines, sacrificing the quality for profit and pushing the pharmaceutical market to the brink of chaos and criminal activity, to such an extent that 30% of pharmaceutical products are said to be both counterfeit and smuggled into the country.

The tripartite alliance mafia, commercial-administrative-political, has manipulated the medicines industry, prompting the emergence of undesired trends: a massive increase in the number of medicines, without any tangible improvement in their effectiveness or in the quality of health services; uncontrolled dispensing of medicines to treat mental illnesses without prescriptions, with Lebanon recording the highest level of consumption worldwide; 20% of the most consumed medicines are among the most expensive worldwide, not to mention that the industry lacks scientific and laboratory controls and is monopolized by 10 exporters who control 90% of the market, while local pharmaceutical production hardly accounts for 8%.

“Even if the medicine mafia has become a quasi inevitable destiny, I won’t surrender to it,” writes Soukarieh as he sets out to chronicle his experiences in the industry, documenting the queries he raised along with the answers he obtained as well as the interrogations he directed at the government in the areas where answers proved insufficient. Central Inspection reports touching on relevant matters were also part of Sukarieh’s documentation. The book approaches the public health and drug sector from all its angles, using an overarching perspective pointing out to the need to form a special parliamentary committee to tackle the thorny and far-reaching implications of the medicines issue.

In 2002, the National Health Committee was formed under the chairmanship of Soukarieh. Reform was at the forefront of the aspects marking the committee’s work. Over the course of 12 years, it was able to craft an approach that exposed the flagrancy of the medicine mafia’s freedom of action and the scandalous absence of quality control testing on medicines, which left patients at the mercy of the trader’s conscience- or lack of it. Over 6000 medicinal products were found to have been registered without undergoing any form of scientific censorship. Worse still, it turned out that 30% of the medicines circulating in the market posed a threat to the public health as they were either counterfeit or withdrawn from the world market but somehow still available in Lebanon.

“I was appalled, rather frightened, by the dreadful state of affairs at some supervisory entities, the Central Inspection in particular, and by their ways of handling and investigating critical issues,” he notes.

Medicaments… Mafia or Systemic Crisis? brings the crisis-ridden medicines industry to the public eye categorizing the sector’s shady practices under the label of the administrative corruption unfolding in Lebanon’s public administrations, particularly in the Ministry of Public Health, which has been struck by a chronic illness resulting from political interference in the appointment of supervisory committees.