THREAD Lebanon has continually warned of a looming covid crisis over the past six months, while doing very little to shore up its capacity to manage one. The reason is not a lack of resources, but an inefficient (albeit time-tested) way of allocating them

Amazingly, the crisis has not served to revive public health infrastructure. Several public hospitals remain abandoned, such as the Turkish-funded hospital in Saida and the Emirati equivalent in Shebaa, along with facilities in Qartaba and Saksakiya

Only 9 public hospitals, out of 29 mentioned in the National Covid Response plan, have been equipped (often partially). Public health authorities even struggle to confirm a total number of beds for covid patients in public hospitals, suggesting capacity is limited

The Rafik Hariri University Hospital (RHUH), which has been a focus of media attention and funding, claims to have just over 20 beds available for critical cases and 80 for mild ones. Oddly, it is lobbying for resources to go to private hospitals that can share the burden

Lebanon has long believed that private hospitals can compensate for failing public health capacity—turning what was a temporary fix in the aftermath of the country’s civil war into a durable ideology. But private hospitals are neither qualified nor willing to manage this epidemic

In recent months, private facilities have turned down ordinary patients on the pretext that they may spread covid. They have also been accused of discriminating against patients who depend on social security rather than private health insurance or their personal resources

Such people get shunned because the state has allowed its outstanding bills with private hospitals to surpass $1 billion. The government also pays its dues in Lebanese pounds at the official exchange rate, meaning hospitals incur huge losses on imported medicine and equipment

Instead of building up public capacity, Lebanon is now attempting to rescue private hospitals by redirecting more resources toward them, notably through an arrangement with the World Health Organization, which would cover covid-related expenses in lieu of the state

But private hospitals have little experience with epidemics, charge much higher fees, and will be tempted to add overhead to recover other costs; the same amount of money will thus produce fewer results than it would if invested in the public sector, which is equally in need

This transfer of funds from the public to the private sector reflects the ministry’s tendency to undermine its own role. It has delegated the bulk of testing to private laboratories, while failing to restore Lebanon’s national laboratory and enforce protocols to centralize data

Since the Beirut port blast, it even seems to have handed over the task of coordinating health-related foreign aid, inexplicably, to the military. This is another step toward securitizing and politicizing health, after the ministry pressured hospitals to report wounded protesters

The current health minister—who only recently celebrated anti-covid efforts as a personal victory, riding on the shoulders of his partisans flocked together in his hometown—is now seeking to shun responsibility altogether, by invoking the government’s caretaker nature

As usual, Lebanon is responding to a crisis by doing anything other than tackle its root causes: Fighting covid and strengthening a desperately neglected public health sector are one and the same. Ad hoc workarounds will only leave the country more exposed

For updates on health, follow our fellow @fahadalsudaid, who authorized this excellent, short overview of the problems faced by the Lebanese health sector https://www.synaps.network/post/lebanon-health-hospital-covid-coronavirus