Daraa – Halim Mohammad

“ I need four types of medicines regularly, and I do not have enough money to buy them. Moreover, I do suffer to find my medicines in the pharmacies of our region,” with these words, Ahmad al-Mustafa, an old man suffering from hypertension, described his situation to Enab Baladi. 

The residents of Daraa complain of significantly increased prices of medicines, especially during the current July, after the Syrian Central Bank (SCB) raised the official exchange rate from around 700 to  1,250 Syrian Pounds (SYP) to the dollar. 

A pharmacist, who declined to publish his name, said to Enab Baladi that some pharmacists and owners of pharmaceutical warehouses monopolize several types of medicines which led to their loss in the region. 

Patients of chronic diseases, such as diabetes, hypertension, kidney disease, etc, are negatively affected by the loss of drugs more than others. According to the pharmacist, most chronic disease patients are old, and sometimes a person has more than one disease at the same time. 

Enab Baladi has monitored the opinions of a number of elderly people with chronic diseases.  Ahmad al-Mustafa highlighted that even though he is suffering from high blood pressure, he has a greater concern than this, which is to find medicine and afford its price.

Al-Mustafa needs four types of medicines every ten days, he is having difficulty finding them in pharmacies, in addition to that, the price rises every time he wants to buy.”

A nurse, who spoke on condition of anonymity, told Enab Baladi that monopoly is one of the most important factors in losing the drug in the pharmacies of the region,  stressing that raising the price is varied among pharmacists, especially in rural Daraa, due to the absence of government oversight.

The head of the Daraa branch of the Syndicate of Pharmacists in the Syrian government Walid al-Dakhoul, told “Tishreen,” one of the state-owned Arabic daily newspaper, that the price of medicines was raised due to the scarcity of importing some of raw materials involved in the pharmaceutical industry as a result of the economic blockade on Syria and the spread of the novel coronavirus (COVID19).

Al-Dakhoul added that the exchange rate fluctuations issued by the SCB play a role in raising drug prices.

The head of the Pharmacists Syndicate in Syria, Wafaa Kishi, told “Sham FM,” a local radio station, on 13 July, that the prices of medicines varied more than once because they were priced based on the exchange rate of 750 and then adjusted to 1,265 SYP per USD.

Governmental procedures and presidential decrees… but

The Syrian government took a course of action last June and in the current July, to reduce the high drug prices and the high cost of medicine production set by the pharmaceutical manufacturing plants. 

First, the ministry of health issued an explanation on 2 June, in which it stated the governmental measures that support the pharmaceutical sector and finance imported pharmaceutical requirements, according to the price of the SCB’s bulletin.

The import of pharmaceutical products and materials, which reached 40 percent of the import transactions, was cancelled. Besides, the customs duties for pharmaceutical raw materials are paid according to the official exchange rate of 438 SYP per USD. Plus, the value of imported materials’ foreign exchange commissions is to be reduced by five percent. 

Second, the head of the Syrian regime, Bashar al-Assad issued a decree No.14 of the current year on 13 July, which exempted production requirements, and raw materials used in manufacturing medicines for human use from customs duties and taxes.

The decree exempts production requirements and pharmaceutical raw materials from the fees determined under the schedule of the customs tariff regulations, and from all taxes and other fees imposed on the import process for one year from the beginning of next August.

However, a medical source in Daraa, who asked not to be named, in an interview with Enab Baladi, minimized the importance of the decree in reducing the prices of medicines, saying that it is possible to reduce the cost of producing medicines after taxes and customs duties on importing medical supplies, but we must not forget the sanctions imposed on the Syrian regime and their role in limiting imports. In addition, the spread of the coronavirus greatly affected trade transactions, according to the medical source.

In a statement to the Chairman of the Scientific Council of Pharmaceutical Industries National Dr. Zuhair Fadloun to the local newspaper al-Watan, on 1 June, he said that 70 percent of the raw materials used in the pharmaceutical manufacturing process is imported at the US dollar exchange rate on the black market, because the SCB does not cover the costs of any raw imported materials, and 90 percent of medicines are imported.

There were 78  pharmaceutical plants in Syria, the plants in Aleppo alone covered 50 percent of the pharmaceutical market needs, according to Germany’s Firil Center for Studies. 

The head of the Pharmacists Syndicate in Syria, Wafaa Kishi, said that today Syria has 97 pharmaceutical plants. 

What does it mean not to get medicine regularly?

Patients need to take the drug regularly and without a break. However, stopping medication or not taking medication on time causes health problems that may lead to a loss of the patient’s life.

And a vascular doctor in Daraa believes that the risks in the event that the patient does not get the medication are great.

For example, if a hypertension patient did not take his medicines regularly according to the doctor’s prescription, he could have a brain hemorrhage, coma, idiopathic intracranial hypertension, or hemiplegia, the vascular doctor told Enab Baladi.  

Um Abdo (65 years old) has heart problems, she said to Enab Baladi that the doctor prescribed a set of medicines that cost up to ten thousand SYP (around five USD) after she previously bought them with three thousand SYP (1.5 USD), and warned her that she needs to take her medicines regularly to avoid risks that might lead to her death.

Ahmad al-Mustafa said that he started thinking of using herbal medicine to maintain his blood pressure level.

90 percent of the Syrian people are below the poverty line

The residents of Daraa cannot afford to buy medicines amid the country’s recession condition, which led to low-income levels, the depreciation of the SYP, and unprecedented cost of living.  

The Representative of the World Health Organization (WHO) in Syria, Akjemal Magtymova, estimated that 90 percent of the Syrian population lives below the poverty line.