The provinces under the control of the Syrian regime are experiencing a medicine crisis, reflected in the absence of critically important types for patients, especially those related to chronic diseases.

Patients and pharmacists in Latakia province told Enab Baladi of the unavailability of many medications related to chronic diseases such as heart disease and high blood pressure, as well as pediatric drugs, in addition to several types of stomach drugs and nerve treatments.

Despite the repeated and significant price hikes that drugs saw during the past year, the problem of drug availability in Syria remains, as it appears that pharmaceutical manufacturers are striving for further price increases.

With great difficulty

“I managed to get a box only with great difficulty,” said Mania, as she spoke to Enab Baladi about the disappearance of medicines in Syria.

Mania, a 32-year-old government employee in Latakia, reported that she searched extensively for Carvedilol, a medication for her mother’s heart disease and blood pressure, but was unable to obtain it nor any alternatives.

Mania searched for Carvedilol in more than eight pharmacies along the Syrian coast, while the drug was absent in all of them, without any alternatives, until she reached a pharmacy in Damascus and obtained a single box.

Even with drug prices increasing by more than 70% in December of last year, many medications remain unavailable amid news about several pharmaceutical factories ceasing operations at the beginning of the current year.

No fault of the pharmacies

Lina, a pharmacist from the city of Jableh, said that the matter was not pharmacies’ fault, but it was due to several factories halting operations, such as the Balsam company, as well as Unipharma and many others.

The pharmacist added to Enab Baladi that there are many out-of-stock varieties, especially neurological, psychiatric drugs and antipsychotics, as well as some blood pressure and heart disease medications, like Desertic and Carvedilol, as well as certain vascular disease drugs like Trental, and drugs used by kidney patients.

Lina continued, “The most dangerous aspect of the situation is the absence of alternatives for most of these medicines, due to the reluctance of many factories to distribute to pharmacies on the pretext that there is no current production.”

Among the currently missing medications are all drugs for kidney transplant patients, as finding them is almost impossible, especially Cellcept. Occasionally, the smuggled foreign type can be found but at exorbitant prices exceeding tens of thousands of Syrian pounds.

This is also the case with Amin, the owner of a pharmacy in Latakia, who said that neurological and psychiatric medications are entirely cut off, noting that patients can get the medicine if they are able to pay 150,000 pounds for a box whose official price does not exceed 22,000 pounds.

The pharmacist confirms that distributors of pharmaceutical factories do not give pharmacy owners their need for drugs, “I request 30 boxes of a specific drug, yet the distributor refuses to give me more than 10 boxes at most,” he expressed.

He mentioned that pharmacists are not responsible for raising drug prices, as they also face new challenges in the pharmaceutical market, including changing how citizens purchase their medicines. Many now ask to buy by the pill or by a blister pack instead of the box as before.

Declining purchasing power

Pharmacist Amin said that if it were not for the weak purchasing power that has left many patients unable to buy their medications, the situation would be frightening and the drugs would be completely cut off. However, the weak purchasing power allows for the availability of some of them despite their scarcity.

Amin recalls an incident that occurred with him a while ago, when two women came to the pharmacy and initially apologized to him for their strange request, hoping he could help them. One of them took out a bottle of Paracetamol, a children’s fever-reducer medication, and asked the pharmacist whether the drug was still valid for use. The woman bought the medicine about a month and a half ago and about half of it is still in the bottle. Amin answered that if she kept it in the fridge, it would be fit for long-term use.

Amin added that the reason for the question was the woman’s intention to sell the remaining half of the drug bottle to the other woman with her, who was her neighbor, as she could not afford a full container for her child. She decided to sell what remained of the bottle to her neighbor at a lower price, in order to use the money to secure a part of the cost for the vitamins needed by her child.

The pharmacist confirmed that many patients ask him to sell half a blister pack of medication, and it is rare for someone to buy a full box. They either purchase a blister or half a blister; he refuses to sell half a blister but if he could, he would give it to the customer free of charge, according to his statement.

The continuous increase in drug prices in Syria, the latest of which was in December 2023, places significant strain on the majority of patients due to the deterioration of most Syrians’ purchasing power.

Price hikes and production halts

The regime’s Ministry of Health raised drug prices, in the last instance, by percentages ranging from 70 to 100%, after approximately a month since some drug varieties had been cut off.

The head of the Pharmacists’ Syndicate in Damascus, Hassan Dirowan, told the government newspaper Tishreen that the prices of pills, capsules, and syrups increased by 70%, while ointments, creams, and bronchial sprays went up by 100%.

Pharmaceutical factories and companies stop production, hoping to pressure the Ministry of Health to agree on raising prices, while poor patients are the only ones paying the price, without the regime government’s promises to provide a dose of medicine for their diseases coming to fruition.

For the well-off and wealthy people, the majority do not buy locally manufactured medicines but purchase them from neighboring countries, especially Lebanon, as observed by Enab Baladi.