DAMASCUS, ALEPPO, Syria (North Press) – Dana Muhammad, a pseudonym for a 25-year-old pharmacist from the countryside of Homs in central Syria, has stopped serving her customers. “I can barely provide medicine for my own family,” she says.
Muhammad’s word summarize the state of the pharmaceutical industry in Syrian government-held areas, from the Syrian coast passing through Homs and Hama, all the way to Damascus. A severe shortage plagues pharmacies in the region as the distribution of medicines by manufacturers has grinded to a halt.
Small portions
Medicine manufacturers in Syria follow a quota system. Every pharmacy is apportioned a certain amount of medicine by the manufacturing laboratories. However, in December 2022, portions decreased in size and eventually completely stopped arriving.
Muhammad Muhammad (name changed), 50, a pharmacist in Hama, told North Press, “This is the first time in my 25-year-long career that a pharmaceutical crisis like this happens.”
Muhammad, looking back, adds, “In the past, when a certain drug by a certain company became unavailable, another company would manufacture a substitute. Today, every pharmacist’s allocation is only two boxes of Aspirin, which is the most in-demand blood-thinner product we sell.”
According to Muhammad, the pharmaceutical companies’ reasons for the lack of production are electricity outages and high fuel prices.
The two pharmacists, Muhammad and Dana, noted that pharmaceutical manufacturers and companies have increased the prices for pharmacists by 35 percent for certain types of drugs.
A source from the Syrian Pharmacists Association told North Press that problem is not just fuel or the absence of raw materials. It is also the fact that companies conduct inventories which last until mid-January every year.
The source stressed that manufacturers want to increase prices by more than 35 percent “to keep pace with the economic gap opened up by the high exchange rate of the USD against the Syrian pound, especially since most manufacturers import their material in foreign currencies.”
In 2022, pharmaceutical prices increased by 130 percent, according to a source speaking to The New Arab.
The Pharmacists Association “cannot pressure pharmaceutical manufacturers because, after all, they are trade companies”. “Nowadays, pharmacists are losing out and their profits are next to naught, especially after the last increase in prices,” the source added.
In mid-December 2022, the Syrian Ministry of Health increased the prices of 20 types of medicines by 22-26 percent, including heart, inflammation, epilepsy, thyroid and cortisone medications.
Shutdown not an option
Despite the scarcity, drugs in Damascus remain abundant, since its pharmacies receive a larger share of the available products. Nevertheless, they are becoming increasingly scarce.
Ali Ali (name changed), 30, a pharmacist in Damascus, told North Press, “Medicine will be available if prices increased by 300 percent, not only 100 percent. In that case, factories could make a profit.”
He noted that, as of late, more physicians are “prescribing foreign medication, due to its availability, via smugglers. Some pharmacies provide all types of foreign drugs, however pricy they may be, since there is a demand. Some doctors question the effectiveness of locally-produced drugs and they are right to do so,” according to Ali.
“How effective can an inflammation drug that costs 7000 SYP [$1] be when the foreign version costs no less than 100.000 SYP [$14.5]?” Ali wonders.
Asked about the possibility of closing some pharmacies, all three pharmacist said this would be impossible, for a number of reasons. “The pharmacist will get a fine. And the current situation will not last forever. This is a way for companies and manufacturers to pressure the government to increase the prices.”
Widad Tahan, 55, who lives in the al-Iza’a neighborhood in Aleppo, is forced to buy whatever substitute to the medication she used to take is available.
Tahan told North Press that the price of the drug she used to take increased threefold in 2022.
When she asks pharmacists about the reasons of the spike, she gets no clear answer.
Rising pharmaceutical prices
Ismail al-Atrash (name changed), who works in a pharmaceutical warehouse in Aleppo city, told North Press that “for over a month we have not sold any medicine, despite the great demand by pharmacy owners.”
“In general, warehouse owners have stopped providing the pharmaceutical markets with drugs, waiting for prices to adjust, since the main drug suppliers have raised the freight and raw material fees, while the Syrian Ministry of Health has yet to make amendments to the product prices,” al-Atrash noted.
He said that warehouses are distributing some available medications manufactured by the government-owned Tamico company. However, Tamico only manufactures painkillers.
Some patients have resorted to buying medicine in bulk and hoarding, particularly those suffering from chronic diseases. This leaves others empty-handed.