By Muhammad Habash
QAMISHLI, Syria (North Press) – Residents in the city of Qamishli, northeast Syria, criticize the shortage of medications and their soaring prices amidst a deteriorating purchasing power and challenging economic conditions that the country has been going through over the past 13 years.
Shivan Omar and other kidney failure patients in Qamishli spend the majority of their week scouring the city’s pharmacies in search of prescribed medications.
Omar, along with seven members of his family, suffer from severe kidney failure. He lost his mother and sister to the illness, while his brother undergoes three kidney dialysis treatments per week in Germany.
He told North Press “I underwent a kidney transplant 12 years ago after both of my kidneys failed.” Holding up a medication box, he said, “I have to take this medicine on a daily basis, but it is nowhere to be found in the pharmacies.”
The situation is similar for Abdulmajid Ali, from Qamishli, who struggles to afford the costs of his wife’s diabetes medications.
He told North Press “Prices keep soaring, and I simply cannot bear the burden of medication expenses.”
He explains that he spent between 400,000 to 500,000 Syrian pounds (SYP, which equals about $26-33) to purchase medications despite his challenging living conditions.
While Khadija al-Saleh points out pharmacists manipulate drug prices, making the search for affordable prices an arduous task.
“Each pharmacy has its own pricing scheme. I have to pay 12 million SYP ($800) for medications every month. It is exceptionally expensive,” she said.
Many patients are struggling to find life-saving medications due to shortages and high costs, adding to the challenges they face in an already dire economic situation.
Who control the prices?
The Autonomous Administration of North and East Syria (AANES) relies on importing medications, either from the government-held areas or from outside the country, due to the lack of local production facilities in the region.
Salah Ramo, a pharmacist in Qamishli, says the high prices of medications are because of the taxes imposed by checkpoints of the Syrian government forces when transporting drugs from their areas to the AANES-held areas. As a result, the cost of medications increases by 28 percent compared to their actual price.
Ramo told North Press, “There is no oversight on the quality and pricing of medications entering the region. We are unaware of the true market value of these drugs.”
He also noted that pharmacists’ profits do not exceed 25 percent, regardless of whether the medicines are domestically produced or imported.
The scarcity of medications is more problematic than their high prices, as production has significantly declined, Ramo says.
Additionally, one of the main factors contributing to expensive medications is the devaluation of the local currency against the U.S. dollar.
The Syrian Ministry of Health raised medication prices three times in 2023, with the latest increase ranging from 70 to 100 percent. Prior to that, prices of over 13 pharmaceutical items had already been raised by 50 percent in August of the same year.
Factors contributing to price hikes
Muhammad al-Hassan, owner of a pharmaceutical warehouse in Qamishli, agrees with Ramo, highlighting that security checkpoints impose a fee of $450 to $600 per cubic meter of medications.
He explains, “There is another factor contributing to the high prices of medications. Some Syrian factories have stopped producing certain types of drugs, which forces us to import them using hard currency that may be beyond the means of some people.”
He also says that Syrian sources of medications manipulate the prices set by the government, claiming it is due to increased production costs.
Al-Hassan acknowledges the presence of corruption in some pharmacies or warehouses in northeastern Syria and stresses that “A price list should be issued and enforced on pharmacies and warehouses.”
Future plans
Kamiran Majdal Bek, co-chair of the Pharmacists Union, affiliated with the AANES in Qamishli, said that prior to the Syrian crisis prices were standardized across all Syrian regions as they were based on the agency system. However, during the crisis, medicine traders acted as middlemen and started manipulating prices.
“Some pharmaceutical factories introduce products that are not in demand in other areas, and they raise prices for traders in the areas of the AANES without being subject to control by the Syrian government,” he noted.
“To ensure medicine availability, the AANES has to source medicines from different places, which caused price differences between pharmacies,” Bek noted.
To address the difference in prices, the Union conducts regular inspection visits to pharmacies and drug warehouses, particularly in response to residents’ complaints.
Bek noted that the Pharmacists Union intends to lower the taxes imposed on medicines to alleviate the burden on patients and revert to the agency system as a means of regulating corruption, price manipulation, and ensuring the availability of different medication varieties through collaboration with pharmaceutical sources.
Bek added that the Union is in the process of establishing a medicine warehouse to regulate prices and sell them with a minimal profit margin, similar to “People’s Hospital” in Amuda and other hospitals affiliated with the AANES.
As the economic crisis worsens and the shortage of medicines persists. Ensuring access to healthcare and medications remains a pressing necessity for the residents in northeast Syria. More efforts are needed to support patients and improve the overall health situation in Northeast Syria.