Medical Program

The medical assistance program was established in 1988 and became a joint program with the ministry of public health in 1993. The program was mainly funded by the Ministry of Public Health, however, in recent years it received much needed support from several organizations, mainly the EU, ECHO and CERF through the WHO and from UN-OCHA. The program also received YMCA also regularly receives in-kind donations through  partnership with Anera and UPA.The program includes training, awareness sessions, and prevention programs on health-related topics such as the rational use of medicine, stock management, substance abuse, communicable, and non-communicable diseases. 
The YMCA provides subsidized NCDs medications including essential mental health medications to vulnerable populations through the chronic medications program, based on an approved Essential Chronic medication list, updated every 3 years in consultation with WHO and the Ministry of Public Health (MoPH). This program is a joint initiative between the MOPH and the YMCA for the provision of chronic medications to the most vulnerable in Lebanon. The MOPH-YMCA joint chronic medications program has been operational since 1988 and is implemented through a network of 465 health facilities (latest list 28 July 2021operated by the Ministry of Public Health (MOPH), NGOs, and Ministry of Social Affairs (MOSA) across the country. YMCA is working with the MOPH to review this list taking into consideration catchment areas and number of active beneficiaries.
 

1.Health needs:

 

Lebanon is suffering from a prolonged economic depression with its signs started to emerge in 2016. The depression is caused by many factors that come together to deplete the Economic structure, contracting the actuarial GDP growth by 20.3% (as reported by the world bank in April 2021[1]). Inflation exceeded 400% and the exchange rate against the Lebanese pound kept losing value (on 26th of May, the devaluation of the currency reached -90%.)

Since the crisis started gradually in 2019, the central bank intervened to subsidize three main commodities that were considered essential; Wheat, medicine and fuel by subsidizing US dollars at a pegged currency rate of 1507[2]., In addition to a list of 300 basic food items suggested by the Ministry of Economy was added to the subsidized prices the central bank adopted by providing importers with “hard currencies” at another currency rate of 3,900 LBP per dollar, altogether with the continuous deterioration of the market rate reaching 22,000 LBP per US dollar. At the moment, the decision was taken to remove the subsidy on the majority of medication and to fix the selling price for 12,000 LBP versus 1 USD. This caused a severe shortage of medications in the private sector due to the big difference between the USD real value and the price fixed by the central bank. A 1 week strike was held by the pharmaceutical sector all over the country.

The impact is found not only within the poor Lebanese communities and the refugees, but it extended to reach all the residents at the Lebanese territory.  This is leading to a significant increase in demand for health services especially chronic medications.

The medicine crisis raised the concern of all the health actors and was highlighted by the media and influencers. People were encouraged to approach healthcare facilities via Tv shows, WhatsApp messages and Facebook posts in the last month. This instant awareness about the role of the Primary health care centres and dispensaries increased the referrals of new beneficiaries and thus the demand on chronic medications. Nevertheless, and since the medicine crisis was escalating with the economic one since 2019, the number of new beneficiaries has been increasing constantly as shown in figure 1 below. A dramatic increase is expected in Q3 2021 since no solid solution was placed for the medicines crisis and also on the number of new referrals received since the beginning of July.

2.Project beneficiaries

 

The 104,227 patients benefiting from the program are vulnerable Lebanese (80.54%), Syrians refugees (19.03%), and other vulnerable populations (0.43% i.e. Iraqi) accessing primary health care centres and dispensaries.

Adults aged between 45 and 69 constitute 59.6% of the beneficiaries, while the adults above 80 are 13.13%.

The disaggregation of the project beneficiaries is found in the figure below.

 

The highest percentage of beneficiaries take medications for cardiovascular diseases (35.54%), while 19.75% for hyperlipidemia and 12.9% for diabetes as shown in figure 3 below.

 

Reports from recipients also show that:

 

  • 14.11% of the beneficiaries take medications for one disease, 17.81% for two diseases, 21.7% for three diseases, 20.26% for four diseases and 26.12% for 5 diseases or more.

 

  • 10.2% of chronic patients are treated with one medication, 12.5% are treated with two medications, 14.35 % are treated with three drugs, 15.7% are treated with four drugs and 47.25% treated with five drugs or more.

 

YMCA Medical Program will ensure that sufficient supplies of chronic essential medications for patients are available at 465 primary healthcare centres and dispensaries that are part of the MOPH/YMCA operated program, as shown in figure 4 below.