The former Assad regime relied on Iranian and Indian medications to treat chronic diseases amid international sanctions and a collapsing health sector.
Syria’s healthcare system has been in steady decline since 2012. Once capable of producing over 90% of its pharmaceutical needs, the country now faces a severe shortage of essential drugs. Most recently, on March 26, the Ministry of Health from the former provisional government issued an urgent humanitarian appeal, calling on international and regional bodies to provide immediate medical assistance, especially due to the critical lack of cancer treatments.
Following the outbreak of war in 2011, domestic drug production plummeted, and importation became increasingly difficult. In response, the ousted Assad regime turned to Iranian and Indian pharmaceuticals to address serious chronic conditions such as cancer. However, these treatments were widely considered ineffective, according to Dr. Jamil Al-Debal, Chairman of the National Consultative Committee for Hematology and Oncology in Syria.
“These medications had limited efficacy, but they were the only available options,” said Dr. Al-Debal. “The extensive sanctions, compounded by underfunding and neglect, left one of Syria’s most vital sectors in ruins”.
A Profitable Industry in the Wrong Hands
In the fifth issue of the printed edition of +963, Dr. Mohammad al-Dablouni described the pharmaceutical sector as “reeling”. He stated, “After the popular uprising began, pharmaceutical strategy deteriorated dramatically. Medicine, arguably the most essential product in society, became a commercialized commodity. This led to a wide variety of medicines of inconsistent quality, damaging both production levels and Syria’s global reputation”.
He added that while pharmaceutical production is a strategic industry in sovereign nations, Syria’s experience was different. “The sector became a lucrative business for figures linked to the former regime. Some pharmaceutical facilities even shifted to manufacturing illicit substances such as Captagon after the regime compromised the integrity of the industry. Syria quickly earned a reputation as one of the worst in pharmaceutical manufacturing and credibility”.
Despite a 23% increase in the number of pharmaceutical laboratories between 2011 and 2018, from 58 to 73, according to Health Ministry data, medicine prices skyrocketed as living conditions deteriorated and the economy collapsed.
Maher al-Sharaa, former Minister of Health in the Syrian Provisional Government, criticized the lack of regulation, “Pharmaceutical manufacturing in Syria is chaotic, he said, “the ministry imposes pharmaceutical herds, arbitrary production directives, on labs to meet perceived market needs. Labs often prioritize drugs with cheap raw materials and high-profit margins”.
A Shadow Market and the Medication Mafia
In 2023, the Ministry of Health under the ousted Assad regime tripled drug prices, with some products seeing hikes of up to 100%. These increases were reportedly the result of deep conflicts of interest between pharmaceutical manufacturers and the Health Ministry, which faced intense lobbying at the time.
Chemical pharmacist Dr. Omar Kloundi referred to this dynamic as the work of a “medication mafia” He told +963, “Since the regime’s collapse, some medicines for seasonal ailments are available, but treatments for life-threatening conditions like cancer, cardiovascular disease, and diabetes remain scarce. The absence of these drugs can result in patients’ death”.
Dr. Kloundi added that with Syria’s borders increasingly open to Turkey, Turkish-made medications have entered the market, especially those treating common illnesses like asthma and bronchitis. “But their prices are disproportionately high when compared to average incomes. Importers dictate the prices due to a lack of regulatory oversight. As a result, even essential drugs are treated as commodities, subject to supply and demand. Rigorous pharmaceutical regulation is urgently needed”.
