Statement Addressed to the Lebanese Government and International Organizations
The 2019-Coronavirus Disease (COVID-19) pandemic has affected countries and populations around the world, including Lebanon, adding to the burden of vulnerable groups and people already living in poor conditions before the pandemic. In Lebanon, COVID-19 outbreak has further confirmed, highlighted, and exposed fundamental inter-sectoral problems in various areas of social, economic, civil, and political life. The outbreak has aggravated long-standing structural inequalities in terms of access to basic goods and services including healthcare, WASH, education, and protection. As COVID-19 vaccines have already started to be provided in Lebanon, there is a need for a comprehensive, sound, and transparent vaccination plan including prioritization, distribution, and implementation, following a human rights-based approach.
In 2020, the Health sector was faced with an unprecedented crisis which started late in 2019 with country-wide protests and a deteriorating socio-economic situation. The COVID-19 outbreak further hampered the access for both vulnerable Lebanese and displaced individuals to needed primary healthcare and hospital care. At the beginning of August 2020, the devastating Beirut Port explosions topped off the exceptional situation and hindered access to physical and mental healthcare services even further not only in Beirut and Mount Lebanon but across the country. In the blast area, three major hospitals had to close and three more had to reduce their capacity. In some facilities, COVID-19 preventive measures were not being adhered to. The medical supplies were depleted in all health facilities especially first aid and trauma kits. Healthcare facilities were faced with an increased demand that put them under pressure given their already compromised capacity in terms of human resources and healthcare workers leaving the country seeking better work opportunities.
Today, with the situation described above and the surge in the number of COVID-19 positive cases, the capacity of the Lebanese Health sector in general and the hospitals in particular to deal with the continuation of care and the COVID-19 healthcare needs became highly compromised. From December 25, 2020 to January 25, 2021, COVID-19 positive cases, registering an average of 3,679 cases per day. Up to January 27, 2021, there has been a record of 2,477 COVID-19 related deaths in the country, which has an estimated population of 5.6 million with a substantial refugee population including approximately 1.5 million Syrian refugees. At the level of hospital care, the multiple crises did not only affect the public facilities. The private hospitals have experienced a financial hardship as well and were challenged to offer needed general or COVID-19 care for the population.
Lebanon has secured around 6 million doses of COVID-19 vaccine, 2.1 million from Pfizer-BioNTech, more than 2.5 million through the COVAX platform, and two million from AstraZeneca. The vaccines will cover 3 million of the country's residents, both Lebanese and non-Lebanese according to the Ministry of Public Health. Dr. Hamad Hassan, the Minister of Health, affirmed that the country was about to sign a deal for vaccine supplies and that the first batch, out of three batches, would arrive during the first week of February. The vaccines will be distributed through 35 centers across the country. Healthcare workers, as well as people aged 75 and above (Phase.1 A) will be prioritized for the first batch. A registration platform meant to identify priorities was made available End of January, with the start of the vaccination campaign.
The World Bank allocated $34 million under the Lebanon Health Resilience Project to support vaccines to face the unprecedented surge in coronavirus cases. Although Lebanon has signed up to join COVAX, a global scheme backed by the WHO to provide vaccines to poorer countries, there are still mounting concerns that vulnerable populations in Lebanon might be left without vaccinations. Some refugees and undocumented migrants may refrain from accessing health services, fearing that their legal and/or medical status might put them at risk of detention or deportation. These vulnerable groups often face obstacles in accessing COVID-19 testing facilities and some of them are likely to end up excluded from the vaccination process. It is important to note that the exclusion of these groups jeopardizes the global effort to contain the outbreak.
With more than half of the Lebanese population and the majority of refugees trapped in poverty, it is essential for the Lebanese government to adopt a human rights-based approach when tackling the global and critical issue of access to vaccination. According to the United Nations Human Rights Office of the High Commissioner (OHCHR), COVID-19 vaccines should be treated as global public goods rather than products available only to those who can afford to pay the asking price, as access to health and development is a basic human right. The vaccines should be fairly distributed across the country in alignment with the Sustainable Development Goals (SDGs), which include reducing inequality within and among countries and require States to cooperate towards an enabling environment for human rights and development. COVID-19 vaccines should be accessible and affordable for all without discrimination. This is especially relevant in relation to vulnerable groups experiencing marginalization or exclusion such as refugees, persons with disabilities, older people, undocumented migrants, women and girls, stateless and others. The Lebanese government should ensure full accessibility to COVID-19 vaccines to all persons residing in Lebanon following a clear prioritization mechanism. In addition, private financial profit should not be prioritized over public health and the Lebanese government should adopt a strategy to protect the primacy of the right to health for all. Furthermore, there is a need for transparent and clear protocols and procedures in relation to the prioritization of the vaccine delivery. The decision should be based on appropriate criteria in line with human rights standards and norms and made public. Furthermore, the government needs to implement a clear communication plan with the general public and to explain about the vaccination plan and the prioritization mechanism and the importance of vaccinating all population cohorts in order to account for and prevent social tension. Finally, civil society must be included in the development of vaccine distribution processes in order to support public institutions and authorities in Lebanon in assuring a fair, transparent, inclusive and accountable implementation, hence rebuilding trust in the public system.
In this context, we urge the Lebanese government to adopt the following recommendations:
- Guarantee the inclusion of all people living in Lebanon, the fair and unbiased implementation of the vaccination strategy, and ensure that the government will follow the designated criteria without exceptions.
- Implement a clear communication plan with the public that explains the flow of the vaccination process and the prioritizing mechanism and that highlights the public health importance of vaccinating all the population groups on the basis of a non-discriminatory approach.
- Ensure that the distribution chain will take into account all the technical aspects needed for safely preserving the vaccines (temperature, storage, adequate transportation, etc.)
- Include civil society and community groups in the process of planning and implementing the vaccination and the communication campaign.
- Guarantee transparency and clarity in relation to prioritization protocols and procedures for vaccine delivery.
- Prioritize public health over profit among private healthcare providers and adopt a strategy to protect the primacy of the right to health for all. The government should set a margin for profit for companies who will be selling the vaccines and assure close monitoring by the MOPH of the companies as well as private laboratories and hospitals.
- Make health services, including COVID-19 testing and treatment, accessible and affordable for all regardless of citizenship status, legal status, or background.
- Create a protective environment through ensuring coordination between health and security services to enable asylum seekers, refugees, migrants, and stateless persons to access services without fear and risk of arrest or detention.
- Safeguard the vaccination process to ensure that it does not result in fueling xenophobia and racial discrimination.
 WHO (2020), Beirut blast: WHO warns dozens of health facilities 'non-functional’
 Lebanon started to experience a spike in COVID-19 positive cases in December 2020. The maximum number of cases reached up to date per day is 6154 positive cases (COVID-19 Daily Brief, WHO, January 14, 2021). The situation forced the national COVID-19 committee to lockdown the country for one month.
This statement was initiated by the Lebanon Policy Research Network on Displacement (LPRND). LPRND which was founded in September 2016, contributes to the vision, principles, and charter of the MENA Civil Society Network for Displacement (CSND). The Network works and advocates for refugee policies that are based on human rights, dignity, and respect. It aims to address the negative narrative associated with refugees and influence policy making in a way that promotes refugee dignity. Through a participatory approach, the Network seeks to amplify the voices of local actors and strengthen inclusive partnerships which encompass refugees and host communities, as well as diverse components of civil society. The Network functions in close coordination with UNHCR and other relevant stakeholders.
The AUB Issam Fares Institute for Public Policy and International Affairs serves as the secretariat of the Network which includes a diversity of members such as NGOs, universities, research institutes, foundations, media, and academia who work on displacement issues and can be further engaged in the protection, resilience, and integration of displaced persons and their host communities.
The statement is endorsed by:
The Lebanon Policy and Research Network on Displacement
ALEF - Act for Human Rights
Arab NGO Network for Development (ANND)
Issam Fares Institute for Public Policy and International Affairs, AUB
Lebanese Center for Human Rights (CLDH)
Ruwad alHoukouk FR
Skoun Lebanese Addictions Center
The Middle East Council of Churches
Download the statement, here.
Read the statement in Arabic, here.