“The governance of the COVID-19 response in Lebanon is dysfunctional,” said Dr. Fadi el-Jardali, a professor and internationally recognized expert on health policy and management.
For example, the parliamentary committee recommended closing businesses for the holidays and closing the airport after new variants appeared. But the ministerial committee refused, citing the country’s dire financial crisis, and carried out the disastrous holiday reopening that led to Lebanon’s worst fatalities.
“The communication is broken; some committees don’t talk to each other because of personal fights,” said Dr. Pascale Salameh, a professor of epidemiology at the Lebanese University and a member of the Independent Committee. “It makes you want to cry.”
“The communication is broken; some committees don’t talk to each other because of personal fights… It makes you want to cry.” —Dr. Pascale Salameh, Lebanese University professor of epidemiology
She has good reason. At the end of January 2020, a month before Lebanon registered its first case, the newly appointed government established a National Committee for COVID-19 to oversee national preparedness and pandemic response. The committee did not include a single epidemiologist, so Dr. Salameh volunteered.
In July 2020, Dr. Salameh proposed a project to collect and analyze demographic data on COVID-19 cases and deaths. She wanted to know who was getting sick and dying — their age, medical conditions, and what preventive measures they had followed. Such information is crucial to understanding how the virus is spreading, who is at most risk, and how to protect the population. The committee agreed, and appointed Dr. Salameh to lead the project.
And yet, despite the committee’s green light, the Ministry of Public Health refused to share any of the data that it collects from hospitals. During two months of back and forth, Ministry employees demanded volunteers and expert help, both of which she said she provided. But the Ministry never shared any of its data.
“They never said no, they never said they don’t want to share the data,” Dr. Salameh said. “But the treatment and excuses led me to believe so.”
When she resigned from the committee and tried to collect the data on her own, the Lebanese Order of Physicians and the World Health Organization told her that other teams were working on a clinical register, and she had no right to collect the same data. She put the project on hold.
“I don’t want to sit back, but I can’t do more than this,” said Dr. Salameh, with clear frustration in her voice. “They don’t let us work.”