Tunisia’s financial crisis leaves the sick struggling to find medicine

A view shows boxes of medicine at retired soldier Nabil Boukhili’s unofficial medicine exchange room at the roof of his house, in Tunis on May 29, 2023. (Reuters)
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Updated 01 June 2023
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Tunisia’s financial crisis leaves the sick struggling to find medicine

  • Hundreds of medicines have been missing for months, pharmacies say, including important treatments for heart disease, cancer and diabetes
  • "The issue of missing medicine has become very hard for patients," said Douha Maaoui Faourati, a Tunis doctor

TUNIS: Sick Tunisians face a frantic struggle to find some medicines because the cash-strapped state has reduced imports, leaving doctors unable to control debilitating health problems and patients turning to informal markets for their medication.
Hundreds of medicines have been missing for months, pharmacies say, including important treatments for heart disease, cancer and diabetes as well as more basic products such as medicated eye drops whose absence worsens chronic conditions.
“The issue of missing medicine has become very hard for patients. We have a real problem with some medicines for which there are no generics available,” said Douha Maaoui Faourati, a Tunis doctor specializing in kidney and blood pressure disease.
Faourati has had to ask patients to try to get drugs from Europe, including ones used to control dangerously irregular heartbeat, swelling and clotting, and for which she says no good alternative is available in Tunisia.
Her difficulties show how Tunisia’s worsening fiscal problems are hitting ordinary people and adding to public anger at a state barely able to maintain even basic services.
Since last year Tunisia has struggled to pay for other goods that are sold at subsidised rates, causing periodic shortages of bread, dairy products and cooking oil as foreign currency reserves dropped from 130 days of imports to 93 days.
Tunisia wants a $1.9 billion International Monetary Fund bailout, without which ratings agencies have warned it may default on sovereign debt, but President Kais Saied has rejected key terms of the deal and donors say talks have stalled.
Tunisia imports all medicine through the state-owned Central Pharmacy, which provides drugs to hospitals and pharmacies around the country which offer them to patients at a subsidised rate.
The head of Tunisia’s Syndicate of Pharmacies, Naoufel Amira, said hundreds of medicines are no longer available, including for diabetes, anaesthesia and cancer treatment.
Amira and two officials at the Central Pharmacy who spoke anonymously because they were not authorized to talk to media, said the body owed large sums to foreign suppliers, which had restricted their sales to Tunisia in response.
“The problem is primarily financial,” Amira said.
Amira said the Central Pharmacy owed about 1 billion dinars ($325 million) to suppliers. The officials there said it owed about 800 million dinars, adding that public insurance companies and hospitals were delaying paying their bills by up to a year.
Tunisia’s Health Ministry and Central Pharmacy did not respond to requests for comment.

MEDICINE EXCHANGE
From the roof of his Tunis house, retired soldier Nabil Boukhili has opened an unofficial medicine exchange for his neighborhood in coordination with local doctors. “We have dozens of people coming here daily to get medication,” he said.
He sources medicine from people traveling overseas as well as leftover pills from people who have finished their own treatment, dispensing it free of charge to people who can show a prescription.
While Reuters was interviewing Boukhili, a woman arrived needing medicine for a thyroid problem. “I’ve been without this medicine for over a week,” said Najia Guadri, adding that she felt unable to function without it.
Sitting at his parents’ home in Tunis, Abdessalem Maraouni described how a lack of medicated eye drops has left him at risk of blindness and unable to go outside, forcing him to abandon his law studies at the university.
“This country can no longer provide even a box of medicine,” he lamented, sitting in the modest family home decorated with posters of his favorite football club but unable to see objects more than a few meters away.
The 25 year-old has not been able to find the medicine, or an alternative, for six months and has had to seek supplies from people traveling abroad, paying far more than he would from Tunisian pharmacies and rationing his use.
Maraouni’s father Kamal wept as he described how the state’s inability to import medicines had hit his son’s prospects.
“We don’t ask the state for money or grand places to live. We only ask for medicine. Is that too much?” he said.


’One war too many’: Lebanese angry with Hezbollah for attacking Israel

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’One war too many’: Lebanese angry with Hezbollah for attacking Israel

  • “Hezbollah must surrender its weapons to the state, period,” Randa Harb told AFP
  • “Hezbollah makes decisions without concerning itself with the country or even its support base, it is waging pointless battles,” a store owner said

BEIRUT: When an air strike hit their Beirut neighborhood, people were angry with Israel, but they reserved their deepest rage for Hezbollah, for dragging Lebanon into the Middle East war.
Israel and the United States launched huge strikes on Iran on February 28, killing its supreme leader and sparking a massive retaliatory campaign.
Iran-backed Hezbollah, already weakened by war, attacked Israel in support of its sponsors, pulling Lebanon into a new cycle of strikes, death and mass displacement.
“Hezbollah must surrender its weapons to the state, period,” Randa Harb, an elderly woman who runs a fruit and vegetable stall in the neighborhood of Aisha Bakkar, told AFP.
The densely populated area was struck on Wednesday morning, wounding four people according to the health ministry, and sparking shock across the capital.
Another woman, who refused to give her name, told AFP a relative was wounded, and she accused Hezbollah of forcing “one war too many” on the Lebanese.

- ‘Killing each other’ -

Lebanon was torn apart by a civil war that ended in 1990, with only Hezbollah refusing to hand over its weapons to the state when peace returned.
For decades, it was believed to have an arsenal more powerful than the military’s, and it fought multiple wars with Israel that each took a devastating toll.
The most recent hostilities should have ended in a ceasefire in 2024, but that too proved fragile, with Israel keeping up its strikes even as the Lebanese military sought to disarm Hezbollah under the terms of the truce.
Inspecting the damage in her cousin’s apartment, 46-year-old Amal Hisham screamed: “I do not care about Hezbollah!“
The windows were shattered, and the gold-colored sofas left in tatters.
Hisham was also enraged with Israel, saying she couldn’t just blame one side. “They are all just killing each other,” she said.
“Do you think they are happy about their areas being destroyed? They’re not happy. Their families have been displaced,” she said, referring to Hezbollah members and their wider support base.
“Who will compensate these people?“

- ‘Pointless battles’ -

As soon as the injured had been evacuated, residents began to wonder who the target had been.
A shop owner, also requesting anonymity, believed Hezbollah operatives were hiding there, while others imagined it was Hamas, the group’s Palestinian ally.
“No matter,” said Mohammed Ahmed, 42. “The presence of Hezbollah or Hamas poses a great danger to us.”
“If one wants to be martyred, let him stay where he is... let him be martyred alone, why come to people who are already tired?“
Lebanon is deeply divided along sectarian lines, with Hezbollah rooted in the Shia Muslim community, that was long sidelined by authorities.
Aisha Bakkar is one of several Beirut neighborhoods that are majority Sunni Muslim, while Lebanon is also home to Christians, Druze and others.

- ‘They shot my son’ -

Aziza, who sheltered families fleeing the 2024 war, worries about the massive influx of displaced people from Beirut’s southern suburbs, where Hezbollah holds sway, and which have come under Israeli bombardment.
“We came to welcome them... they shot my son in the leg” after he complained that they had raised Hezbollah’s flag, she said.
In majority-Christian Mar Mikhael on the other side of Beirut, a 68-year-old grocery store owner also deplored the group’s decision to enter the war.
“Hezbollah makes decisions without concerning itself with the country or even its support base, it is waging pointless battles... what good will it do? You fire a missile, they fire a hundred back at you,” he said.
Hezbollah was at the height of its popularity following the 2006 war with Israel, which it claimed to have won.
That changed.
“We never hated the Sayyed,” said Ghada, a municipal worker, referring to late Hezbollah leader Hassan Nasrallah who was killed by Israel in 2024.
“He is the one who stopped Israel,” she said.
Bolstering the belief that Hezbollah was operating solely as an Iranian proxy, the Iranian Revolutionary Guard Corps announced that Hezbollah had “officially entered the war” around three hours before the Lebanese group had issued its own statement.
Some Lebanese Shia have also grown impatient.
“No one wanted this war,” Lina Hamdan, a Shia lawyer, told AFP, adding that her community “are the first victims.”
A longtime critic, she believes this war may be a “turning point” for Hezbollah, whose military activities were outlawed by the government last week.
While many displaced stranded in the capital refrained from criticizing Hezbollah, some voiced frustration.
“What was the point of this war? Nothing about this makes sense,” said Hiam, a 53-year-old mother sheltering in a school.
Hezbollah runs schools and hospitals, and long provided Shia Lebanese with assistance.
“This time, we are left to fend for ourselves,” Hiam added.