As it deals with COVID-19, the aftermath of the devastating port explosion last summer, and an economic crisis, Lebanon’s health care system is on the brink of total collapse. Beds, medicine, and oxygen tanks are in short supply as coronavirus cases reached a record daily high this month. Unfortunately, urgent foreign assistance is unlikely without critical government reforms. A locally-brokered solution to the crisis is implausible as political elites squabble and sectarian divides harden. The United States, largest donor to the IMF and Lebanese army, is the nation’s last hope.
In October 2019, mass protests sought to upend the government and the foundations on which it was built. Though Lebanon’s leaders have failed its citizens in more ways than one, their corruption and incompetence have depleted the country’s resources. Food insecurity impacted 60 percent of the population by the end of 2020 and 30 percent of the population is currently unemployed. An acute banking crisis caused the Lebanese lira to lose 90 percent of its value and banks have imposed strict caps on dollar withdrawals, leaving many Lebanese penniless. The economic crisis has also led to shortages of personnel, medicine and supplies due to the dollar shortage. And despite a 170 percent debt-to-GDP ratio, no credible economic resuscitation plan is in sight.
Efforts to secure the coronavirus vaccine were initially thwarted by bureaucratic delays, though a recently-approved draft law in parliament should pave the way for deliveries. Lebanon’s politicians and their patrons, however, have yet to agree on the composition of a new government, a process that has been hamstrung for months by haggling over the cabinet’s size, responsibility for appointments, and controversy over “ownership” of the interior, energy and public works portfolios where “fresh” dollars will go once reconstruction is underway. The Biden administration’s approach to Iran will also likely influence next steps, as cabinet posts have been promised to individuals who could be targeted for sanctions.
While jockeying for posts continues, international assistance is being conditioned on the formation of a functional government able to handle its affairs, plus serious economic and political reforms that are not taking place. Negotiations with the IMF over a $10 billion loan program are also frozen, and not just because of the state’s inability to satisfy minimum loan requirements.
Meanwhile, no official has accepted responsibility for the port blast. Instead, the country’s politicians have united to block accountability efforts. Most shockingly, Lebanon’s health minister stated publicly that the deaths claimed by the explosion were “preordained.” The efforts of Judge Fadi Sawan, tasked with determining the explosion’s causes, led to the indictment of four politicians, including caretaker Prime Minister Hassan Diab, on charges of negligence. But Sawan was quickly discredited and accused of political targeting.
The coalition of angry citizens that rallied from October 2019 until quarantines began in April 2020 initially viewed the August explosion as a defining moment that could produce real change and finally overcome the culture of impunity dominating Lebanese politics. This sentiment was reinforced by the government’s inaction on reconstruction, primarily driven, instead, by civil society groups and solidarity networks. Since then, not only has no decision been made on debt restructuring to forestall the economic crisis, but central bank reserves are dwindling. When these are depleted, Lebanon will not be able to pay for food (Lebanon imports 85 percent of it), let alone health care, because the country will simply be broke.
The Lebanese will have lost all hope with the realization that the kleptocracy is here to say. As a harbinger of the unrest that is brewing among the destitute, protests in Tripoli have already shown the limits of the patience of a citizenry that has lost all confidence in its ruling class. The state of Lebanese health care highlights the chronic corruption afflicting a dysfunctional, mismanaged state that is unable to govern, let alone provide the most basic services to its citizens. The only fix for Lebanon would be the full-fledged reform of, not just its bloated bureaucracy and health care system, but the pervasive clientelism that is endemic to its political arrangement and the corruption it fuels.
Although Lebanon is unlikely a high priority for the Biden administration, only the US has the gravitas and resources to produce a plan that could help save Lebanon. And the Lebanese should solicit America for help based on shared democratic values. The continuing civil society engagement that spurred the revolution is pushing for a necessary overhaul to the entire political system. Without a reinvention of Lebanon—a new vision and strategy that allows for the emergence of a political alternative to the existing corrupt political class—the entire nation risks becoming a failed state.