Lebanese authorities are intensifying a judicial investigation into a major scandal involving the smuggling of counterfeit medications, including drugs intended for cancer patients, through Beirut’s Rafik Hariri International Airport. Officials say the illicit operation sought to generate millions of dollars in profit. So far, five suspects have been arrested, all linked to a wider smuggling network involving security personnel and individuals with political connections.

While Lebanon has seen previous probes into drug smuggling, this case is the first to reveal disturbing details of a criminal network that traded in patients’ lives, distributing fake medications amid one of the country’s worst economic crises. 

The ordeal of Fadia Makawi, a woman in her early 30s battling breast cancer, illustrates the human cost of the scandal. She recounted how she obtained a critical cancer drug from Turkey through a private contact, since it was unavailable locally.

“I rushed to the hospital, relieved to receive treatment on schedule,” Makawi told Al-Modon. But moments after the medication was prepared for injection, it turned into bubbles and then a solid white lump.

“The doctor shouted, ‘This drug is fake.’”

She said she was warned the injection could have been fatal and left without treatment that day. Makawi paid $900 for the medication—a sum raised by friends—but described the experience as “brutal,” especially amid a nationwide shortage of cancer drugs. She has since left Lebanon and is now undergoing treatment in Qatar, where she receives timely and effective care.

Makawi’s story is one of many, as the drug smuggling crisis peaked between 2022 and 2023, leading to widespread suffering for cancer patients. Hundreds have died due to drug shortages, while others’ conditions worsened after using counterfeit drugs.

Hani Nassar, head of the Barbara Nassar Association, which supports cancer patients, described the situation as a “human massacre.”

“Patients were forced to turn to ‘suitcase traders’ to obtain drugs after the Ministry of Health ran out of supplies,” he told Al-Modon. “They paid thousands for medications that were ineffective or harmful.”

Nassar said the network had expanded openly, with dozens sourcing unlicensed medications from abroad and selling them in Lebanon without any quality control or medical testing. The smugglers even offered their services to pharmacies nationwide, flooding the market with unverified drugs that worsened patients’ health.

Dr. Jean Cheikh, a hematologist specializing in blood cancers, stressed the dangers of the counterfeit drugs.

“These drugs can cause harmful side effects and even death,” he told Al-Modon. “None of the smuggled drugs were tested or approved by the Ministry of Health, meaning they could accelerate illness or cause fatal complications.”

He recalled cases where desperate families spent all their savings on fake medications.

“One father, a taxi driver, sold his car to buy drugs for his son, only to discover the medication was counterfeit.”

According to Dr. Cheikh, the Ministry of Health was largely absent during this crisis, overwhelmed by other challenges and unable to enforce regulation. Patients resorted to alternative means, relying on smugglers who brought drugs in their luggage. The American University of Beirut Medical Center refused to administer unlicensed medications to protect patients.

“The state has a responsibility to provide treatment,” Dr. Cheikh said. “It’s shameful that patients had to beg in the media to fund their care.”

Despite these hardships, Dr. Cheikh noted an encouraging trend: cancer survival rates in Lebanon have improved to over 80%, largely due to access to advanced immunotherapy treatments.

“Cancer is no longer a death sentence when diagnosed early and treated properly,” he said.