Lebanon’s Deepening Crisis: The Case for a Sustainable Aid Response

Introduction

A severe economic and financial crisis is causing tremendous hardship for the people of Lebanon, a quarter of whom are refugees, forcing an unprecedented number of people to rely on humanitarian assistance. The World Bank (WB) has described the crisis as one of the most severe globally since the mid-nineteenth century. With the collapse of virtually all sectors of the economy, large segments of the population have lost their means of subsistence and access to essential services including food.

The situation requires a critical humanitarian intervention, with an understanding that a purely humanitarian intervention is unlikely to improve the long-term outcome. The crisis will almost certainly become protracted and will require complex interventions that respond to urgent needs while simultaneously building resilience and reducing vulnerabilities. Moreover, addressing the needs of refugees should not fall through the cracks of the worsening situation. If the overall situation is to be improved, a holistic approach that involves the needs and rights of both Lebanese and refugees is necessary.

Across the globe, humanitarian agencies have often found themselves trapped in short-term cycles of immediate assistance, which have done little to advance durable solutions. These cycles entrench dependence on foreign aid and international relief groups. It is possible to avoid such an outcome in Lebanon. A careful humanitarian response must respond to immediate needs but should also aim to preserve what remains of the Lebanese state’s capability to provide essential services and invest in local capacities.

Striking the right balance will be challenging. The country’s economic collapse has been years in the making, but the last 24 months have witnessed massive capital flight, foreign currency shortage, and the insolvency of the banking sector. The ripple effects have been devastating: a 90 percent devaluation of the Lebanese pound; more than 280 percent inflation since late 2019; a loss of savings as hundreds of thousands were cut off from their deposits; jobs and salary cuts; and depreciated incomes. These factors have deprived large segments of the population of their livelihoods.

The crisis dealt a heavy blow to most sectors. In the summer of 2021, there was a shortage of most basic goods and services including fuel, power, water, medication, and many essential food items. When they are available, few could afford them. Due to power outages, the country plunged into long hours of darkness daily. Residents waited in line for up to five hours to fill a rationed amount of fuel. Misgovernance, corruption, instability, and political divisions have all exacerbated the crisis.

In September 2021, a new government was formed, putting an end to a 13-month political impasse. However, the new team is poorly positioned to take the hard steps required to address the crisis. First, the new cabinet led by Prime Minister Najib Mikati will be short-lived as parliamentary elections are scheduled in March 2022. More importantly, Lebanon’s entrenched political system has proved very resistant to change.

At present, international and national aid organizations are striving to address the urgent needs of those disproportionally hit by the crisis. But humanitarian actors have neither the mandate nor the capacity to address root causes of the situation. Still, donors and international aid agencies should focus on durable solutions and make sure that their efforts address state capacities, are transparent, and empower local actors. Implementing these priorities will not be easy, but sticking with short-term goals is unlikely to address the economic crisis or to improve the worsening humanitarian situation.

A Deepening Crisis for Lebanon’s Disenfranchised

People from all walks of society have felt the reverberations of the economic crisis. But for hundreds of thousands of Lebanese—and most Syrian and Palestinian refugees who are already at a disadvantage—its impact has been life threatening. This includes loss of livelihoods, devastation of the health sector and public water delivery, and rising criminality and insecurity.

Marginalized Lebanese

Until 2019, Lebanon was considered a middle-income country, despite entrenched inequalities. Today, the country has sunk into destitution. Nearly three-quarters of the Lebanese population now live in poverty, 34 percent of whom lived in extreme poverty.

Many of those newly impoverished are having trouble putting food on the table. An estimated 77 percent of Lebanese households do not have enough food or enough money to buy food, according to a UNICEF report from June. Food insecurity has become so grave that the World Food Program (WFP) added Lebanon to a list of the world’s 20 worst hunger hotspots in need of urgent assistance.

Areas of the country already suffering from years of marginalization have been hit the hardest, exacerbating regional disparities and socio-economic inequalities. For example, Tripoli–the second largest city in the north of Lebanon—has long been one of the country’s poorest urban areas. Even before 2019, an estimated 53 percent of its inhabitants were unemployed and 77 percent were economically deprived. Likewise, rural areas of Akkar in the North and the Bekaa in the northeast, as well as some suburbs of Beirut, are home to some of the poorest segments of the population. Adults and children asking for money in the street, homeless people, and individuals looking in dumpsters for something to eat or to sell, have become all too common across the country.

The crisis has been particularly debilitating for Lebanon’s healthcare sector, which was already contending with shortages of medical supplies and personnel, and the impact of the COVID-19 pandemic. Since August 2020, the country has endured repeated surges in coronavirus infections. Preventive measures, including several lockdowns, failed to stop the spread of the virus and exacerbated the economic crisis. By November 2021, the total number of cases had reached more than 668,087, including 8,709 deaths.

In February 2021, Lebanon launched a COVID-19 vaccination campaign. However, due to a shortage of supplies and strained medical resources, the vaccine rollout has been slow. To date, 27 percent of the population have been fully or partially vaccinated—far below the national vaccination plan’s goal of 80 percent by the end of 2021. According to the plan, the Ministry of Public Health (MoPH) signed an agreement with COVAX facility—the global mechanism for equitable access to vaccines—to purchase 2.73 million doses of vaccines. However, based on a WB 2018-2019 classification as an upper middle-income country, Lebanon was not eligible to benefit from COVAX’s Advance Market Commitment (AMC), which aims to secure vaccines for up to 20 percent of populations in low- and middle-income countries. Therefore, and notwithstanding the country’s severe economic and financial crisis, Beirut will be self-financing the COVAX vaccines at a cost estimated at nearly $28.8 million. Given the country’s nearly unprecedented economic collapse, COVAX co-leads—the World Health Organization (WHO), the Global Alliance for Vaccines and Immunization (GAVI), and the Coalition for Epidemic Preparedness Innovations (CEPI)—should reconsider the country’s eligibility for the COVAX AMC. For its part, the MoPH should establish additional vaccination centers to ensure a more effective rollout.

The widespread shortages of fuel and power have increased pressure on the public and private health systems. A lack of U.S. dollars and restrictions on bank accounts are preventing hospitals, clinics, and pharmacies from purchasing vital medical supplies and equipment, 99 percent of which are imported. This has resulted in acute shortages of lifesaving drugs and other medicines. Hospitals have cut down on elective surgeries to save medical supplies for emergency procedures. The crisis has cut off access to healthcare for much of the general public. But for the most disadvantaged, the situation has become acute if not life-threatening. Studies show that people living in poverty have avoided spending money for preventive measures and have delayed seeking care until their condition became critical.

Similarly, the collapse of the economy has exacerbated an existing water crisis in the country. Fuel and power shortages pushed public water institutions to the brink, severely impeding access to safe water for millions of residents. Refugees and marginalized Lebanese are at greater risk given their lack of access to costly alternative sources of water. UNICEF warned that more than 4 million people might be forced to resort to unsafe water, which would compromise public health and hygiene, and could lead to an “increase in waterborne diseases, in addition to the surge in COVID-19 cases.”

Worryingly, the worsening crisis threatens to further destabilize the already volatile security situation. Violence over scarce commodities—sometimes turning into sectarian clashes—has been widespread with many reported skirmishes and shooting in front of gas stations and in supermarkets. One incident was particularly tragic when, in a town in the Akkar governorate, a gasoline tank—confiscated by the army and redistributed to residents—exploded, killing 28 people and injuring more than 80. Rising poverty and despair have turned unlit cities, once deemed safe, into ghost towns at night, as theft crimes have reportedly increased by 144 percent between 2020 and 2021.

Excluded Refugees

Lebanon is host to more than 1 million Syrians who fled the now decade-long war in their country. It is also home to an estimated 300,000 Palestinian refugees, the majority of whom have been living in 12 overcrowded and poverty-stricken camps for decades. Despite being host to one of the highest ratios of refugees per capita, Lebanon has rarely been sympathetic towards the forcibly displaced. Successive governments have repeatedly adopted discriminatory and restrictive policies toward refugees to prevent their definite resettlement in the country. More than 70 percent of Syrian refugees lack legal documentation, which undermines their safety, mobility, and ability to work. Similarly, Palestinian refugees continue to suffer decades of systemic discrimination and marginalization. They are still denied basic rights, including the right to own property and the right to work in nearly 40 professions. Lebanon’s economic crisis has limited refugees’ access to basic goods, leading to a rapid and unprecedented deterioration in their already dire living conditions. Most refugees, including children, are forced to skip meals, and many could not afford basic food items for survival.

Upon their arrival, most Syrian refugees have sought shelter in some of the poorest areas in the country, including Tripoli, Akkar, the Bekaa, and some of the poorer neighborhoods around the capital. The crisis has exacerbated poverty among refugees and their hosts. Resources and jobs have become increasingly scarce, worsening existing competition between these populations. Before the crisis, most refugees were primarily employed in the informal labor market in poor conditions and with no protection, and were often paid less than the minimum wage. Over the last two years, many have lost their jobs as hundreds of businesses closed or cut down on salaries and personnel, exacerbating poverty and hardship. According to the UN, nine out of ten Syrian refugees live in extreme poverty, and a staggering 99 percent of Syrian households struggle to put food on the table. Faced with funding shortages, UNHCR, the UN Refugee Agency, became overwhelmed with increasing needs. More than half the Agency’s financial requirements of $553.7 million for 2021 remained unfunded.

From the onset of the Syrian conflict and refugee influx, Lebanon has rejected the establishment of formal camps. While camps are not ideal, their lack thereof has further complicated the conditions of Syrian refugees. Today, 73 percent of refugees live in rented (often shared) housing units in inadequate conditions, while 20 percent live in fragile makeshift informal settlements. A small percentage live in non-residential structures like garages, farms, or shops. The modest rent refugees were accustomed to paying has become excessively exorbitant for most. For instance, a $100 monthly rent, previously equivalent to 150,000 L.L., is now nearly 2,500,000 million pounds. As a result, housing conditions for refugees have worsened as additional families are sharing housing units, while others have moved to informal settlements or are at risk of being expelled from their homes.

This has led most refugees to resort to negative coping strategies, including a sharp increase in child labor, child marriage, begging, and borrowing money. In addition, many refugees have minimized or stopped spending money on health-related expenses all together. Humanitarian organizations, including UNHCR, cover 75 percent of primary healthcare costs for Syrian refugees. However, the 25 percent of the remaining costs not covered by the UN has become an unbearable burden for most refugees, who now must choose between health and food. Lack of access to healthcare has also put refugees at a disadvantage in the face of COVID-19. Syrian refugees died from COVID-19 at a rate more than four times the national average. Yet, they have received only 3.5 percent of the total administered vaccines, despite accounting for nearly one quarter of the population. Notwithstanding Lebanon’s inclusive vaccination approach, limited mobility, the insufficient number of doses, identification requirements, and skepticism towards the vaccine are among the many barriers preventing higher vaccination rates among refugees.

Moreover, many families stopped sending their children to school, worsening an already bleak prospect for the education of Syrian children. Even before the economic crisis and the COVID-19 pandemic, more than 55 percent of Syrian children lacked adequate education, 30 percent of children (6-17 years) have never been to school, and nearly 33 percent attended afternoon classes in public Lebanese schools as Lebanon, with international support, tried to accommodate Syrian children in second shift classes. However, school attendance for Syrian children (6-14 years) dropped by 25 percent in 2021. Formal education opportunities for Syrian children in the already overstretched public sector will likely diminish as thousands of Lebanese families, unable to afford tuition and other fees of private schools, are increasingly transferring their children to public schools. Moreover, the Lebanese government has imposed a growing number of restrictions—requiring legal documentation to take official exams, or prohibiting humanitarian groups operating informal schools from teaching the official curriculum—on educational opportunities for Syrian children. The government of Lebanon (GoL) efforts to accommodate Syrian refugees in public schools should continue and should be supported by donors and international organizations. But to reach a wider number of Syrian children, the GoL should allow aid groups to teach the official curriculum in informal education settings.

Similarly, the economic crisis has taken a great toll on Palestinians refugees, pushing them deeper into destitution. Like Syrians, many were employed in the informal sector or worked in agriculture, construction, and other few low-skilled jobs they are legally allowed to hold. Palestinian refugees were hit hard by waves of lay-offs and salary cuts, undermining their already modest livelihoods. In addition, the crisis significantly reduced commercial activities in the camps. Loss of limited purchasing power, skyrocketing prices, and scarcity of commodities led many small businesses to close. As COVID-19 cases surged, death among Palestinian refugees—who face challenges similar to those of Syrian refugees—was three times higher than the national average. Vaccination rates among Palestinians remained low. While accounting for nearly 7 percent of the population, Palestinians have received only 2.5 percent of total administered vaccines.

The United Nations Refugees and Work Agency (UNRWA) is responsible for providing vital health, education, and other relief and social services to nearly 5.7 Palestinian refugees in Lebanon, Syria, Jordan, and the occupied Palestinian territory. It also provides cash assistance to the most destitute among them. Socio-economic needs multiplied not only in Lebanon, but also in Syria and Gaza as a result of protracted conflicts. Yet, the Agency has been struggling with increasing budgetary difficulties for years. Earlier this year, the Biden administration reversed its predecessor’s political decision to cut all Palestinian funding since 2018. But soon after, the United Kingdom (UK)—the third largest donor to UNRWA in 2020—cut its core funding to the Agency by more than 50 percent. Gulf countries too have gradually reduced their contributions, which have decreased from $200 million in 2018 to only $20 million in 2021.

Currently, UNWRA suffers from a budget shortage of more than $100 million. In addition, the failure of donors to pledge multi-year commitments has left the UN organization to operate on short-term, unpredictable, and unreliable funding.

A Careful State Engagement

Given the misgovernance and pervasive corruption, donor countries and international financial institutions have made future assistance packages to support Lebanon’s economic and financial recovery contingent on genuine and structural reforms. Meanwhile, to assist humanitarian efforts, they have bypassed the state, directing their funding to UN agencies. However, efforts to thwart elite corruption should not further weaken state capacity.

Politics in Lebanon show no sign of improvement, and the downward spiral is likely to continue. None of the traditional political groups have demonstrated a good faith commitment to changing the system. Mismanagement, corruption and the lack of transparency and accountability all hinder effective aid delivery. Aid delivery through the government is fraught with many challenges including the risk of aid becoming a conduit for political patronage and corruption. The deep distrust toward the state among Lebanese nationals, refugees, and international actors comes as no surprise. However, circumventing the state, if prolonged, can prove harmful. Such a strategy can weaken capability and competence where they exist inside state bureaucracies. It also risks entrenching dependence on foreign aid.

Haiti offers a cautionary tale of the long-term consequences of bypassing state institutions. The absence of a strong central government opened the space for international aid organizations and national charities to fill the void, which has further undermined the state and led to an “NGOization” of services, leading to a so-called “republic of NGOs.” Worldwide, CSOs are an important pillar of most humanitarian responses. However, their role should not become a substitute to state institutions.

Lebanon’s history with refugees, too, exposes some of the negative impacts of this approach. Funneling aid through UN agencies and international organizations has fueled the fragmentation of public services in the country, and prevented buy-in from officials, some of whom attempted to obstruct international efforts.

Future international assistance efforts aimed at alleviating humanitarian and socio-economic hardship in the country should aspire to both circumvent elite corruption and avoid hollowing out what remains of the state capacity. The latter will play an essential role in any successful reform effort and should be preserved. Lebanon has a pool of capable civil servants, who can be incorporated into a transparent humanitarian and early recovery response. Providing them with incentives, investing in their skills, and establishing innovative monitoring and evaluation mechanisms will be key to success.

A few examples help highlight some hard-won gains within Lebanese institutions. For instance, in the aftermath of the Lebanese war (1975-1990), the Ministry of Public Health established a primary health care network (PHCN) which had reaped some beneficial outcomes, despite a highly fragmented and privatized healthcare system. The ministry worked to strengthen the capacity of health centers that joined the PHCN by providing trainings, access to a health information system, and access to subsidies and supplies. In return, health facilities committed to deliver healthcare services at discounted rates, adhere to national health regulations and standards, and submit regular reports to the MoPH. By 2018, the Network had more than 235 centers across Lebanon, serving over 1 million beneficiaries annually, including poor Lebanese and refugees. Supported by local and international actors, this initiative created a “space for public health as a public good,” which allowed the delivery of health services beyond the country’s historical sectarian, geographic, or political divides. In addition, the Beirut public hospital affiliated with the MoPH played a central role in Lebanon’s coronavirus response.

The education public sector suffers from many shortfalls, including a shortage of qualified teachers, poor infrastructure, and a historic funding deficit. Yet, in 2012-2013, the Ministry of Education and Higher Education (MEHE) agreed to open public schools to Syrians. As the number of Syrian children increased, the MEHE, with the support of international donors and UNHCR, opened second shift classes in state-run schools to accommodate greater numbers of refugees. Given the overall weak public education sector, the second shift model came with its own set of problems and suffered from unreliable and short-term funding. Still, despite its shortcomings, the program has significantly expanded Syrian refugees’ access to education.

A new government one-year cash transfer program (CTP) could serve as a good opportunity to implement a new approach. The program, known in Lebanon as the “ration card,” aims to provide between $93 and $126 a month to mitigate the crisis for nearly half a million Lebanese households. One-third of nearly $1.4 billion received from the International Monetary Fund (IMF) in Special Drawing Rights (SDR)—a supplementary international reserve asset—will be allocated to finance the program.

However, many uncertainties and delays surround its implementation. For example, questions remain around household eligibility requirements and the sustainability of the funding for the program. Most importantly, fears remain that the CTP is vulnerable to elite corruption and patronage. Not long ago, a WB loan to help families living in poverty was stalled for months as the Lebanese government sought to benefit from the loan to beef up its reserves.

Cooperation between state institutions and civil society organizations (CSO) could serve as a model to ensure a transparent and efficient process. Therefore, the government should allow for NGOs and municipalities to participate in the selection of beneficiaries and to monitor the program’s implementation. It should offer recipients the possibility to report their grievances and submit complaints online and in-person. Likewise, offering the public and CSOs access to non-sensitive information related to the program and the possibility to monitor its physical and financial progress through an online platform could minimize concerns related to corruption and favoritism.

Going Local

Working with the Lebanese state will remain challenging. Even if the political will existed, it would take years to undertake the needed reform of public institutions. Thus, it is necessary to work to strengthen the capacity of local actors to meet humanitarian needs and build community resilience through small but important initiatives.

Establishing Local Partnerships

The Lebanese state has long failed to provide adequate essential services to much of the population. Over the years, a wide array of national and local actors has stepped in to fill the gap. In recent years, some municipalities and NGOs have been at the forefront of efforts to respond to the needs of refugees and their host communities. These actors have tried to mitigate the impact of the country’s consecutive crises through the distribution of food, clothing, cash, medicine, and other necessities. They also have played a leading role in the aftermath of the August 4, 2020 Beirut Port blast.

Yet, donors have often ignored the importance of Lebanon’s vibrant civil society. UN agencies remain by far the primary recipients of Western funding. In 2019, more than 75 percent of funds were directly allocated to UN agencies, while the share for Lebanese NGOs was as low as 4 percent. Although UN agencies often partner with local groups who are the main implementing partners, these groups are rarely included in the conceptualization and planning of the responses to these crises, and they are often sidelined from decision-making.

This must change. NGOs and local governments are often best positioned to understand the needs of Lebanon’s most marginalized communities. They are also important partners in addressing social and geographic inequalities. And, unlike international aid organizations, they are part of the community. Local actors should be partners in selecting beneficiaries of the CTP and other aid programs. They can communicate directly with recipients and relay their grievances to the central government and international actors. They can also serve as watchdogs, monitoring these programs to ensure a fair and transparent process. The United States Agency for International Development (USAID) should live up to its pledge to increase its direct funding to local partners over the next four years, to reach at least a quarter of all funds, and to include these partners in the design, implementation, and decision-making of its programs. Likewise, other donors should commit to increase direct funding and inclusiveness of local actors.

For their part, local NGOs can take steps to improve their performance. The growth of civil society organizations has led to competition over resources. Some have been coopted by political elites and then leveraged the provision of relief aid to bolster patronage networks. The often disorganized and competitive NGO scene has created a certain level of distrust among local communities. NGOs should establish coalitions that will help improve coordination and information sharing among them. Working in consortiums like the Lebanon Humanitarian INGO Forum (LHIF)—a forum that brings together 60 international organizations—helps bolster the capacity of the Lebanese aid community to influence decision-making, and to serve as watchdogs of state institutions, UN agencies, and other stakeholders in the humanitarian field. Finally, NGO efforts to work together will help to identify and separate active, transparent, and trusted organizations from ones seeking to take advantage of the crisis.

Local governments like municipalities should have a prominent role in coordinating and monitoring the delivery of assistance. Close partnerships between NGOs and municipalities will help regulate the provision of services, reduce fragmentation, and consolidate humanitarian efforts. Yet, local governance bodies, particularly in marginalized areas, have often suffered from inadequate funding and limited resources, including technical capacity. Thus, donors and international aid agencies should bolster their existing cooperation with municipalities. They should increase the funding to these bodies, support the capacity building of their staff, and provide trainings on monitoring, transparency, and accountability mechanisms.

To complement these efforts, international donors and aid agencies should multiply efforts to strengthen resilience and local autonomy in the face of economic collapse.

Supporting Local Initiatives

Despite its devastating impact, the economic crisis might have at least one silver lining—a new space for local production. Lebanon has emerged from the 15-year war (1975-1990) heavily dependent on imports, which make up nearly 80 percent of all goods and commodities available on the market. However, the Lebanese pound devaluation has rendered imported goods prohibitively expensive for large segments of the population. Local production is increasing in some sectors including clothing, furniture, agriculture, and local food like jam, olive oil, traditional thyme, small industries, and some services.

Local production faces major challenges, not least of which are prolonged power cuts, expensive fuel, and continued reliance on costly imported inputs. Still, international and national actors should build on this trend and support these new local production initiatives. Some of these sectors—like agriculture, despite the country’s vast arable land—remain underutilized. Investing in them will not only help create jobs, but in the case of food and agriculture, will help reduce vulnerabilities and humanitarian needs like rising food insecurity.

International aid institutions and donors should provide incentives to landowners and employers to encourage them to recruit among marginalized Lebanese communities and refugees. For example, in addition to financial grants, donors and aid agencies could offer technical support, capacity building of staff, and trainings in marketing and selling strategies, among others. They also should establish partnerships with them to buy their products. Such strategies at the local level might take more time, resources, and efforts, but will help longer-term resilience.

Conclusion and Recommendations

The economic collapse and the ongoing apathy of Lebanon’s successive governments have rendered humanitarian aid a lifeline for millions of people in the country, Lebanese and refugees alike. Protecting the population’s poorest segments from the dire consequences of the crisis should remain an overarching goal. Yet, humanitarian assistance, however crucial, should be a short-term approach. First, protracted humanitarian intervention is not sustainable. Donor fatigue will gradually creep in as the crisis lingers. Furthermore, it risks entrenching dependency on aid. International and national actors should focus on addressing the immediate consequences of the crisis while also building some pillars that could contribute to a potential long-term change.

Alleviating Refugee Hardship

Only a holistic approach that involves both citizens and refugees will help improve a situation in Lebanon. Thus:

• The government of Lebanon (GoL) should lift restrictions, including the requirement of legal documentation to take official exams, that hamper Syrian children’s access to education. It should increase the number of schools that offer second shift classes to accommodate a greater number of refugees.
• The GoL should refrain from obstructing aid groups’ efforts to provide education in informal settings to refugees. It should allow these groups to teach the official curriculum in informal schools. Aid organizations should boost their efforts to provide non-formal education to the more than 50 percent of Syrian children not enrolled in schools.
• Donor countries should significantly increase UNHCR funding to meet the nearly $550 million required in 2021. They should prioritize the medical and education sectors, which suffer from significant funding gaps. They also should commit to predictable, multi-year funding to ensure continuity of aid and long-term programming.
• The UK should reverse its decision to cut more than half of the core funding it provided to UNRWA in 2020.
• Gulf countries should significantly increase their contribution to UNRWA to match the $200 million contribution they made in 2018.
• The United States, European, and Gulf countries should commit to multi-year funding to UNRWA to help the Agency secure the $800 million core budget needed annually.

An Inclusive COVID-19 Response

A comprehensive response to the COVID-19 pandemic should ensure that refugees and marginalized Lebanese alike receive informed and equitable access to vaccines. Thus:

• The GoL, with the support of the World Bank and donors, should significantly increase the purchase of vaccines to reach the 80 percent stated in its national vaccination plan. It should also establish additional vaccination centers to ensure a more effective and quicker rollout.
• Due to the country’s severe economic crisis, COVAX co-leads should re-evaluate Lebanon’s eligibility to receive doses to vaccinate 20 percent of its population through COVAX’s Advance Market Commitment (AMC).
• The Ministry of Public Health (MoPH) should partner with local NGOs to establish vaccination centers in remote areas and in areas with high concentrations of refugees to allow for greater access to vaccines, including among refugees.
• Municipalities, local and international aid organizations, and public health centers should conduct awareness campaigns about the prevention of COVID-19 and the vaccine to address concerns and misinformation.

Improvement of Governance and Accountability

While corruption and misgovernance remain a great concern, a total bypass of the GoL would be harmful. Instead, there is a need for careful international engagement of the GoL that enhances its capacity while it circumvents negative trends within it. Thus:

• Donors and aid agencies should continue to partner with governmental bodies involved in alleviating suffering, including the MoPH, the ministry of education, and municipalities. They should dedicate specialized staff to closely monitor the implementation and financial progress of programs. They should encourage the participation of qualified and vetted civil servants in these partnerships, and provide training to improve staff management, planning, financial, budgeting, and technological skills.
• The GoL should prioritize principles of transparency, accountability, and inclusiveness in the implementation of its humanitarian programs, including the Cash Transfer Program (CTP). It should allow NGOs and municipalities to participate in the selection of beneficiaries, and to provide oversight of the implementation of programs. It also should establish a mechanism that allows recipients of aid to report grievances and submit complaints online and in-person to the government, municipalities, or NGOs. The GoL should create an online platform that publishes non-sensitive information related to aid programs like the CPT, including its implementation and financial progress.
• Donors and international aid agencies should work closely with municipalities to improve the provision of services, monitoring mechanisms, transparency, and accountability. They should increase funding to municipalities and support building staff capacities.
• Municipalities should establish partnerships with local NGOs and coalitions to regulate and coordinate the provision of services and humanitarian assistance. Both parties should regularly share information and updates related to needs and the implementation and funding of aid programs.

Pillars for Durable Solutions

While state capacity is important, Lebanon will only move forward in partnership with a vibrant civil society sector, to include CSOs as well as the private sector. Thus:

• The United States should gradually increase direct funding to Lebanese NGOs to reach 25 percent of its total funding over the next four years, in line with the U.S. Agency for International Development 2021 worldwide commitment. It should take steps to strengthen the role of local partners in the design, implementation, and decision-making of its programs, including providing training to improve management, accounting, and legal skills among local partners.
• Lebanese NGOs should establish coalitions to improve coordination and information sharing, bolster their capacity to influence decision-making, and enhance their ability to monitor state-led and international programs.
• Donors and aid agencies should establish partnerships with small entrepreneurs and landowners and encourage them to recruit people hit hardest by the crisis, including Lebanese and refugees, in return for incentives. These incentives should include technical support, capacity building, trainings, and small loans.
• Through these partnerships, aid organizations should buy locally produced food, agricultural produces, and clothing, and include them in aid packages to beneficiaries.

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PHOTO CAPTION: People light candles during power cuts due to the fuel shortage and problems in the supply of fuel in Beirut, Lebanon on July 25, 2021. (Photo by Houssam Shbaro/Anadolu Agency via Getty Images)