In Lebanon the executive power is vested in a Council of Ministers, of which the Ministry of Public Health is the ultimate authority on matters related to responses to public health crises. The law provides that where such crises are so severe that the capabilities of the Ministry of Public Health are insufficient, that Ministry may seek assistance by proposing the issuance of a presidential decree that defines the assistance needed, the entities involved, and the measures to be taken by each. The Ministry has taken several measures to address the Ebola threat, and thus far has not seen a need to request a presidential decree.
I. Government Structure
Lebanon is a republic that has a centralized parliamentary form of government, with the executive power vested in a Council of Ministers. The Ministry of Public Health is the ultimate authority in charge of all public health matters, including responses to public health crises. The main mission of the Ministry is to protect and improve the status of public health. The Ministry defines its mission as follows:
To Improve the health status of the population by ensuring an equitable accessibility to high quality health services through a fairly financed universal coverage. And by addressing economic and social determinants of health through trans-sectoral policies.
II. Public Health Crises
Public health crises are generally associated with threats to the health of the population of a geographic area or areas caused by the spread of communicable diseases. Lebanon has enacted a special law, the Law of Communicable Diseases, to deal with these situations when they arise. This law assigns certain duties and responsibilities relating to individual cases of communicable diseases and provides a general framework for the response needed to deal with any outbreak of such diseases that might endanger public health.
Article 3 of the law provides for combatting communicable diseases by one or more of the following means: reporting or informing about the disease, quarantining or isolating those infected, isolating those who came in contact with those affected and providing them with preventive treatment, disinfection, investigating the source of the disease, making environmental adjustments, and providing general health education.
Treating physicians are required by the law to convey information on cases of listed communicable diseases to the authority designated by an order of the Minister of Public Health.
Family heads, guardians, the Mukhtar (an elected local official), and managers of industrial or commercial enterprises (such as a plant, hotel, etc.) and of any public or private organization involved in health or social matters are required to call a physician whenever they suspect they have someone who might be affected by a communicable disease, report the incident, facilitate the reporting of it by the physician, and not hide the incident.
The law gives the Minister of Public Health the power pursuant to a recommendation by the Director General of the Ministry to modify the list of the diseases considered contagious or communicable and for which those affected shall be quarantined.
The law empowers the Ministry at any time to enter and search any place that might be suspected of harboring a case of communicable disease.
All the other means mentioned in article three shall be implemented in accordance with orders of the Minister of Public Health issued separately for each contagious disease.
The measures listed in article three employed in accordance with such orders can be used by the Ministry of Public Health to respond to public health crises. But there are instances where that Ministry might also need outside assistance to deal with a crisis when the spread or the threat of spreading of a contagious disease among the population is overwhelming. To address such instances, the law establishes a general framework for the Ministry to seek needed assistance by proposing a plan to be adopted by a presidential decree. The law specifically provides the following:
Such a decree shall designate the role of each authority and body which have been appointed to deal with the crisis, along with the manner by which they are to be established, the limitations on their authority, and the time accorded to them to carry out their duties. The funding cost of such plans shall be borne by the central government paying three-fourths of the cost and the municipalities paying the remaining one-fourth.
If an epidemic disease threatened all or a part of the territories of the Republic or started to spread within such territories without the local measures being sufficient [to deal with it] the Ministry of Health shall ask for a presidential decree to be issued which shall designate the measures that shall be taken to prevent the spread of the epidemic.
It is clear from the foregoing that while the legislature in Lebanon has provided a legal framework to create plans to respond to public health crises, the actual creation of such plans and their attendant details is left to the executive branch of government, to be decided on a crisis-by-crisis basis.
III. The Ebola Threat
Lebanon recognizes the threat caused by the Ebola outbreak in certain foreign countries. The Ministry of Public Health has taken a number of measures to prevent the disease from entering the country, and apparently feels capable to deal with the situation without devising a special plan requiring the issuance of a presidential decree. Among the measures taken by the Ministry of Public Health in this regard are the following:
- Dissiminating information about the history, symptoms, and how to avoid contracting the disease. The sources of most of this information are the World Health Organization (WHO) and the United States Centers for Disease Control and Prevention (CDC).
- Requiring hospitals in Lebanon to create special units equipped to deal with Ebola cases.
- Requiring all passengers entering the country to fill specially designed cards that allow the Ministry to monitor individual situations and take necessary measures when such measures are warranted.
- Requiring the Airport Authority to advise airlines on how to deal with suspected cases of Ebola on planes.
The Ministry has also decided to assist Lebanese citizens living abroad who might have contracted the Ebola virus or any other communicable disease by providing them with hospitalization and lab exams if they decide to repatriate, on the condition that they inform the Lebanese Embassy in the relevant country in advance.
Prepared by Issam Saliba
Senior Foreign Law Specialist
 Presidential Decree 8377 of 1961, art 2, http://www.moph.gov.lb/Rules%20and%20Regulations/Marsoum8377-1961.pdf (in Arabic).
 Ministry of Public Health, http://www.moph.gov.lb/AboutUs/pages/missionandvision.aspx (last visited Nov. 5, 2014).
 Law of Communicable Diseases, Dec. 31, 1957, http://ar.jurispedia.org/index.php/%D9%82%D8%A7%D9 %86%D9%88%D9%86_%D8%A7%D9%84%D8%A3%D9%85%D8%B1%D8%A7%D8%B6_%D8%A7%D9%84%D9%85%D8%B9%D8%AF%D
9%8A%D8%A9_(lb) (in Arabic).
 Id. art. 3.
 Id. art. 4.
 Id. art. 5.
 Id. art. 11.
 Id. art. 12.
 Id. arts. 6, 7, 8.
 Id. art. 9.
 This information is posted on the Ministry website and can be accessed individually, at http://www.moph.gov.lb/ Prevention/Pages/EbolaOutbreak.aspx (last visited Nov. 5, 2014).
 Letter of the Minister of Public Health No. 33150/1/14 (Oct. 23, 2014), http://www.moph.gov.lb/Prevention/ Documents/2014-1-33150.pdf; Letter of the General Director of the Ministry of Public Health No. 31703/1/14 (Oct. 13, 2014), http://www.moph.gov.lb/Prevention/Documents/Letter14-1-31703.pdf.
 Letter of the Minister of Public Health No. 33153/1/14 (Oct. 23, 2014), http://www.moph.gov.lb/Prevention/ Documents/2014-1-33153.pdf; Letter of the Minister of Public Health No. 33148/1/14 (Oct. 23, 2014), http://www.moph.gov.lb/Prevention/Documents/2014-1-33148.pdf.
 Letter of the Minister of Public Health (July 31, 2014), http://www.moph.gov.lb/Prevention/Documents/ Procedures.pdf.
 Letter of the General Director of the Ministry of Public Health No. 24740/1/14 (Aug. 13, 2014), http://www.moph.gov.lb/Prevention/Documents/2014-1-24740.pdf.
Last Updated: 06/09/2015