You Cannot Fix a Health System You Refuse to Measure

Lebanon's health statistics have quietly gone dark. That is a policy choice, and it has a body count.

By Dr. Samir Hayek

Published 2026-05-11 · Updated 2026-05-11

Ask a simple question: how many Lebanese died last year, and of what? The honest answer is that nobody knows within a useful margin. Vital statistics publication has effectively stopped. Hospital discharge data is unpublished. The last credible national health accounts are years old. We govern a health system by anecdote.

I have advised health ministries on three continents, and I will state a professional rule: the completeness of a country's death registry is the single best proxy for whether its government intends to be accountable. Counting deaths is cheap, technically trivial and politically dangerous — because a functioning registry converts "the situation is difficult" into "cardiovascular mortality rose 23% after the subsidy removal." One is weather. The other is a decision with an author.

The blackout is convenient for everyone with authority and catastrophic for everyone without it. Donors cannot target what is not measured; hospitals negotiate tariffs blind; families discover the pediatric oncology drug shortage one prescription at a time.

The fix costs less than a single ministerial convoy: mandate electronic death certification (the software exists, donor-funded, deployed, unused), publish monthly all-cause mortality by district, and restore the national health accounts with WHO technical support already on offer. When you next hear that health reform is complicated, remember that we have declined to count the dead. Complexity is not the constraint. Accountability is.