Health Care

The right to health is recognized as a fundamental human right under international human rights instruments. In Lebanon, however, the exercise of this right by Palestinian refugees is shaped by their specific legal status. As non-citizens, Palestinian refugees are subject to a legal regime applicable to foreigners, which restricts their access to public services, including healthcare.

Within this framework, the Lebanese state’s role in healthcare provision for Palestinian refugees remains limited to preventive, regulatory, and exceptional interventions dictated by public health considerations. The primary responsibility for the provision of health services rests with the United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA), pursuant to its international mandate. As a result, healthcare services for Palestinian refugees in Lebanon are provided through non-national and non-comprehensive arrangements.

1. General Legal Context:

Palestinian refugees residing in Lebanon are subject to Lebanese laws governing foreigners and do not have the status of Lebanese citizens. This legal classification limits their access to public services, including healthcare and hospitalization.

Lebanese legislation does not provide for a specific legal framework granting Palestinian refugees a comprehensive and autonomous right to healthcare at the expense of the state. Consequently, state intervention remains governed by general administrative discretion and public health considerations.

While the Preamble of the Lebanese Constitution affirms the state’s commitment to the United Nations Charter and the Universal Declaration of Human Rights, this constitutional commitment has not been translated into comprehensive legislative provisions guaranteeing healthcare rights for Palestinian refugees.

Health and Hospitalization Services Provided by the Lebanese State: Public Hospitals:

Palestinian refugees may access Lebanese public hospitals under the following conditions:

• At their own expense; or
• Upon referral issued by

Coverage by the Lebanese Ministry of Public Health is limited to exceptional circumstances, such as epidemics or public health emergencies. Such coverage is based on the principle of safeguarding public health within Lebanese territory, rather than on recognition of an individual and permanent right to hospitalization.

In certain instances, coordination agreements have been concluded between the Lebanese authorities and UNRWA to allow Palestinian patients to be admitted to public hospitals within predefined financial ceilings borne by the Agency.

Preventive Healthcare and Public Health Measures:

Palestinian refugees benefit from national immunization programs targeting communicable diseases, including poliomyelitis, measles, and tuberculosis, implemented by the Ministry of Public Health in coordination with UNRWA and the World Health Organization. These measures are adopted in line with national public health requirements and preventive health policies.

Oversight and Regulatory Role:

Lebanese health authorities exercise general oversight over environmental and public health conditions in Palestinian refugee camps, pursuant to their sovereign responsibilities in the field of public health. In practice, the scope of this oversight remains constrained by the specific security and administrative context of the camps.

Accordingly, the role of the Lebanese state in the healthcare sector with regard to Palestinian refugees is primarily regulatory and preventive, rather than service-oriented.

Health and Hospitalization Services Provided by UNRWA:

UNRWA assumes primary responsibility for healthcare provision to Palestinian refugees in Lebanon, in accordance with its mandate established by United Nations General Assembly Resolution 302 (IV) of 1949.

Primary Healthcare:

UNRWA provides primary healthcare services through:

• A network of health clinics operating inside and outside refugee camps;
• General medical consultations, follow-up of chronic diseases, maternal and child healthcare, vaccination services, and school health programs;
• Free provision of essential medicines to registered Palestine

Mental Health and Psychosocial Support

UNRWA also implements mental health and psychosocial support programs, including:

• Psychosocial services integrated into selected clinics and schools;
• Health awareness, family planning, and substance abuse prevention

Institutional Coordination:

UNRWA maintains ongoing coordination with the Lebanese Ministry of Public Health, the World Health Organization, the Palestine Red Crescent Society, and the Lebanese Red Cross.

Conclusion:

The legal and institutional framework governing healthcare for Palestinian refugees in Lebanon demonstrates that refugees do not enjoy a comprehensive national legal right to health and hospitalization equivalent to that of Lebanese citizens. Instead, access to healthcare is characterized by:

• Limited state interventions driven by public health considerations; and
• Essential healthcare services provided primarily by UNRWA pursuant to its international mandate.

This framework remains structurally fragile and highly dependent on international funding, rendering healthcare access for Palestinian refugees vulnerable to recurrent disruptions, particularly in the absence of a comprehensive national health policy addressing refugee health needs.

Do Palestinian refugees in Lebanon have an effective legal right to health and hospitalization, or do the services available to them remain limited to exceptional and discretionary interventions that fall short of constituting a legally enforceable right?

This question raises two related issues:

1. What is the scope of the Lebanese state’s legal obligations in the field of health and hospitalization toward Palestinian refugees?
2. What is the legal basis for UNRWA’s assumption of primary responsibility for healthcare provision to Palestinian refugees in Lebanon?

The Lebanese Palestinian Dialogue Committee (LPDC) was established by a decision of the Lebanese Council of Ministers in 2005 as the official governmental framework responsible for coordinating state policies concerning Palestinian refugees in Lebanon.

Within its comprehensive approach to improving living conditions, the Committee has identified health and hospitalization as priority areas, given their direct impact on human dignity, social stability, and public health.

The Committee’s engagement in health-related issues has been reflected through:

• The preparation of analytical studies and field assessments on health conditions within Palestinian refugee camps;
• Continuous emphasis on the structural fragility of healthcare services in the camps and their dependence on unstable funding mechanisms;
• Advocacy for enhanced coordination among relevant Lebanese ministries particularly the Ministry of Public Health UNRWA, and international partners, in order to address health risks whose consequences extend beyond refugee communities and affect public health in Lebanon as a whole.