A narrative review of CBRN health sector preparedness in Lebanon

As chemical, biological, radiological, and nuclear (CBRN) events become increasingly recognised within international and national emergency preparedness efforts, this study aims to provide the first system-level overview of Lebanon’s preparedness capacities for CBRN-related health emergencies. A narrative review of peer-reviewed and grey literature was conducted using a structured search strategy, with findings thematically synthesised to assess governance and operational CBRN preparedness capacities across eight health system domains in Lebanon. The review identified important advances in Lebanon’s preparedness for CBRN health emergencies, including engagement with international preparedness frameworks, development of governance structures, and implementation of coordination, training, and simulation initiatives. However, preparedness remains uneven and constrained by fragmented coordination, legislative gaps, limited surveillance and operational integration, shortages in material and human resources, and dependence on external support. Economic instability and workforce migration further challenge sustainability, while preparedness capacities and readiness levels vary across emergency response and healthcare institutions. Overall, strategic planning and governance capacities appeared stronger than operational response and surveillance functions. While major efforts towards CBRN preparedness in Lebanon have been initiated, key aspects remain under-developed. Given Lebanon’s continued exposure to recurrent crises and regional instability, strengthening CBRN preparedness should be considered a critical component of broader health system resilience and national disaster risk reduction efforts.