Iran Grapples with Severe Medication Shortages Amidst Reimposed International Sanctions

Sanctions Reimposed, Healthcare Impacted

The Islamic Republic of Iran is facing severe shortages of life-saving medications, a direct consequence of international sanctions reimposed to curb its nuclear program. The crisis, which has escalated since the United States withdrew from the Joint Comprehensive Plan of Action (JCPOA) in May 2018, has left the country's most vulnerable citizens struggling to access essential treatments.

Following the US withdrawal, a wide range of economic sanctions, including 'secondary sanctions' targeting Iran's financial, energy, and petrochemical sectors, were reinstated. While humanitarian goods, such as medicines and medical equipment, are formally exempt from these restrictions, the practical implications of the sanctions have severely hampered Iran's ability to import these critical supplies.

Mechanisms of the Shortage

The primary mechanisms driving the medication shortages are multifaceted:

• Banking Restrictions: Broad sanctions on Iranian banks and financial institutions make it exceedingly difficult to process international payments for imports, even for humanitarian goods. International banks often 'over-comply' with sanctions, fearing penalties, which deters them from facilitating transactions with Iran.
• Foreign Currency Shortages and Depreciation: Sanctions have led to a significant depreciation of the Iranian Rial and a scarcity of hard currency, dramatically increasing the cost of imported medicines and raw materials. This reduces the purchasing power for essential healthcare items.
• Reliance on Imported Raw Materials: Although Iran produces a substantial portion of its medicines domestically (reportedly over 90% or 97%), it remains heavily dependent on imported raw materials and active pharmaceutical ingredients (APIs). Disruptions in the import of these components directly impact domestic drug production.
• Supply Chain Disruptions: Restrictions on shipping and insurance further complicate the logistics of transporting medical supplies into the country.

Impact on Vulnerable Populations

The shortages disproportionately affect patients with chronic and rare diseases. Reports indicate critical scarcity of drugs for conditions such as:

• Cancer
• Multiple Sclerosis (MS)
• Thalassemia
• Epidermolysis Bullosa (EB), often referred to as 'butterfly kids'
• Hemophilia
• HIV/AIDS

An Iranian pharmacist noted that 'Many life-saving drugs are no longer available,' with the supply crisis worsening dramatically. Some sources suggest that as many as 300 types of drugs are in short supply, with approximately 100 types entirely unavailable. Patients are often forced to seek expensive black-market alternatives, delay crucial treatments, or face significantly increased prices, with some drugs reportedly tripling or quadrupling in cost.

Official Statements and Ongoing Challenges

Iranian officials have acknowledged the crisis, with the government allocating foreign currency for medicine and medical equipment. However, shortages in available hard currency have reduced access to these funds. The Iranian Food and Drug Administration, despite producing a high percentage of the country's medicines, faces raw material shortages due to import bans. Health Minister Saeed Namaki previously stated that 'The American claims that medicine and medical equipment are not subject to sanctions is a big and obvious lie.' The ongoing financial strain also includes the government's failure to pay its debts to pharmacies, further disrupting the medicine supply chain.