by Muhammad Sahimi

The illegal economic sanctions that the Trump administration has imposed on Iran are ruining its economy by increasing the inflation rate—from nine percent before the sanctions to 35-40 percent today—as well as unemployment, and forcing countless numbers of small businesses to close. Whereas Iran’s economy grew by 12.5 percent in 2016, it has shrunk by six percent in the first six months of 2019. These are the results that President Donald Trump, Secretary of State Mike Pompeo, and National Security Advisor John Bolton constantly brag about. But they have created unspeakable suffering for ordinary Iranian people, who don’t even have a say in what their political system does.

The worst aspect of the sanctions is their human toll, caused by severe shortage of critical medicines and medical equipment for millions of Iranians. Fear that common citizens will be unable to obtain the medicines they need is everywhere in Iran, and for good reason. Every year, there are 112,000 new cases of cancer in Iran, one of the fastest growth rates of cancer in the world. The most painful aspect is the situation faced by children with cancer whose chances of growing up have been dramatically reduced. As one Iranian mother whose child has cancer put it, “Children battling cancer are an unintended victim of American sanctions on Iran. Maybe I have the financial support to travel to neighboring countries in order to provide medication, but what about other ordinary people? They are losing their child in front of their eyes. What about supporting human rights [as Pompeo and Bolton claim to do]? A lot of people are saying human rights, so where is it? There is no support for human rights, it is just a claim.”

In a letter published by The Lancet, the prestigious medical journal, three doctors working in Tehran’s MAHAK Pediatric Cancer Treatment and Research Center warned that, “Re-establishment of sanctions, scarcity of drugs due to the reluctance of pharmaceutical companies to deal with Iran, and a tremendous increase in oncology drug prices [due to the plummeting value of the Iranian rial by 50–70%], will inevitably lead to a decrease in survival of children with cancer.”

There are 5.2 million Iranian people who suffer from diabetes. Over 72,000 people suffer from multiple sclerosis (MS). There are at least 66,000 people afflicted by the AIDS, but many experts believe that the actual number is much larger because, due to the social stigma associated with the disease, many people are reluctant to seek treatment. There are at least 800,000 people with Parkinson’s disease and at least 700,000 people with Alzheimer’s. There are more than 23,000 people with thalassemia in Iran, who suffer from shortage of medicine despite great progress on the part of the Iranian government in addressing the problem. Such patients are treated by blood transfusion once every few weeks and take a medication called deferasirox, which treats a side effect of blood transfusion (excess iron). Iran has been able to produce some generic versions of the medication, but still needs to import significant quantities of it.

Another thirteen percent of Iran’s population of 83 million, about 10.8 million people, suffer from asthma. But while asthma is a global problem and, therefore, one would think that treating it should be routine and inexpensive, U.S. sanctions have also hit Iranian asthma patients hard. “My father has suffered from asthma for 15 years and needs a new inhaler every month, one young man said. “But the inhaler he used to buy has totally disappeared from the market. My sister is a nurse, but there is nowhere to find the inhalers in Iran anymore.” Another 3,000 people suffer from what are called “rare diseases”—those for which there are not many medications even in the West.

When the Obama administration imposed its crippling sanctions against Iran, there were credible reports of hemophiliac Iranians dying due to the interruption in the supply of essential medicine, 75 percent of which is produced in the U.S. and the European Union—on which Iran has long relied as suppliers. The same shortages exist today, putting thousands of lives at risk.

By far the most important cause of these shortages—and even total absence—of medicines for such terrible diseases is the economic sanctions imposed on Iran by the United States. Britain, France, and Germany tried and failed to persuade the Trump administration to guarantee Iranian imports of basic foods and medicine.

Officially, U.S. economic sanctions do not include medicine. But in practice, medicine is subject to sanctions. The reason is twofold: no pharmaceutical company producing critical medicines is willing to sell its products to Iran for fear that the Treasury Department might find some small technical or administrative errors in their applications and go after them with a vengeance. The enforcer of the sanctions is Sigal Mandelker, the under-secretary of Treasury for terrorism and financial intelligence, who said recently, “without a doubt, sanctions are working.” The question is, for whom are the sanctions working? Ordinary Iranians?

The second reason is practical. Even if a pharmaceutical company was willing to export its medicines to Iran, Iran’s banking system has been effectively cut off from the rest of the world. At present, there is no mechanism to pay for the imports except through the personal accounts of individuals in Europe or elsewhere. This avenue was used during the crippling sanctions that President Obama imposed on Iran in the early 2010s, but it resulted in incredible corruption, theft, and the importation of expired medicines. As a result, the Rouhani administration has so far avoided this route.

One of the few Iranian financial institutions that the Obama administration did not sanction was Parsian Bank, which was a critical conduit for humanitarian trade, especially medicine and medical devices, with Europe. But, the Trump administration sanctioned Parsian Bank as well. So, while there still was a shortage of critical medicine under Obama, it was nowhere close to what we are witnessing now.

Even when some medicines are not in short supply, the huge inflation has put their costs out of reach for many Iranians. “The artificial tear drop that my son has to use for his eye condition has doubled in price,” from the equivalent of about $2.50 to $5, a housewife and mother of two told ABC News last month. Another drop went from $1.50 to $8 in a year. There are thousands of such stories reported by social networks.

My personal experience confirms such reports. My wife is a medical doctor who received her education and training in Iran. She and hundreds of old friends and classmates have a large network that helps ordinary people with their medical problems. Every single member of this network has been telling us the same thing: that the shortage of critical medicine is so severe that people are losing their lives. Two of my brothers-in-law and a nephew are pharmacists in Iran, and they tell me that they have to turn away more than half of the people who come to their shops every day because they have run out of medicine. My father-in-law suffers from severe diabetes and has to pay huge sums to get his medicine. He can afford it, but what about millions of other diabetic patients? A first cousin with three children suffers from Multiple Sclerosis, and she cannot even find her medication at any price. Shortages for MS medication is everywhere in Iran.

Under the Obama-era sanctions, leading science journals reported their crippling effect on the supply of critical medicines to Iran. A December 2013 report published in Nature, one of the world’s top science journals, stated, “A tightening of already draconian international economic sanctions against Iran is causing serious shortages of certain drugs, vaccines and other key medical supplies in the country, medical researchers and public-health officials are warning.” A letter by a faculty member in the department of pharmacology at Baqiyatollah University of Medical Sciences in Tehran that was published by the Journal of Pharmaceutical Science stated, “Although medicines are exempted from sanctions, due to restriction on money transaction and proper insurance Iranian pharmaceutical companies have to pay cash in advance for imports of medicines and raw materials or to secure offshore funds at very high risks…. Sanctions against Iran are affecting ordinary citizens and national health sector which resulted in reduction of availability of lifesaving medicines in the local market and has caused increasing pain and suffering for Iranian patients.”

If these were the conditions in Iran under the Obama sanctions, one can only imagine the situation now, because the Trump sanctions are far more draconian than anything imposed on Iran in the past. In fact, a comprehensive review of the state of healthcare in Iran published in 2018 by International Journal of Health Policy and Management, demonstrates the severe adverse effect of the sanctions on the state of healthcare in Iran. Even if the sanctions are lifted, the article notes, their “adverse consequences … have already taken place and will take a long time to be alleviated.” Additionally, “the social impact of economic sanctions against Iran may extend beyond the sanction period because the costs of imposing sanctions exceed the benefits of lifting sanctions.”

But the shortage of vital medicines is only one factor that contributes to the unfolding human tragedy in Iran caused by the Trump-Pompeo-Bolton sanctions. A shortage of medical devices is another factor. In this case, the problem is even more complex because some devices are perceived as having a dual use—that is, they could have military as well as medical purposes—and their export to Iran is banned under all circumstances. Asr-e Iran, a reformist website in Iran, reported a list of medical devices that thousands of cancer patients need and that are unavailable in northwest Iran. The list only goes to show the mind-boggling nature of such shortages.

Beyond the medical field, there are several other ways in which U.S. sanctions are hurting ordinary Iranians every day. Another aspect is the shortage of some foodstuffs. As with medicines, the export of wheat, barley, corn, and other food items to Iran is not officially sanctioned, but major global traders have halted their supply agreements with Iran because the sanctions have paralyzed the banking systems required to secure payment. Two Iranian ships contracted to carry corn, soybean and meat to Iran were stranded in Brazil because Petrobras, the Brazilian oil company, refuses to supply fuel to the ships, apparently in fear of running afoul of U.S. sanctions. After Brazil’s Supreme Court ordered Petrobras to supply the ships with fuel, they finally left Brazil.

The most depressing aspect of the inhumane sanctions is that shortage of medicines in Iran has given rise once again to a black market, controlled by the regime’s hardliners and their cronies. The black market only enriches the most radical elements in Iran, those who benefit from continuing tension between Iran and the United States, and were assailed as “merchants of sanctions” by President Rouhani. The same profiteering happened during the Obama years, but has now returned in a much worse fashion because the shortages and desperation they cause are so much greater.

We should recall that, according to UNICEF, the economic sanctions imposed on Iraq in the 1990s killed at least 576,000 Iraqi children due to malnutrition and medical shortages. Given that the current sanctions imposed on Iran are even more severe, and that Iran’s population is three times greater than Iraq’s, there is every reason to believe that the continuation or aggravation of the sanctions regime will translate into the deaths of even more children in Iran.

Secretary of State Mike Pompeo has repeatedly claimed that the U.S. stands with the Iranian people. But the effective embargo of medicines, medical equipment, and basic food staples gives the lie to that claim. It’s quite clear that the lives of Iranian people do not matter to him. After all, this is the same man who suggested in 2014 to attack Iran with “2000 sorties,” which would have led to war with Iran, killing at least hundreds of thousands of people, if not more, and the same man who has been linked with some of the worst Islamophobes in this country. He and John Bolton shed only crocodile tears for the Iranian people.

Pompeo has also claimed that he cares about the Iranian government’s violation of its citizens’ human rights. According to the 1948 UN Declaration of Human Rights, however, everyone has a right to a standard of living adequate for his health and well-being, including food, medical care, and social security without any kind of discrimination on grounds such as gender, race, and the political, jurisdictional, or international status of the place to which a person belongs. Article 12 of the UN-approved International Covenant on Economic, Social, and Cultural Rights, adopted in 1966, asserts the right to “the highest attainable standard of physical and mental health” for everyone around the globe. By championing crippling sanctions against Iran under the policy of “maximum pressure,” Pompeo has only demonstrated that his claims are similar to those of his boss—fake.

Muhammad Sahimi is a Professor at the University of Southern California.