During their debate about foreign policy last Monday, President Barack Obama and his Republican challenger Mitt Romney both agreed that the crippling unilateral sanctions imposed on Iran by the the United States and its allies must continue, until the Islamic Republic recalibrates its nuclear ambitions.

Both seem to have also adopted Israeli Prime Minister Binyamin Netanyahu’s favoured refrain that “Iran must not be allowed to acquire a nuclear capability” and that such a capability constitutes a “red line” not to be crossed at any cost. Previously the inveterate refrain had been “Iran must not be allowed to acquire a nuclear weapon”.

The definition of “capability” has continued to remain vague and ill-defined, and a number of analysts have concluded that the Islamic Republic is already nuclear capable and has all the necessary components it would need in order to assemble a bomb if it so desired. Once a country has mastered enrichment technology it is generally accepted that the decision to weaponise largely becomes a political one.

Both Israeli and American intelligence continue to hold that Iran has not yet taken any such a decision. A crucial caveat is of course is that as a signatory of the Non-Proliferation Treaty (NPT) with all its enrichment sites subject to IAEA inspections, if it desired to make a dash for the bomb, Iran would have to withdraw from the NPT. An act that would immediately raise alarm bells across the world and most likely provoke a rapid Western military response.

Apart from the vague and shifting red lines which continue to afflict the thick fog of Western national security rhetoric vis-a-vis Iran, not a single word was uttered by either men about the plight and suffering of the Iranian people who have had no role in the decisions made by the Islamic Republic’s leaders. But, the fact is that the sanctions, exacerbated by government incompetence, have the potential to give rise to a major human catastrophe.

‘Smart’ and ‘targeted’

The lack of sensitivity to the plight of ordinary Iranians was – at least on the President’s part – surprising, because when his administration together with the European Union began imposing sanctions on Iran, they promised the world that the sanctions will be “smart” and “targeted”. The world was promised that the sanctions will not hurt millions of ordinary Iranians who go about their daily lives and, in fact, oppose many of their government’s policies.

But, the sanctions are now in full force, and are hurting the same people who we were told were not meant to be their target, in what is yet another case of “collateral damage” inflicted by Western policy towards Iran, and its disenfranchised people who have lost control over their destiny at both home and abroad. In fact, there are very strong indications that a human catastrophe could emerge whose scale poses as much a threat as an outright military attack.

The supposedly “smart” and “targeted” sanctions have been increasingly expanded to all areas, even if they are not part of the official sphere of sanctions. This is intentional, even if Western leaders tell us otherwise. To avoid criticisms of the type that they were confronted with after they imposed all-encompassing sanctions on Iraq in the 1990s, the US and its EU allies have imposed sanctions on Iran’s Central Bank and practically all other Iranian banks that are involved in commercial transactions with the outside world. Since these banks open lines of credit for imports, and provide financial guarantees for commerce with the outside world, it has become very difficult, if not impossible, to import vital goods and products into the country, even those that absolutely have nothing to do with the military, or oil, or the nuclear programme. In effect, this is the type of sanctions imposed on Iraq, but in a supposedly more “humanitarian” way.

An area that has been hit very hard is the pharmaceutical sector. Although Iran produces a large part of the medicines and drugs that its population needs, based on the generic versions of brand-named pharmaceuticals, it is still unable to produce the most advanced drugs that have come to the market over the past 10 to 15 years that deal with a variety of serious illnesses, simply because their generic versions are not yet available. As a result, Iran must still import a significant amount of drugs every year to address the needs of the Iranian people when dealing with such illnesses as leukaemia, AIDS, and others.

Sanctions on banks

Empire – Targeting Iran

But, the sanctions imposed on Iran’s banks and financial institutions have effectively prevented Iran from importing the necessary drugs and the associated chemicals. At the same time, as Iran’s oil exports continue to decrease due to the sanctions strain on the country’s resources, it becomes increasingly difficult to pay for the expensive imported drugs, even if a way can be found for importing them. As a pharmacist in Tehran said, “The warehouses for pharmaceutics are empty because we cannot import what we need due to the sanctions, and even if we could, we do not have the resources to pay for them due to the sanctions.”

As a result, the shortage of drugs has all the makings of a human catastrophe. According to recent estimates as many as 6 million patients are currently being affected by the impact of sanctions on the import and manufacture of medications inside Iran.

This has prompted many of Iran’s healthcare professionals to raise their voices, and begin protesting the impending danger they’re witnessing before their eyes. The board of directors of the Iranian Haemophilia Society recently informed the World Federation of Haemophilia (IFH) that the lives of tens of thousands of children are being endangered by the lack of proper drugs as a consequence of international economic sanctions imposed on Iran.

According to the letter that the Society’s board sent to the IFH, while the export of drugs to Iran has not been banned, the sanctions imposed on the Central Bank of Iran and the country’s other financial institutions have severely disrupted the purchase and transfer of medicines. Describing itself as a non-political organisation that has been active for 45 years, the Society condemned [FA] the “inhumane and immoral” US and EU sanctions and appealed to international organisations for help.

No drugs to treat illnesses

Some statistics are very telling. Tens of thousands of Iranian boys and young men are haemophilic and need certain drugs that must be imported. Many of them may need surgery for a variety of reasons, but in the absence of proper drugs for their haemophilia illness, the surgeries cannot be performed, because the bleeding could not be stopped.

Several credible reports from Iran indicate that surgeries for all haemophilic patients have been cancelled, and at least a few have already died.There are about 37,000 Iranians with MS, a debilitating disease that can be controlled only with advanced medications; otherwise, the patients will die. In fact, three members of one of our extended families in Iran are afflicted with multiple sclerosis. Furthermore, given that even under the best medical conditions 40,000 Iranians lose their lives to cancer every year, and that it has been predicted by many medical experts that Iran will have a “cancer tsunami” by 2015 as every year 70,000 to 80,000 new cases of cancer are identified in Iran, the gravity of the situation becomes even more perilous.

Fatemeh Hashemi, head of Iran’s Charity Foundation for Special Diseases, which cares for the needs of patients with life-threatening diseases, including a variety of cancers in adult patients as well as children, heart diseases, lung problems, multiple sclerosis (MS), and thalassemia, recently wrote a letter to United Nations’ Secretary-General Ban Ki-moon. The Foundation has been a highly successful nonpolitical organisation that, in addition to Iran, has also served many people in Iraq and Afghanistan, and whose work has been recognised by the UN.

In her letter Hashemi said that she leads an organisation “with 6 million patients and, hence, in contact with 30 per cent of Iran’s total population”. Emphasising the non-political nature of her organisation and her letter, Hashemi added:

“Although drugs have not been sanctioned, due to the impossibility of paying for the imported drugs through the banking system, the heavy shadow of the sanctions is felt in the health sector. Not only has importing drugs been disrupted, importing the raw chemicals [for the drugs that Iran does produce] has also been disrupted… As a human activist, I call on humanity’s conscience to pay attention to the fact that, despite the claims by those that have imposed the sanctions, their pressure is having its destructive effect on the life and health of the people.”

Sanctions threaten ancient tradition in Iran

Hence, the supposedly “smart” and “targeted” sanctions that were not going to hurt the ordinary Iranians have been inflicting significant damage on the Iranian people.

The net result is that shortage of drugs for patients with serious and life-threatening illnesses is becoming chronic in Iran, and is reaching hazardous levels.

Shortage of drugs

Meanwhile, recent reports indicate that two large plants that produce drugs for a variety of illnesses have also been closed. The reason is that it has become essentially impossible to import the chemical compounds used in the production of the drugs, due to the sanctions imposed on Iran’s financial institutions that deal with the outside world.

The world must recognise that in certain respects the path taken by the United States and its allies is eerily similar to what was done to Iraq in the 1990s. The United Nation’s UNICEF estimated that the sanctions imposed on Iraq caused the death of up to 500,000 Iraqi children. Given that Iran’s population is three times that of Iraq, if the sanctions imposed on Iran last several years – as they did with Iraq – the number of dead resulting from them could be larger than that of Iraq.

Moreover, given that Iran still imports a significant amount of wheat, rice and other food products, if the sanctions drag on, not only could hundreds of thousands of Iranians die due to shortage of drugs and medical goods, the shortage of food could also become very significant. It should also be noted, if only in passing, that sanctions did not change the policy of Saddam Hussein’s regime.

Thus, after causing the death of hundreds of thousands of Iraqi children, those who had been jockeying for war with Iraq all along argued that the sanctions had failed, and “regime change” was the only alternative. As we now know Iraq did not have weapons of mass destruction, nor was it trying to produce them. Iran also does not have nuclear weapons yet, but Western policy has the power to change the Iranian leadership’s calculus and make it seem like the only viable option remaining with the power to guarantee regime survival.

In sum, comprehensive sanctions not only killed thousands in Iraq, but they eventually laid the path to war. One key difference in the case of Iran is of course that one of its few lifelines to the outside world is still China, which depends on Iranian energy to abet its ongoing economic expansion, hardly a commendable development for those supporting human rights and entertaining hopes of democratisation in the Islamic Republic.

The sanctions have arguably failed to meaningfully shift the stance of Iran’s Revolutionary Guards and the Supreme Leader Ayatollah Ali Khamenei, who most recently emphasised that the Islamic Republic is prepared to negotiate and has in fact never left the negotiating table, but will not be cowed into submission. So, if, for instance, Iran is expected to forgo 19.75 per cent uranium enrichment and close the underground Fordow enrichment facility, two of the P5+1’s key demands at the Baghdad and Moscow talks, there must be some form of quid pro quo. Without one, there is no incentive for Iran to cooperate in an atmosphere already severely afflicted by a longstanding deficit of trust. There have been rumblings and rumours of possible sanctions relief after the US presidential election but nothing tangible as of yet.

There are many voices within Iran that have called on the leadership to find a compromise with the West. The US and its allies can make such voices stronger and louder if they offer to lift some of the sanctions, or at least have exceptions that allow Iran’s financial system to be involved in the import of vital goods and products with no military or

nuclear applications, such as drugs and food stuffs.

It may be useless to preach to the Obama administration about the human, moral, and ethical toll of its policy toward Iran, given that the President has in many respects perpetuated the destructive Middle East policy of George W Bush, which in Iran’s case has been even tougher and more damaging to the livelihood of the Iranian people.

But, the emerging catastrophe will be an ethical and moral problem for the West for decades to come, a catastrophe that is being created simply because Western governments appear to blindly pursue crippling sanctions against Iran as an end in themselves, as opposed to a means by which to further the diplomatic process.

Given the tragic history of the US intervention in Iran in the past, it is be prudent to rethink the consequences of such blind sanctions, and their effect on the thinking of the Iranian people about the US – a largely pro-US population in one of the most turbulent areas in the world that has been known for its hostility towards the United States and its perceived negative impact in much of the region.

Muhammad Sahimi, a professor at the University of Southern California in Los Angeles, analyses developments in Iran for the website PBS/Frontline: Tehran Bureau.

Eskandar Sadeghi-Boroujerdi, a former Iran researcher at the Oxford Research Group, is Editor of Al-Monitor’s Iran Pulse. He is also a fourth-year doctoral candidate at the University of Oxford.