By Emma Kazaryan
In September, after months of medical tests and analyses, Akhtar Karimi, 53, was diagnosed with bone cancer that had metastasized to her lungs and liver. Coming from an upper class family, Ms. Karimi could afford a private clinic treatment, however her doctor had prescribed a seven-month therapy that required a drug, which was impossible to find in Iran, and the alternative Iranian-made cancer medication was not even considered as an option.
Her brother, Majeed Karimi, who lives in New York, spent two stressful weeks in extensive search for Caelyx, a monotherapy treatment medicine for metastatic cancer, in the United States and Europe and finally found it in Kuwait through a family friend.
“Caelyx is the hardest drug to find around the world and she needs four of them every 21 days, which is about $7,200,” said Mr. Karimi, who is visiting Iran, helping his sister to recover after chemotherapy. “We just finished the last shot of her medication and I have to travel to Kuwait now to buy another four for the next month.”
For more than 35 years Iran has been under economic sanctions that have had a major impact on health care. Although sanctions did not target trade in humanitarian goods, they have caused the deficits in all aspects of care nonetheless, by disrupting health services through restrictions in financial transactions, transportation and reduced imports.
In 2015, after years of intricate negotiations, Iran and the United States signed the Joint Comprehensive Plan of Action, a historic agreement to reduce Iran’s nuclear enrichment in exchange for lifting of economic sanctions, giving a long-awaited hope to millions of Iranians. According to political analysts, this procedure has not been going as smoothly as predicted, since the Iranian hard-liners are showing their disagreement with the deal seeing it as a threat to their regime.
While the Revolutionary Guards together with the Supreme leader Ayatollah Khamenei are creating obstacles in cooperation with the West, people in Iran continue to suffer in need of medical supplies.
“The timeline [for lifting sanctions] is in Iran’s control,” said Richard Nephew, an expert on sanctions and energy market in the Center on Global Energy Policy, who served as the lead sanctions expert for the U.S. team negotiating with Iran. “That could happen tomorrow or few months from now. But most probably in February of next year.”
Mr. Nephew, who served as the director for Iran on the National Security Staff from 2011 to 2013 and was responsible for managing a period of intense expansion of U.S. sanctions on Iran said that while they were targeting mainly petrochemical and oil industries, they have expanded the exemption on medication and medical devices. Though the fall of drug imports can be explained by the mismanagement of Iranian government at that time.
Based on Siamak Namazi’s report on medical supply and shortage in Iran, imports from American and European pharmaceutical companies were down by 30 percent in 2012, a year when sanctions on Iran have been expanded limiting banking transactions and access to hard currency, which were necessary for Iranian manufactures and importers to maintain humanitarian trade.
In recent years Iran has seen a dramatic rise of cancer in the country, which is now the third cause of death after cardiovascular diseases and accidents. According to the Cancer Research Center of Iran about 70,000 people are diagnosed with cancer and 41,000 die each year. Since treatment of malignant tumors requires advance medicines, Iranian-made substitution is often impractical.
“When it comes to regular medication it is not a big issue, because Iran’s pharmaceutical industry is strong,” said Mehrshad Haghighi, a radiologist, who worked in Iran as an internal medicine specialist 17 years ago. “However, when you are talking about cancer–the quality of Iranian medication is not great and has more side effects. Only people with money can afford to buy Western drugs on the black market.”
According to the Statistics Center of Iran report, in 2014 the average salary of Iranian family was 17,030,000 rials, equivalent to $470 per months. With the rising inflation, which was 36.7 percent in 2014 compared to 15.2 in 2005, it is becoming harder and harder to buy medication even for those who could afford it few years ago.
“My medication was $500 for each shot, after insurance covered 80 percent of the cost,” said Noorarash Charlie, an American born Iranian, who was diagnosed with B-cell lymphoma in 2007.
Although Mr. Charlie, 28, had his biopsy and surgery at Stanford, near San Francisco, he decided to move back to Iran for remission.
“Family and friends are much more important than having the best treatment,” said Mr. Charlie, who received his chemotherapy in Iran, though his family had to find Bendamustine, a chemotherapy drug prescribed by his American doctor, which was nowhere to be found in Iran.
“We found it through a private dealer company that brings expensive medication to Iran and charges three times more than the original price of the medication,” he said.
Mr. Charlie, who currently lives in Tehran and works in the art and fashion industries, said that he has seen people who couldn’t even afford a basic check up, without even talking about sophisticated treatments.
Comparing Iran with the West, Mr. Charlie admits that the resources and monitoring are very low in Iran, because of the lack of new technologies.
“I have heard Iran has new screening machines, but I don’t know how much I can trust them,” he said. “But we are all hopeful about the deal being signed.”