Mental Health in Iran
The Islamic Republic of Iran is the second-largest Middle Eastern country, home to roughly 83 million people. Iran is one of the oldest civilizations but has the classification of being a developing country. However, its healthcare system is not underdeveloped. Iran has both public and private health care organizations extended to urban and rural areas. Nevertheless, Iran has maintained a 17-18% population share of people with a mental health or development disorder. The global population share of people with any form of mental disorder is 10.7%.

Mental Health in Iran

Mental health issues are prevalent in Iran. About one-fifth of people have a mental illness or substance disorder, amounting to nearly 10% of the total disease burden. Over 60% of Iranians do not receive any treatment, and only 15-25% get proper treatment. Many do not seek treatment, and resources are currently limited to treating disorders for those who do.

While 64% of the population reside in urban areas, mental health is nearly identically prevalent in rural areas. Iran aims to aid urban and rural areas accordingly. The Iranian health care initiative intends to soften the gap between urban-rural access to healthcare. Part of the initiative is lessening the disparity of primary health care between urban and rural areas. The gap has decreased significantly, and Iran has begun integrating mental health treatment into its primary care system.

Therefore, rural areas are obtaining near-equal access to mental health treatment as urban areas. However, only 3% of Iran’s healthcare spending goes toward mental health, which complicates its success in treating mental health. Iran has a robust healthcare system, allocating more money toward mental health should down-trend its number of mental health cases.

Various mental disorders are prevalent in Iran. Iran’s mental health difficulties vary depending on the type of disorder. Overall, mental health maintains a vital challenge for the country. With 4.3 million Iranians currently suffering from depression, it equates to around 5% of the Iranian population, compared to 3.4% of the global population suffering from depression. Another 688,000 Iranians have bipolar disorder, which is less than a percentage point of Iran’s population. Meanwhile, 5.75 million Iranians have an anxiety disorder and over 180,000 Iranians have schizophrenia. With that, mental health disorders of all severities continue to be prevalent in the nation.

Underlying Causes of Mental Health Issues in Iran

Several underlying factors escalate the issue of mental health in Iran. The nation has a fluctuating unemployment rate, shifting between 10-15%, with almost one-third of people living in poor conditions, exacerbating the attempt to aid mental health. While unemployment and poverty are sources of mental health issues, they also lead to mental health deterioration factors. Therefore, women have a higher rate of mental illness in Iran, as they are twice as likely to be unemployed than men in Iran. Another issue is the rate of mental illness increases within older age groups, although adolescents maintain similar rates.

Solutions

Iran has continued to address the issue. Iran has made several attempts to find solutions to lower the number of people with mental health disorders within it. From 2013 to 2018, Iran increased its health expenditure by 2.6% totaling almost 9% of its total GDP. Aforementioned, Iran integrated mental health treatment into its primary care system in 1989, improving access to treatment. As the country increases its healthcare expenditure, mental healthcare funding would increase within Iran’s primary care system. With the steps occurring to reduce the percentage of people needing mental health treatment, resources such as having enough facilities, hospital beds and doctors to treat people are the next step for Iran.

With 792 million people globally living with any form of mental illness, mental health is not only prevalent in Iran. Similarly, the stigma behind mental health has contributed to the setbacks and barriers. Though, Iran maintains a firm hold over taking steps to eradicate the issue over time. As the country continues to make public health care a primary focus, the goal is to see mental health cases slowly dwindle in the foreseeable future. Continuing the betterment of mental health in Iran serves to alleviate unemployment and poverty in the nation.

– James Van Bramer
Photo: Unsplash

Period Poverty in Iran
Menstruation is a normal, healthy part of life. However, for women and girls worldwide, having a period can be a barrier to attaining true gender equality. Period poverty in Iran is the result of many factors including misconception, lack of training and education, stigma and traditional, conservative religious beliefs. With “millions of women and girls [continuing] to be denied their rights to water, sanitation, hygiene, health, education, dignity and gender equity,” some are directing attention and resources to the menstrual equality movement.

Misconception and Restriction

In the Islamic Republic of Iran, taboos, misconceptions and social and cultural restrictions shadow menstruation for many women. A study among school girls in West Iran found that “41.2% of girls understood that menstruation is a normal physiological process in women,” leaving the majority of pubescent girls in this study to form inaccurate perceptions about this normal bodily function. In a similar study, 48% of Iranian girls stated they believed that menstruation was a disease. The feelings of confusion, panic and fear that accompany such beliefs can inhibit girls from experiencing true dignity and comfort in their bodies.

Cultural, religious and traditional beliefs have a significant impact on norms and attitudes. Islamic rules dictate various prohibitions for menstruating women. During menstruation, women cannot bathe, pray, enter a mosque, fast during Ramadan, touch the Quran or have sexual intercourse. Certainly, the level of restriction varies amongst communities and families, however, much of these restrictions predominate.

A study that occurred in secondary schools in the city of Tabriz, the most populous city in northwestern Iran, indicated that the majority of female students were able to access menstrual hygiene products. Specifically, out of the 1,000 students included in the study, two-thirds reported a favorable economic status and 95.6% reported using disposable pads during menstruation. Though these rates are encouraging, Iran’s poverty rates remain very high. After the last census in 2016, an Iranian economist estimated that 30 million Iranians were living in relative poverty and 12 million in absolute poverty. High poverty rates correlate to less access to water, sanitation and hygiene resources, including menstrual pads.

The Impact of Education

While organizations and governments can best tackle the complex issue of combating period poverty in Iran through collaboration across disciplines of education, urban planning, water and sanitation, a study out of Iran University of Medical Sciences and Health Services states that “health education is among the fundamental and successful approaches to health promotion.” It is promising, then, that in early 2019, a group of officials from the Iranian Ministry of Science and Health as well as the Vice President for the Women’s and Family Affairs, collaborated to create a document aimed at promoting sexual health awareness and education. The document provides guidance to empower teachers and parents, implement education packages and establish policies and interventions to promote indirect sexual education through media. This document is the first of its kind and marks a critical undertaking of improving adolescents’ sexual health education in Iran.

Training and education have a considerable influence and can help mitigate period poverty in Iran. One study found that the use of sanitary pads, as well as bathing and washing after urination or defecation during menstruation, were practices significantly elevated in groups of young girls that received training. The stakes of proper training are beyond fostering hygienic practices; education has a direct impact on health outcomes. Young girls who are first learning about menses are a particularly vulnerable group. Lacking information about menstruation can lead to anxiety and lowered self-esteem but also reproductive tract infections and pelvic inflammatory diseases. The International Journal of Pediatrics found that “young girls with better knowledge and practice toward menstrual hygiene are less vulnerable to adverse health outcomes.”

The Importance of Mothers

Iran can best take on the task of providing reproductive education to its youth by utilizing a critically helpful source: mothers. Countless studies state that the most efficient, culturally and religiously sensitive strategy to convey information to girls about menstruation involves families, mothers in particular.

A study by the International Journal of Preventive Medicine compared different training sources for adolescents’ menstrual health education. Its findings indicate that partnering parents and school trainers as equal stakeholders “leads to more successful results in health implementation.” Another study based out of Iran suggests that education to mothers could be even more effective than directly training adolescent girls themselves. With 61% of Iranian girls reporting that their mothers are the best source of information about menstrual hygiene, it is critical that mothers receive sufficient education so they can share accurate information with their daughters. It is urgent, ethical and resourceful to prioritize education and training for menstrual health management.

Organizations Addressing Women’s Health

While there are over 2,700 NGOs working in Iran on women and family affairs, including Relief International and Center for Human Rights in Iran, the work of Imam Ali’s Popular Student Relief Society, IAPSRS, has been substantial in the area of reducing period poverty in Iran. This prominent group includes 12,000 volunteer university students and graduates. It aims to promote social and economic justice by supporting marginalized children and women in the most problematic, marginalized neighborhoods in Iran. The organization has provided workshops about personal hygiene, birth control, maturity and sexually transmitted disease prevention, as well as deployed volunteer gynecologists for biannual disease screenings.

The work of this group is currently in jeopardy, however. In early March 2021, a court verdict dissolved the NGO, stating that it “deviated from [its] original mission and insulted religious beliefs.” The Human Rights Watch has already called on the U.N. High Commissioner for Human Rights to reverse this action and reinstate the organization.

The Period Equity Movement

The last decade has illuminated the need for a growing focus and global movement on menstrual health management. Significant developments have occurred to address the barriers facing girls and women all over the world, but the need for major overhauls in programming and policy agenda persists.

– Brittany Granquist
Photo: Flickr

HIV/AIDS in Iran
Iran discovered its first case of HIV/AIDS in 1987. Now, over 30 years later, UNAIDS estimates that more than 59,000 people are living with HIV/AIDS in Iran. While Iran has had success managing its HIV/AIDS epidemic in the past, shifting conditions surrounding the spread of the disease has made prior prevention plans obsolete. Iranian non-governmental organizations (NGOs) are taking a new approach to help tackle the present crisis.

HIV/AIDS in Iran

Avert is an organization working in HIV/AIDS education. According to its reports, the Middle East and North Africa (MENA) region, the area where Iran is located, has the fewest HIV/AIDS infections in the world. However, a concerning aspect of the region’s HIV/AIDS epidemic is that so few people are aware of their infected status. Of the estimated 59,000 people living with HIV (PLHIV) in Iran, UNAIDS estimates that only 22,000, or 37%, know that they are carrying the disease. By comparison, only about 15% of PLHIV in the United States are unaware of their status.

This lack of awareness amongst Iranian PLHIV is concerning both in its implications for the quality of life of those individuals, but also in its potential to increase the spread of the virus. This is part of the reason why Iran continues to see the steady spread of HIV/AIDS. According to UNAIDS, while new infections are down from a spike in 2004, Iran saw more than 4,000 new infections in 2019. The AP reports that this increase could be due to the rising prevalence of sexually transmitted cases of HIV/AIDS in Iran, where infection by contaminated drug injection has traditionally fueled the country’s crisis.

Knowledge and Perceptions of HIV/AIDS in Iran

The unknown status of many Iranian PLHIV results from larger issues surrounding Iran’s attitude towards the virus. Specifically, a lack of education regarding HIV/AIDS and prevailing cultural stigma towards PLHIV impacts how Iranians treat the virus and those living with it.

A 2013 survey showed that public education about HIV/AIDS in Iran is limited. The survey included 4,950 participants, each of whom had to fill out a questionnaire regarding their understanding of and attitudes towards HIV/AIDS.

The results of this survey showed that more than 80% of participants were aware that HIV/AIDS could spread through sexual contact or the sharing of a needle with a person with HIV/AIDS. In addition, 70% of participants knew that the use of a condom decreases the likelihood of contracting the virus during sex. However, despite this understanding, only 21.8% of respondents consistently used a condom during sex. This is particularly concerning given the rising role of sexual transmission in the spread of the disease in Iran.

The survey also revealed high stigmatization of PLHIV by respondents. Among respondents, 43% believed that HIV was a “fair punishment,” for “sins of the past,” and 48.6% said that they would stop interacting with somebody who contracted HIV.

Stigma towards PLHIV in Iran results from numerous factors. Misunderstandings about the spread of HIV/AIDS are part of the equation. Due to cultural norms, the association of HIV/AIDS with drug use, homosexuality and premarital sex have led to the widespread nonacceptance of PLHIV, a sentiment echoed in the aforementioned survey.

A New Approach to HIV/AIDS in Iran

Fortunately, NGOs in Iran exist that are advancing a more compassionate and effective approach to HIV/AIDS. The Tehran Positive Club is one such organization. The club devotes itself to assisting Iranian PLHIV, educating the public about HIV/AIDS and reducing the stigma against PLHIV. It provides services to PLHIV including counseling, group therapy, material support and vocational training.

Based out of Iran’s capital, the Tehran Positive Club has thousands of members and multiple branches throughout the country, including in populous cities like Isfahan, Kermanshah and Qom.

By providing material support, the Tehran Positive Club hopes to alleviate the social and psychological trauma that societal stigmatization causes PLHIV. And by increasing public understanding about the disease, it seeks to eliminate the prevailing cultural stigmata that result from misinformation. Reducing stigmatization creates empathy for PLHIV and raises the likelihood that more Iranians will receive testing for the disease, thereby reducing its spread and increasing the chances of survival for the unwittingly infected.

In 2016, the Tehran Positive Club received the Red Ribbon Award from UNAIDS for its work with the HIV/AIDS epidemic in Iran. Though the organization already has powerful allies at home and abroad, including the Iranian Research Center for HIV/AIDS and the United Nations Development Program, increased foreign aid would undoubtedly help further its mission and turn the tide of Iran’s HIV/AIDS epidemic.

– Joseph Cavanagh
Photo: Creative Commons

Sanctions prevent humanitarian aid
When looking at what contributes to poverty in a nation, one might first look at the government and economy to try and figure out what is inhibiting the state’s growth. Sometimes though, the hindering factor does not lay within the developing state’s own government or economy, but a neighboring one’s, or perhaps in one with a substantial trade relationship with the state. Many struggling countries establish trade relationships with more economically stable nations to help foster their own economies. When others impose sanctions on these ‘helper’ countries, this can impact how quickly or how much they can still receive these resources. Moreover, sanctions can prevent humanitarian aid.

Sanctions Set Ripples

The U.S. and Iran’s relationship soured following the broken agreement between them regarding nuclear arms. Afterward, the U.S. killed top Iranian general, Soleimani, and imposed sanctions against 18 Iranian banks. The intention was to keep Americans from engaging with the banks. Meanwhile, the U.S. government imposed secondary sanctions on other countries to prevent them from doing business with those same banks.

While the U.S. issued a statement in December 2020 that stated the sanctions would not apply to humanitarian aid, Iran claimed that the U.S.’s sanctions have strained its relationship with South Korea, a U.S. ally. As a result, $7 billion from oil sales is still in South Korea due to U.S. sanctions. Iran claims this money was for humanitarian goods such as COVID-19 vaccines.

Influenced by the U.S. sanctions, South Korea’s relationship with Iran has deteriorated and inhibited the economic relationships, and assumedly others, since the U.S. secondary sanctions on nations engaging with the 18 Iranian banks do not exclusively apply to South Korea.

Effects On Humanitarian Aid

The act of imposing sanctions poses a threat to humanitarian aid in a variety of different ways. The most obvious is if an organization or staff member has sanctions directly or explicitly against them, although this remains hypothetical.

Another threat involves the fear and paranoia surrounding the idea of sanctions. In trying to avoid sanctions, many humanitarian organizations act with more caution than is necessary. As a result, this stringent self-policing ends up making their work less effective, which is counterintuitive to the purpose of humanitarian aid. This is observable in the case of Afghanistan, where groups avoid working in areas where the government does not have control – although that does not mean that people do not require aid there. Therefore, the sanctions directly prevent regions in Afghanistan from receiving humanitarian aid.

Corruption and Sanctions

Studies found a correlation between corruption and GDP, meaning the poorer the country, the more likely it has a high level of corruption. A high level of corruption, on the other hand, harms economic growth, creating a possible cycle of corruption and economic stagnation. However, the graphs and knowledge that experts have presented do not indicate the causality of low GDPs leading to corruption. One cannot say a country is corrupt because it is poor. Since fighting corruption is one of the U.S. Department of Treasury’s priorities, corrupt countries receive more sanctions than their counterparts, damaging the affected nations’ economy even more.

However, this does not only mean that corrupt countries lose money but it also most likely results in people in need receiving less aid. Reducing aid and applying sanctions also means that people have less money and trade options. Countries that receive sanctions may also lose jobs as industries suffer and businesses shutter, leaving the people and humanitarian workers to take the brunt of the consequences that those imposing the sanctions intended for their governments.

Relief International is Helping Iran

Regardless of the sanctions against Iran, Relief International has been working in Iran since 1990 when it emerged to help respond to the Manjil-Rudbar earthquake, the worst national disaster in the country’s history that had a death toll of 50,000 people. From there, Relief International has taken it upon itself to send whatever resources Iran might need, considering that it is a disaster-prone area. In 2019, 12,400 people received assistance from Relief International in the wake of the Nowruz floods. About 11,500 Afghan refugee students enrolled in Relief International’s education programs, while 2,500 were able to increase their income due to Relief International’s job programs. The organization has rehabilitated 27 schools after natural disasters ravaged them.

Avoiding Sanctions

Facing the COVID-19 pandemic, Relief International has prioritized sending medical supplies to frontline healthcare workers in Iran. Items as simple as masks, gloves and hospital coveralls are basic but essential to protecting healthcare workers as they fight on the pandemic’s frontlines. Relief International sent 1,000 kits with protective equipment, such as protective wear, hand sanitizer and shoe covers. Furthermore, it gave 40,000 testing kits to the Pasteur Institute of Tehran. To further help support healthcare workers, Relief International has started an Iran program to produce medical supplies and equipment locally, mitigating the delivery times and logistical hurdles of donating resources.

With mainly focusing on medical components, Relief International can avoid the negative effects that U.S. sanctions cause. However, with the sanctioning of banks, financial aid programs can face more difficulties with these measures and financial transactions to NGOs may only occur after catastrophes. The example of Relief International shows how crucial it is to protect organizations that deliver humanitarian aid. Alternatively, to put it more directly, sanctions can complicate and prevent humanitarian aid and others’ ability to save lives.

– Catherine Lin
Photo: Flickr

COVID-19 in Iran
On December 5, 2020, Iran announced that the national death toll from COVID-19 had surpassed 50,000 people. However, medical experts from within and outside Iran have estimated that the number of Iranians who have died of COVID-19 is at least double that figure. Additionally, they estimate that the nation may be on the brink of collapse from the uncontrolled spread of the virus. A mix of social, political and economic factors have created a unique situation that has made the containment and treatment of COVID-19 in Iran nearly impossible. Medical experts have warned that a third wave would be a destabilizing threat to the nation. Remedying this crisis will require international support and effort at Iran’s federal level to alleviate the burden on frontline workers, increase access to healthcare resources and create a path for Iran to receive an effective vaccine.

A Fertile Ground for an Uncontrolled Spread

An economic depression, onset by U.S. sanctions and government mismanagement, has plagued Iran in recent years. The U.S. has posed various economic sanctions on Iran since 1979, after the storming of the U.S. Embassy in Tehran. As a result, the average purchasing power of Iranian families has decreased, drug and consumer product prices have soared and housing has become unaffordable for many Iranian families.

Economic sanctions do not explicitly ban the sale of pharmaceuticals to Iran. However, the Human Rights Watch reports that many European and American companies, fearing sanctions, are unwilling to sell drugs or pharmaceutical equipment to Iran. This, coupled with the skyrocketing prices of pharmaceuticals in Iranian pharmacies, places the Iranian public at a major health risk. Even before the spread of COVID-19 in Iran, many Iranian families could not afford basic drugs and waited for hours in line at local pharmacies.

The Iranian government made a number of missteps in the early days of the pandemic. These included reluctance to lock down public places when large swaths of the community were contracting the virus, as well as allowing international flights from China to enter Iran as late as January 26, 2020.

Struggling Healthcare Infrastructure

Getting exact figures of infections and deaths from COVID-19 in Iran is not easy due to the country’s opaque governmental structure. Experts estimate that Iran, along with the United States and India, may be among the countries that COVID-19 has hit hardest. This has put immense pressure on Iran’s already struggling healthcare infrastructure, which, according to Iranian health professionals, is reaching a breaking point during a third wave of the virus.

Almost every hospital in Iran now hosts a COVID-19 ward, and nearly every ward is at full capacity. Some hospitals have had to convert cafeterias into makeshift field hospitals to handle the incredible volume of infected patients. With the lack of necessary healthcare resources and staff to handle an ever-increasing number of infected people, several hospitals are unable to effectively administer care to patients, including those hospitalized for reasons other than COVID-19 infection, and are on the verge of collapse.

The Fight for a Vaccine and Maintaining Daily Life

The light at the end of the tunnel for any nation suffering a COVID-19 pandemic is a contract to receive mass quantities of an approved vaccine. Despite economic sanctions, Iran has entered into COVAX, an international organization that aims to allow foreign countries access to coronavirus vaccines. Due to international banks’ reluctance to grant loans to Iran, fearing sanctions from the U.S. government, Iranian officials may have to fly to Geneva to pay directly for an import of the vaccine. Still, Iran obtained a license to take part in COVAX, meaning that planning is underway to get vaccines to Iran.

The Iranian government has stepped up COVID-19 protocol in recent weeks, extending shutdowns that it put in place before the most recent wave. The government hopes that social distancing and stricter protocol will mitigate the spread of the virus. As of December 5, 2020, the Iranian government has put in place:

  • An extension of partial shutdowns in regions that the spread of the virus most affected.
  • A curfew in 278 cities that are not experiencing uncontrolled spread, but are still at risk of mass infection.
  • A mandatory mask rule in all public places.
  • A ban on people with COVID-19 from taking public transportation.

Taking on the New Wave

As a third wave has descended on Iran, the nation faces a set of difficulties that it has not seen since the Persian Famine during World War I. A combination of sanctions, fear of backlash from the international business community and federal reluctance to make strides in containing COVID-19 in Iran have created a unique crisis that threatens that nation’s health and security.

As hospitals face crowding and the price of available pharmaceuticals remains on the rise, Iran is likely to continue to struggle. Stricter and more thorough social distancing protocol, as well as strategic negotiations to obtain a vaccine, could combat the spread of COVID-19 in Iran and put the country on the path to recovery.

Kieran Graulich
Photo: Flickr

Cuts Increase PovertyIn November of 2019, amid sanctions that resulted in extreme inflation, the three branches of Iran’s government announced a fuel subsidy cut. Officials raised the price of gasoline to 15,000 rials/liter (0.5 $/gallon) for the first 60 liters of gas purchased in a month.  The subsidy cut was intended to generate money for about 18 million low-income families. This increase, however, was unwelcome and resulted in protests and a rise in oil smuggling. Interestingly, Iran’s poorest citizens engaged in these protests. Although the goal of the cuts was to raise money for Iran’s poor, the reform disproportionately hurt Iran’s poorest citizens and statistics suggest the cuts have actually increased poverty.

Case Study: Subsidy Cuts in Tehran

When measuring how drastically the cut affected Iranians at an individual level, it can be useful to evaluate the importance of cars to Iranians. For this, consider Iran’s capital city, Tehran. Iran’s average household had 3.5 members and Tehran’s population was about 8.7 million at the cut’s announcement, indicating there should have been ~2.5 million households in the city of Tehran. Yet the city deals with four million vehicles and 17.4 million trips each day. At first, these numbers may seem unusually high. However, Tehran has many commuters.

Those coming from outside the city rely on cheap gasoline to hold their city-based jobs. It is cheaper to live outside the city, so the average commuter is relatively poor compared to those living within the city. Consequently, the poor are often the most affected by the fuel subsidy cut.

Cuts Increase Poverty

The Iranian government claimed the increased price of gasoline would generate an extra 300 trillion rials per year for around 18 million families— or $395 per family. However, the extra rials that each low-income family receives per year was overshadowed by the high levels of inflation and the increased cost of living. In short, the extra rials received under the cut have not supplemented the more expensive gas.

However, only highlighting the cut’s effect on those living near large cities would ignore one of the subsidy cut’s greatest consequences— cuts increase poverty near Iran’s borders. Higher gas prices had immense implications for provinces that border other countries such as Sistan and Baluchistan. Oil smuggling serves as a reliable source of income for citizens living in border regions; this occupation is especially popular today due to high unemployment rates. Experts have even estimated that oil smuggling in Iran is a multi-billion dollar business. Iranian citizens living in these areas travel to Pakistan to sell their subsidized fuel for a profit. Therefore, these Iranians saw lower profit margins with the arrival of the subsidy cut.

Alternative Strategies to Combat Poverty

Some experts believe that tax incentives or increasing law enforcement would decrease oil smuggling in Iran. Alternatively, a Brookings study on youth unemployment programs suggests that improving education systems could serve as a better long-run solution to poverty.

The success of an education-based initiative would depend on collaboration between education-focused NGOs and the government of Iran. Increasing investments in education are likely to strengthen the economic resilience of border communities. Additionally, it has the potential to generate employment opportunities and to eliminate oil smuggling by creating higher-paying jobs. Improving the quality of jobs will lead to higher wages. In turn, this could prevent people from falling into poverty and remove the financial justification for oil smuggling.

Looking Ahead

With an increasingly strained government budget due to sanctions and coronavirus, it may be a long time before Iran reintroduces the previous fuel subsidy. Partnerships between NGOs and Iran’s government will likely have a larger role in reducing poverty. It will be essential for stakeholders to implement future policies that better protect Iran’s poorest citizens.

Enacting policies where the benefits are not instantaneous is difficult but necessary for Iran. Legislators should aim to develop education and employment prospects despite today’s many economic pressures including sanctions and COVID-19. The development will bolster at-risk communities and provide alternatives to illegal, unsustainable jobs such as oil smuggling.

Eliminating poverty will not happen overnight. Iran’s efforts will require patience and trust. In order to absolve the world of poverty, legislators and NGOs alike must maintain an unwavering commitment.

Alex Berman
Photo: Flickr

Medical Advancements in IranIran is a developing country located in western Asia as part of the Middle East. In the past several decades, Iran has accomplished major strides in terms of its health care system and medicine. The following list details only a few of the successful medical advancements in Iran that have been developed within the last decade.

The Health Care System

Iran adopted the Primary Health System in the 1990s, which revolutionized its health care system. Since its initiation, the country’s life expectancy has increased by eight years. This has had positive effects on both their economy and poor communities. Also, Iran has done tremendous work in improving the accessibility of health care. Currently, more than 90% of rural populations have access to affordable health care. Previously, there was a major gap in providing health care to their less populated, rural areas where many vulnerable groups resided.

Local Production

Since the Iranian Revolution in 1979, the country has made initiating the production of locally produced medicines and drugs a priority. Prior to the revolution, Iran relied on imports from foreign countries for about 70-80% of its pharmaceutical ingredients. As of 2018, it is estimated that around 97% of their drugs were locally produced and manufactured.

Focusing on local production boosted Iran’s economy, making the country a major competitor in the world market. It also increased their GDP through the exportation of their locally produced pharmaceuticals. Furthermore, the country has strict regulations in place for importation. Iran both follows American guidelines and creates its own rules, which ensures high-quality, safe products.

Iran’s health minister stated that the country saves around 700 million euros simply by producing their own products. The country can now allocate this money to other necessities, which displays the importance of medical advancements in Iran.

Medical Biotechnology

Biotechnology is the production and development of products by manipulating living organisms. Medical biotechnology has the power to uplift health care systems for countries across the globe. Iran’s advanced health care system has allowed them to become a leader in medical biotechnology across the Middle East and North Africa.

Iran’s boost in local production stems from pharmaceuticals to biotechnology. As of 2012, the country had 12 approved products and 15 more products pending approval. These products placed Iran among the frontrunners of biotechnological production. Other countries now rely on Iran for medical trade. Biotechnology has the potential to produce a multitude of medical advancements in Iran. If the country earns the spot as the leading country of biomedical technology, the benefits for their economy and citizens would be numerous.

New Medical Treatments

Medical advancements in Iran have also led to new medical treatments. The country has developed new, upcoming medicines and treatments in hopes to cure certain diseases. Just this year, a group of scientists announced they developed an herbal treatment for epilepsy, Fenosha, that resulted in successful outcomes during their clinical trials.

Reza Mazloom Farsibaf, the founder of the medicine, stated there is no other medicine that competes with Fenosha. The treatment is non-toxic and has minimal side effects and symptoms. If approved, mass production is expected for Fenosha. The herbal medicine could potentially become a viable option for the 340 million people across the world that require treatment for epilepsy. The country is expected to continue generating products that will further mobilize its position in medicine.

Bolorzul Dorjsuren
Photo: Flickr

US Sanctions on Iran
In a 2018 interview with Stephen Colbert, former president Jimmy Carter said that “sanctions exhaust rulers, and hurt the people.” More recently, the maximum pressure policy on Iran of former President Donald Trump marked a shift from Carter’s view on U.S. sanctions. The Carter Administration did coincide with the collapse of U.S.-Iranian relations. At the time, however, both countries had reasons to be hopeful. Here is some information about U.S. sanctions on Iran amid the novel coronavirus.

The Fall of the Shah and Jimmy Carter

The U.S. was pressuring Tehran to demolish despotism, and the Shah was compliant. The Nixon doctrine, a doctrine that stressed military support for authoritarian proxies as an impediment to the spread of communism, was eroding.

Despite these transformations, shows like “60 Minutes” were exposing the Shah’s human rights abuses. The most salient of these abuses was the SAVAK, a clandestine police and intelligence service devoted to the torture and murder of suspected communists, which the U.S. funded.

Additionally, the shah had more focus on military strength than social and economic reforms. In hindsight, the Iranian revolution and the collapse of U.S.-Iranian relations may seem inevitable. Critics of Carter argue that his failure to save the hostages signaled the death knell of his Administration.

The Obama Sanctions and the JCPOA

Since that time, the chasm between both countries has grown wider. Washington and Tehran have been rapidly heading toward collision; disaster feels imminent. During the Obama Administration, the U.S. imposed sanctions on the sale of oil and the funding of Iran’s nuclear program. The intent was to bring Iranian officials to the negotiating table.

In 2012, Obama deemed the “grinding” of the Iranian economy a success. During this time, the value of Iran’s currency plummeted. From 2011-2012, the rial lost 38% of its value, deterring many corporations from doing business with Tehran and plunging the economy into economic isolation.

In 2015, the P5+1—the U.S., Germany, China, Russia, France and the U.K.—reached an agreement that would ease U.S. sanctions on Iran in return for restrictions on its nuclear program. This agreement became known as the Joint Comprehensive Plan of Action (JCPOA) or colloquially as the nuclear deal. The International Atomic Energy Agency praised the deal. CIA director, John Brennan, and former national security advisor, Zbigniew Brzezinski, voiced their support for it.

Trump’s Withdrawal from the JCPOA

In 2018, President Trump withdrew from the JCPOA, famously calling it the “worst deal ever.” Critics of the deal argue that in spite of the deal Iran continues to provide support to various terrorist proxies, such as Hezbollah, the Houthis and the Badr Corps, in addition to the Assad government. As Iran’s sphere of influence burgeons in the Arab world, Tehran draws nearer to the Saudi Kingdom’s sphere of influence. Saudi Arabia has been an ally of the U.S. since World War II. Critics of the deal also contend that a sunset clause will leave open the possibility of Iran continuing its nuclear program in the future.

Now, after pressuring the U.N. to multilaterally reimpose sanctions, the Trump Administration has prolonged the arms embargo previously scheduled to end on Oct. 18, 2020. The administration has also reinstated U.S. sanctions on uranium enrichment and ballistic missile development.

The Impact of the Sanctions on Iran’s Coronavirus Response

As the value of the rial continues to dwindle and inflation continues to soar, the price of food and medicine is skyrocketing. In addition, U.S. sanctions have impaired Iran’s ability to afford humanitarian supplies amid the novel coronavirus. Relief International is providing tens of thousands of masks, coveralls and test kits to frontline workers, as well as giving thousands of hand sanitizer bottles to Afghan refugee camps in Iran to mitigate this dire situation. At the moment, the death count in Iran due to COVID-19 is over 60,000.

Conclusion

U.S. sanctions impinge on Iran’s response to the novel coronavirus. From the revolution until now, amicability between Iran and the U.S. has deteriorated. The Iranian people are the victims of this decay. Today, the Iranian economy is suffering from the novel coronavirus, while Iranian and U.S. officials continuously make accusations toward one another.

Blake Dysinger
Photo: Flickr

Healthcare in Iran
The Islamic Republic of Iran is an ancient country with a special geostrategic location in the Middle East and West Asia. Iran throughout its history has faced revolutions, wars and periods of instability that might make people believe that its healthcare system is underdeveloped. Additionally, sanctions from the West have had a direct effect in the medical field, specifically in the access of certain pharmaceuticals. Nevertheless, in the last decades, Iran’s motivation to improve the healthcare infrastructure has resulted in surprising figures and has contributed to rural poverty alleviation. Today, Iran’s healthcare system includes both public and private facilities and services. Here are eight facts about healthcare in Iran.

8 Facts About Healthcare in Iran

  1. Healthcare is a constitutional right. After the 1979 Revolution, Article 29 of the Constitution of the Islamic Republic of Iran established that every Iranian citizen has a right to enjoy the highest attainable level of health. The Ministry of Health and Medical Education is responsible for providing the enjoyment of this right by designing and implementing coordinated health policies and plans at a national level.
  2. Iran’s health investment has increased significantly in the last 10 years. The country’s focus on expanding and improving its healthcare system is evident. In 2014, when initiatives had already started, the health expenditure was 6.89%. By 2017, it increased to 8.7% out of a Growth Domestic Product of $1.64 trillion. Comparing this figure to a Western country to place it in context, the United Kingdom’s health expenditure that same year was 9.6% out of a GDP of $2.93 trillion.
  3. Public facilities are the main provider of healthcare. During the 1980-1988 war with Iraq, the Islamic Republic of Iran was in miserable conditions and it was difficult to visualize progress in the Iranian health system, especially the access of health services to rural areas. Nonetheless, the Iranian government has made many efforts to reduce rural poverty, extend the healthcare structure through health houses and provide primary, secondary and tertiary services, especially to rural areas. Today, more than 90% of Iran’s 23 million rural population has access to free healthcare services such as prenatal care and vaccination.
  4. Health houses are the principal access point for rural residents to receive health services. Health houses are small public medical facilities that provide health services to the rural areas surrounding them. Generally, trained medical workers that manage vaccinations, maternal health care and child health care integrate these facilities. There are approximately 17,000 health houses in Iran or one for every 1,200 residents. Health Houses have had a tremendous impact on Iranian rural societies since they have improved the health infrastructure and reduced the distance that people need to travel to receive medical care. Health Houses have become an efficient and cost-effective healthcare network that has met the needs of rural communities that can sometimes experience neglect.
  5. Urban residents can choose between public and private services. In 2016, there were 773 hospitals in Iran, which is one for every 92,100 residents. These are located mainly in cities, so urban residents have the advantage of having access to specialized healthcare. Additionally, the private sector plays an important part in the healthcare provision, focusing principally on secondary and tertiary health services in urban areas. Urban residents can decide between public and private facilities, even if the private sector tends to offer higher quality care, it is still more expensive.
  6. The urban-rural disparity has declined significantly. The country has almost eliminated basic public health indicators, such as the neonatal mortality rate, infant mortality rate and maternal mortality rate. Four decades ago, the urban-rural disparity was significant due to inadequate coverage of the population and general instability. In fact, in 1974, the infant mortality rate in urban areas was double the rural numbers with 76 versus 130 per 1,000 inhabitants. By 1996, the indicators were almost identical with 27.7 versus 30.2 per 1,000 inhabitants. The Health House system, which has permitted access to improved healthcare around the national territory, has softened this gap dramatically.
  7. There are many non-Governmental organizations (NGOs) active in health issues in Iran. Many NGOs are operating inside the Iranian territory offering care for more specialized issues like childhood cancer, breast cancer and diabetes. MAHAK, for example, is a nonprofit, non-political and non-governmental charity that works toward the reduction of pediatric cancer by offering comprehensive and advanced treatment services to children with cancer and their families. In 2007, MAHAK established a Pediatric Cancer Hospital that by 2014, had diagnosed and treated over 23,000 cancer-stricken children; today, this hospital plays a major role in the region for its access to the latest technology of the field. Additionally, the Ministry of Health and Medical Education supervises and supports the NGOs’ efforts to help them obtain the necessary permits in providing medical care to the Iranian population.
  8. Medical tourism has boosted in the country. Another of the facts about healthcare in Iran is that it has become a leading country for medical tourism in the region. Many people travel to the country for its high-quality health services and advanced equipment and affordable medication and treatment compared to other countries of the region. In 2016, around 100,000 travelers visited Iran to receive medical treatment that varies from rhinoplasty to infertility treatments. Every year, healthcare in Iran is growing and calling for more patients from regional countries due to its expanded system and infrastructure.

Despite the challenges in the fields of sustainability of resources and health governance, these facts about healthcare in Iran show that it is exceptionally modern in different ways. Overall, Iran has managed to improve health indicators, reduce the urban-rural gap and develop a system that grants basic healthcare to almost every geographic area in the territory. These efforts have improved the quality of life, contributed to the development of human capital and played an important role in helping rural areas alleviate poverty and health insecurity. In recent years, Western sanctions have made it more difficult, but still, Iran’s health-related figures have improved dramatically and health expenditure has increased. Thus, Iran is becoming a leading nation in the region for its healthcare system because many consider it a secure destination for patients from countries nearby.

– Isabella León Graticola
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Healthcare in IranIran, officially recognized as the Islamic Republic of Iran, has a population of more than 84 million. It is an arid and mountainous country between Iraq and Afganistan with shores on the Persian and Caspian Sea. Iran is the 17th largest country in the world. Healthcare in Iran has improved since the implementation of the Primary Health Care system, but there is still a divide between rural and urban access.

In 1974, Iran began fueling more resources into the expansion and development of its healthcare system. The government hoped that implementing Primary Health Care (PHC) would improve citizens’ access to healthcare in Iran. By 1979, PHC networks slowly began integrating into healthcare in Iran. It wasn’t fully developed and functioning until 1985.

Rural and Urban Divide

Since the Iranian government created a PHC, it has continued to expand healthcare. Currently, Iran has public and private systems; however, public healthcare has taken on the main role in healthcare services. Unfortunately, there continue to be disparities between rural and urban access. Rural citizens obtain healthcare services at health houses that are scattered across Iran’s countryside. These places generally have two working medical professionals with basic equipment to meet standards needs for nearby residents.

There is approximately one health house to care for the needs of 1,200 rural citizens. These centers offer general healthcare needs, such as vaccinations, maternal and child health and health education. As of 2018, around 90% of those in rural areas had access to basic health services. Although these health houses didn’t provide the same care as urban hospitals it did increase the access to health services for those living in rural areas. Those in rural communities did not have to venture into urban cities for their basic healthcare needs or checkups.

At least 75% of the population lives in urban areas and cities. Here, they have access to Iran’s private and public hospitals. There are 773 hospitals in urban areas in Iran. This is where advanced medial professionals reside and specialized treatment is available for the citizens. However, even in urban areas hospital infrastructure is lacking.

Reconstructing Healthcare in Iran

In May 2014, healthcare in Iran entered a major reconstruction period as the Iranian Ministry of Health and Medical Education (MoHME) began implementing its new Heath Transformation Plan (HTP). The new plan involved nine packages to reform the current healthcare system, including improved access and quality of healthcare and increasing the number of specialized doctors. These improvements have since provided healthcare to almost 10 million Iranians in “marginalized areas” throughout Iran. The program also rehabilitated 13,000 existing health centers and built 3,000.

While there continue to be disparities in healthcare access between rural and urban areas. Iran has continued to increase its expenditures for healthcare services and create programs like the Heath Transformation Plan. This has helped healthcare in Iran to continue on the path of growth and development while allowing Iranians to have more confidence in their countries healthcare system.

George Hashemi
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