“It means our hands are tied,” said Nasrin, a doctor at a government-run hospital in the central city of Shiraz. “We’ve been given a list of over 120 drugs that we are not to prescribe, because we simply don’t have them.”
Nasrin said that drugs to treat heart problems, diabetes and cancer are particularly scarce. Like others interviewed for this story, she gave only her first name because of the sensitivity of the issue.
While there is an ample supply of over-the-counter drugs and pharmacy shelves are still well-stocked, patients suffering from more serious conditions are increasingly unable to get treatment for their illnesses.
The scarcity derives from a complicated set of circumstances that includes both a heavy dose of Western sanctions, which are aimed at forcing Iran’s leaders to halt their uranium-enrichment program, as well as what critics here say are missteps by the government. While some of the anger over the shortages has been directed at the United States and other global powers, there has also been an internal backlash.
Hosseinali Shahriari, the head of parliament’s health committee, said this month that “the government is playing with our people’s health and is not assigning the approved finances.”
Shahriari noted that the cost of chemotherapy has quadrupled in just the past year, and is now approximately $67,000 — out of reach for all but the wealthiest Iranians. “Practically speaking,” he said, “we have to tell a majority of such patients to go and die.”
The health-care crunch comes as Iranian officials debate whether to pursue a deal with the United States that would involve nuclear concessions in exchange for an easing of the sanctions.
Iranians have demonstrated a resilience to the impact of sanctions in many sectors of the economy. But Iranians have grown accustomed to receiving highly subsidized medical treatment from the government, and they hold authorities responsible for rising prices or unavailable medicines.
At the start of each year, Iran’s annual budget is submitted by the president’s office to the parliament, which amends and ultimately approves cash allotments to be paid by the central bank to various state ministries.
With oil exports down and Iran’s ability to conduct international financial deals severely hamstrung, the bulk of those funds have not been delivered by the central bank this year. As a result, the health ministry has received only a fraction of its budget, and care has suffered.
Under normal times, the funds are distributed to state-run hospitals and companies with licenses to import medical equipment, supplies and pharmaceuticals.
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