A patient lies for her heart scan at the Shariati hospital, in Tehran, Iran. (Vahid Salemi/AP)

The tightening of U.S. banking sanctions against Iran over its nuclear program has had an impact on all sectors of the economy but is increasingly hitting vulnerable medical patients as deliveries of medicine and raw materials for Iranian pharmaceutical companies are either stopped or delayed, according to medical experts.

The effect, the experts say, is being felt by cancer patients and those being treated for complex disorders such as hemophilia, multiple sclerosis and thalassemia, as well as transplant and kidney dialysis patients, none of whom can afford interruptions or delays in medical supplies.

Milad, an 8-year-old Iranian boy suffering from severe hemophilia, lives in Kuhdasht, a town 400 miles southwest of Tehran, and relies on injections of a U.S.-made treatment, Feiba, which is no longer available locally in large enough quantities.

His parents took him on the 12-hour bus journey to the capital hoping to find supplies of the vital medicine but were given enough for only two days. The boy is now at risk of losing the use of his right leg and is suffering continuous nose bleeds that could be life-threatening.

“I am really worried. My son’s life is at risk,” said Afsaneh, his mother. She says she does not know which countries have imposed sanctions on Iran but believes “no human beings can be so brutal to patients.”

The government of Mahmoud Ahmadinejad says international sanctions have had little impact on the country and insists that its nuclear program should continue. It has launched a public relations campaign stressing that 97 percent of Iran’s medicine is produced domestically — a clear attempt to prevent panic that medical supplies could be at risk.

However, Ahmad Ghavidel, head of the Iranian Hemophilia Society, a nongovernmental organization that assists about 8,000 patients, says access to medicine has become increasingly limited and claims one young man recently died in southern Iran after an accident when the blood-clotting injection he needed was not available.

“This is a blatant hostage-taking of the most vulnerable people by countries which claim they care about human rights,” Ghavidel said. “Even a few days of delay can have serious consequences like hemorrhage and disability.”

Health analysts say that although the volume of imports affected may be small in percentage terms, the products that are involved are vital for chronic diseases for which domestically produced replacements either do not exist or are not as effective.

Iran’s pharmaceutical factories are said by health analysts and medical importers to be dependent on imports from Western countries, as well as China and India, for more than half of their raw materials.

The U.S. Treasury’s Office of Foreign Assets Control (OFAC) has made “the commercial exportation or re-exportation of food and medicine to Iran . . . subject to licensing requirements,” while most goods and technologies in other sectors are banned.

However, even those with a license report problems. Importers say that despite resorting to various more expensive financial channels, such as changing from one European bank to another or using middlemen and unofficial transactions, medicine does not arrive on time or in sufficient quantities.

“We hold a license from the OFAC, but our imports have dropped by more than half while we pay much more than before,” one importer said.

“The exemption of medicine from sanctions is only in theory,” said another. “International banks do not accept Iran’s money for fear of facing U.S. punishment.”

Hengameh Ebrahim-Zadeh, of the Tehran Province Thalassemia Association, an NGO, says patients — estimated to number about 20,000 across the country — now receive enough medicine to cover just a few days of their monthly needs.

She said she knows of four deaths in Tehran over the past month that were a result of the shortage of medicine for thalassemia patients.

Kidney dialysis and transplant patients suffer from similar problems. Daryoush Arman, an adviser to the Iran Charity Association to Support Kidney Patients, an NGO that helps about 65,000 people, said those patients who are prescribed imported medicine by their doctors are struggling. However, he added, “the biggest challenge” lies ahead, as a shortage of dialysis and transplant equipment is likely to worsen.

Many Iranians fear they will face similar shortages for treatments of more common diseases when stocks of medicines are depleted.

But for Afsaneh, Milad’s mother, the concern is more immediate as she keeps an eye on her son’s leg. “His right leg has become softer since this morning thanks to the injection,” she says. “I have to go back to the pharmacy tomorrow to see if I can get more Feiba. Milad’s life is bound to Feiba.”

— Financial Times