Tens of thousands of people in Iran are suffering from numerous diseases whose treatment lies in the lifting of sanctions on the Islamic Republic, as the punitive measures are preventing pharmaceutical companies from entering the Iranian market due to fears of sanctions.

The issue at hand is thalassemia, a disease that has swept the southern province of Sistan-Balochistan, killing children despite not being an inevitably fatal condition; its treatment is quite simple. All a patient needs is regular blood transfusions and oral medications that remove the excess iron build-up in the body.

The Intercept reported on the catastrophe that Iran is facing, highlighting one case in particular: 10-year-old boy Amir Hossein Naroi, whose life was taken from him at such a young age to the medicine he required not being available in the Iranian markets in recent years.

Naori, like many other thalassemia patients in Iran, was taking Desferal, a specialized drug manufactured by Novartis, a Swiss company that succumbed to the sanctions imposed in 2018 by the United States under then-President Donald Trump, who heavily sanctioned Iran after withdrawing from the 2015 nuclear deal.

Maximum pressure policy

The harsh sanctions, known as part of the "maximum pressure" campaign waged by the US against the Islamic Republic, caused the supplies of the iron-chelating drugs to dwindle, alongside many other drugs aimed at helping against numerous medical issues.

In Naroi's case, Trump's maximum pressure campaign, which was upheld by his successor Democrat administration, caused his organs to start failing due to complications as of the summer of 2022. His organs were also heavily damaged due to the excess iron in his blood; this all culminated in his terrible death at a hospital, surrounded by his family and medical staff that could not do anything to help him due to the lack of medicine.

The US foreign policy is ultimately causing the problems suffered by Iranians, multinational corporations providing drugs to Iran and banks acting as intermediaries for attempted purchases said, according to documents obtained by The Intercept.

The debacle has put the US government in the limelight: It is facing a lawsuit from the NGO, Iran Thalassemia Society. The Iran-based NGO is arguing that thousands of Iranians were killed or sustained injuries due to the sanctions imposed on the country despite the US claiming that humanitarian trade would be exempt from sanctions.

However, the comprehensive sanctions on the Iranian banking sector caused foreign companies to be too afraid of trading with Iran out of fear of sanctions.

"The American government has said that they will consider some exceptions for humanitarian aid, but in practice, we have seen that there are no exceptions," staff attorney at the Iran Thalassemia Society Mohammed Faraji said.

Companies not willing to trade with Iran

The Intercept reported that it got its hands on documents showing that numerous companies appeared to be hesitant when it came to trading with Iran because they did not want to suffer from the sanctions that they might be subjected to if any transaction takes place, meaning that even life-saving medication was cut to the country because the parties that would supply them would not want to risk getting sanctioned.

Today, one can easily see how sanctions are more than prevalent in Iran: nearly all aspects of civilian life is hit by some sort of sanction. This marks a victory for sanction-hungry anti-Iranian lobby groups, such as the Unite Against Nuclear Iran think tank, a notoriously pro-Israeli organization, as well as the Foundation for Defense of Democracies. This "victory" has rendered Iran a vehemently isolated and sanctioned country.

It is worth noting that Iran, despite the international sanctions campaigns it is facing, is still rising above the punitive measures and developing its many vital sectors, including the health and industry sectors. 

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Letters between Iranian importers, drug companies, and mediator banks revealed a grim reality about trade with Iran. "Despite the fact that Coloplast products are not excluded by US and/or international export control sanctions, we now face a situation, where the international banks have stopped financial transactions with Iran. Under current conditions, it is not possible to receive money for products sold in Iran," Danish urology products manufacturer Coloplast told its Iranian distributor in September 2018.

Another disease that foreign firms could help with but are not is epidermolysis bullosa, an inherited disease that causes painful blisters and sores that would require a special kind of bandage that Swedish firm Mölnlycke used to supply to Iran but stopped due to sanctions.

The sores require specialized wound dressings to avoid the skin getting torn off upon changing the bandages.

UN experts back in October 2021 warned that over-compliance with US sanctions could strip Iranians of their basic health rights. The experts cited sufferers of the rare skin disease as an example.

"Many banks and businesses, including pharmaceutical and medical companies around the world, over-comply with sanctions out of fear of potential penalties," said the experts in a statement.

Even bandages not exempt

Children and patients of EB have been unable to access a certain type of bandage that provides vital relief and prevents life-threatening infections, with special UN rapporteur Alena Douhan reaching out to the Swedish firm and government to address what has been described as "shortfalls in the due diligence processes applied to ensure that no human rights are violated."

Despite pharmaceutical and medical equipment not falling under international sanctions, the US nevertheless prevented Tehran from using the international payment systems, leading it to suffer from a shortage of drugs needed for the treatment of nearly 30 illnesses, including cancer.

The sanctioning of these supplies has at times led to desperate workarounds by foreign governments, including a 2020 attempt by the German government and UNICEF to purchase and deliver a shipment of the specialized bandages to Iran as doctors have been forced to rely on indigenously-made equipment to help ease the crises facing the country.

Patients suffering from thalassemia were forced to use Desfonac, a locally-produced medicine that is less effective at combating the illness. Further communications obtained by The Intercept dating back to 2018 revealed that local Novartis representatives told the Iranian parties that the company was experiencing difficulties making transactions with the country due to banking sanctions. 

Local organizations said the sanctions on the baking sectors said this moment in time was the beginning of the end of their stead access to thalassemia drugs that must be regularly administered to patients in order for the treatment to be effective.

"We have documented at least 650 people who have died since 2018 when we stopped being able to import medicine and over 10,000 who have had serious complications," the head of the Iran Thalassemia Society, Younus Arab said.

The Swiss company underlined that "the problem created by sanctions is less an unwillingness to do business with Iran over legal fears than an inability of Iranian officials to access their own foreign currency reserves to make payments," The Intercept reported.

Iran's foreign reserves are frozen, with its accessible assets dwindling from $122.5 billion pre-sanctions to just $4 billion, IMF figures show.

Counter-productive sanctions

The sanctions on the banking sector were part of the Trump-era blanket sanctions that practically paralyzed any Iranian trade with international partners, especially as they prevented Iran from accessing its own foreign reserves, with secondary sanctions further undermining international trade for the Islamic Republic.

Secondary sanctions practically mean that any banks or companies that trade with Iranian institutions would risk getting sanctioned or prohibited from doing business in the United States.

The United States claims that the sanctions imposed on Iran come in light of the country's "human rights abuses" and its nuclear program, but the sanctions at hand did nothing but undermine the country's middle class and deprive people of their right to basic necessities, such as medicine and drugs used to treat Iranian patients.

As far as one can tell, the US sanctions never seem to affect the 'political elite,' which Washington paints to be the target of said sanctions. Instead, these sanctions riddle the target country with numerous economic, financial, and humanitarian crises.

Countries hit by US sanctions often suffer from inflation, are pushed to the brink of famine, and are put in dire need of humanitarian assistance, rendering them carrion for the US IMF hawks. Ultimately, these sanctions only affect the country's people rather than the alleged 'target.'