1. Iranian doctors are bravely fighting #COVID19 and Iran's overall response is improving. But inventories of key medicines and equipment are running dangerously low. @TehUofMed professor Abbas Kebriaeezadeh and I explain why in @ForeignPolicy.
foreignpolicy.com/2020/03/03/ira…
foreignpolicy.com/2020/03/03/ira…
2. We tend to think of Iran as an isolated country but #COVID19's arrival and subsequent spread suggest otherwise. The combination of Iran’s physical interconnectivity and its relative political and economic isolation pose unprecedented challenges for international public health.
3. Iran is in the throes of a major, fast-developing public health crisis. One consequence is extraordinary demand for medical treatment and therefore extraordinary demand for medicine, respiratory masks, contamination suits, disinfection equipment, etc.
4. Iran meets its typical demand for these items through a combination of imports and domestic production. Now sanctions are jeopardizing the ability to replenish inventories. Doctors are seeing the early signs of shortages. See @JZarif's acknowledgement:
5. The sanctions impact comes in two forms. First, sanctions made Iran unusually dependent on regional hubs for trade. Goods and raw materials come via the UAE and Turkey. With countries restricting travel, Iran's normal routes of trade via third countries are being cut.
6. One example of this is that the @WHO needed to charter a military transport from the UAE in order to make a simple cargo delivery to Iran from Dubai to Tehran, a destination where few airlines fly even in normal times.
7. The second sanctions impact is the inflexibility in Iran humanitarian trade. It takes weeks, if not months, to prepare the documentation for the sale of any goods to Iran, even those that are sanctions-exempt. Without that documentation, banks won't touch the transactions.
8. This is especially true for situations where the items are not typical humanitarian goods (eg. respiratory masks or body suits) and where the customer is the Government of Iran. So Iran needs good urgently, but it can't easily reach out to new suppliers.
9. This is why the recent move by the E3 to send medical equipment to Iran and provide additional emergency funding to the WHO is commendable. But the move is a stop gap at best.
gov.uk/government/new…
gov.uk/government/new…
10. That's because the sanctions challenges extend to the importation of raw materials for the medicines and items Iran makes domestically. For example, Iran produces most of the antiviral medication it uses. But the raw materials come from China and India.
11. Iranian doctors are no longer worried that their government doesn't take #COVID19 seriously. The response to becoming more organized and robust. But they are increasingly worried that in a few weeks time they will run out of the tools to stem the outbreak and treat the sick.
12. Iran’s experience with #COVID19 offers a cautionary tale about the intersection of sanctions policy and international public health. The economic vulnerabilities that sanctioning countries seek to create in target countries never exist in true isolation.
13. As Dr. Kebriaeezadeh pointed out to me as we were preparing this draft, just as a virus will attack the most vulnerable members of any given population, the coronavirus is now attacking the global health system at its most vulnerable points—before spreading everywhere else.
