National security and regional stability have dominated the political debate over the Iran nuclear accord in recent weeks. Less discussed, however, are the far-reaching, positive implications for public health that will come when sanctions are lifted, as the deal calls for, and Iran’s medical system can begin to cooperate with the West again.
Sanctions for several years have severely restricted access to life-saving medicines for patients in Iran, leading to serious health consequences. Although the US government introduced loopholes to bypass these sanctions for medical purposes, the loopholes have not worked properly and lives have consequently been lost. With the nuclear agreement in place, thousands of Iranians will once again receive treatments for diseases like cancer and hemophilia.
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Yet the calming of political tensions will have broader impact than just inside Iran. Since the revolution of 1979, Iran has been at the forefront of advancing primary medical care for rural populations through a system of robust health networks, which comprises more than 17,000 rural health facilities and a health center for every 7,000 rural residents. This network’s success even drew the interest of public health experts in Mississippi, who collaborated a few years ago with colleagues at Shiraz University of Medical Sciences in Iran to reduce health care disparities between rural and urban parts of the state. Iran has also launched advanced intervention programs for drug users and is home to two out of three HIV surveillance and treatment knowledge hubs for the Eastern Mediterranean region office of the World Health Organization. These hubs are in charge of knowledge transfer to other countries in the region.
Iran’s vast potential to enhance global health is significantly underutilized right now. For example, since 2013, we have trained local ophthalmologists in Tajikistan to treat the main causes of avoidable blindness through a US-based nongovernmental organization. When we sought ophthalmologists who could provide training in Tajikistan, it was only natural to consider enlisting the expertise of Iranian colleagues. Iran, a neighbor of Tajikistan, is home to several reputable training sites sponsored by the International Congress of Ophthalmology. Iranian physicians speak the language and know the culture of Tajikistan and other countries in the region. They are also less expensive to hire than their American counterparts. But current restrictions make even these small-scale collaborations virtually impossible, despite their clear humanitarian purpose.
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Under the sanctions regime, only in rare situations when special permits have been granted through the US Department of Treasury have collaborative projects become a reality. One example is our partnership between the University of California San Francisco and Tehran University of Medical Sciences, to study substance abuse and blood-borne infections in Iran, a project that is being supported by the National Institutes of Health. This research not only advances knowledge about deadly diseases in Iran, but also yields valuable information that could directly be applied to other countries with similar public health challenges including the United States. Securing the permit to launch this work required extensive administrative resources and took nearly a year, adding a great deal of unnecessary complexity. Even once the project was approved, the slightest modifications required amending the permission.
With the Iran deal in place, collaborations like this could be dramatically scaled up. Research shows that improving the health of disenfranchised communities increases their economic productivity. In today’s globalized economy, this growth can “trickle up” and reverberate through different parts of our globe including the United States. Strengthening partnerships with countries like Iran also bolsters our national security through the control of infectious disease outbreaks like Middle East Respiratory Syndrome, or MERS, and Ebola, which started in West Africa but found its way to our shores.
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These proposed health partnerships transcend political ideologies and improve lives from villages in Tajikistan to small towns in Mississippi. But their success depends on the durability of this nuclear agreement. Iran and America do not see eye-to-eye on many political issues, and the current accord will not change that. But support for this agreement can pave the way toward a shared global responsibility to make the world a healthier place.
Dr. Ali Lotfizadeh is a visiting scholar at UCSF School of Medicine’s Institute for Health Policy Studies. Dr. Mohsen Malekinejad is an assistant professor in the same program.