Follow us on social

Shutterstock_1669427956-1-scaled

Trump’s quiet war against civilians in Iran continues amid the pandemic

While the administration piles on more sanctions, real stories from inside Iran show how much ordinary people are suffering under their weight.

Analysis | Washington Politics

With people in Iran already suffering from the COVID-19 pandemic and crippling U.S. sanctions, the Trump administration earlier this month unveiled yet another set of sanctions that could restrict Iranians’ access to food and medicine even further.

This move has gone largely unnoticed in the United States, with the first presidential debate passing without mention of Trump’s disastrous “maximum pressure” policy on Iran. But for Iranians, it is impossible to ignore.

As the world confronts the global COVID-19 pandemic, economic crisis, and the longstanding struggle for racial justice, American officials are denying Iran’s residents the right to health and access to medications and medical supplies by imposing new rounds of racist and violent sanctions. While the Trump administration has thoroughly failed to protect Americans from COVID-19, Trump’s withdrawal from the Iran nuclear deal and re-imposition of open-ended economic sanctions in 2018 has expanded his destruction of the “right to health” beyond U.S. borders.

“Although my death is not free for my family either, it is certainly cheaper to die rather than live,” says Nasrin, my 31-year-old friend suffering from Sjogren's syndrome and cystic fibrosis. She cannot find her prescribed medicines in Mashhad, the second-most-populous city in Iran. Further, even if she could have found her medications on the black market, she was unable to afford them as their prices have quadrupled in the past two months due Iran’s the dramatic currency depreciation.

In 2015, 90 percent of Iranians were enjoying universal healthcare coverage, subsidizing the majority of medications at 70 percent, covering 90 percent of public hospital costs, and 100 percent of treatment expenses for all rare diseases. However, unsustainable financial resources and the loss of export revenue, the primary goal of financial and trade sanctions, have contributed to about a 40 percent decrease in government budget and a 25 percent decrease in its healthcare budget for the previous Persian Year of 1398 (March 2019-2020).

Data by the World Bank and the Central Bank of Iran has revealed that people’s mental health is severely impacted when sanctions are imposed. While economic sanctions have not changed the behavior of Iran’s government until now, they have significantly restricted the collective economic capability of the nation and widened the country’s health gap. As a result, Iran’s residents are becoming poorer and poorer on a daily basis which increases the “risk of mental illness through heightened stress, social exclusion, malnutrition, violence, and trauma.”

In a recent publication, U.N. experts, along with many activists and scientists have stated that sanctions are silent weapons of mass destruction during the COVID-19 pandemic and that U.S. humanitarian exemptions are not working. In short, civilians in Iran have no room to breathe under the catastrophic and life-threatening economic blockade.

Due to the intentional complexity and vague essence of humanitarian exemptions, non-U.S. companies and aid organizations are also prevented from assisting the population. Fear of legal issues and trade barriers has resulted in over-compliance with sanctions. A Human Rights Watch report has indicated that foreign pharmaceutical firms are no longer willing to have trade relations with Iranian companies and banks, preventing Iran from importing their medicines. Additionally, an international lawyer has revealed that the treatment of brain tumor patients in Iran is suspended due to the inaccessible cobalt resources. 

Without access to a functional channel for financial transactions to purchase and import medications, there is no way left but to rely on domestic products. However, sanctions restrict domestic production as well. 

Hamid, my fellow university student at Notre Dame, called me last week and asked if my friends in Tehran could find triptorelin, or Microrelin, a medication used for treating cancer patients. Hamid’s 36-year-old sibling, Hamed, lives in Isfahan, the third-largest city in Iran, and cannot find his medication in the whole of the Isfahan Province. Neither could I, and Hamed was left with no choice but to go with the domestic substitute, although his body reacted badly and rejected it. 

Iran's inability to purchase Active Pharmaceutical Ingredients, or API, from mass-producing companies mostly located in China and India is the main explanation for the shortages of many domestically produced medications, experts say. API are the necessary component of the formulation phase in drug-producing procedure, meaning that Iranian pharmaceutical companies are no longer able to produce any “drug-like” compounds. Accordingly, a variety of conventional medicines are not produced anymore such as Ergotamine-c, used for migraine headaches; Cinnarizine, an antihistamine and anti-vertigo medication; Clomipramine, prescribed for medium to severe OCD; and Insulin. 

Among 8 million people diagnosed with diabetes in Iran, 65-year-old Ehteram, a patient of a friend who is a clinical pharmacist, has been on Insulin pen injectors for the past few years. However, her medical device could not be found for 10 days, forcing her physician to change her medication to a vial dosage form. Instead of painless, easy to administer shots with fewer adverse effects, she had to use a syringe and two different types of vials. Living alone in her tiny apartment in downtown Tehran, it took only two days until she was rushed into the hospital with progressive loss of consciousness because of unintentionally administering too much Insulin. Though Ehteram survived the completely avoidable ordeal, she lost her eyesight and both legs.

According to a local pharmacist, the inability of Iranian companies to import drug coating materials is another barrier. Additionally, U.S. sanctions prevent Iranian manufacturers from repairing or replacing drug-production equipment when it breaks down.

Historically, economic sanctions, which are a form of economic warfare, have been a pathway to major conflict and even full-scale war in Iraq, Syria, and Libya. There is no remaining doubt that quiet — but no less deadly — war against civilians in Iran is proceeding as a result of Trump’s failed policies. 

In a just and democratic society, we have a responsibility to keep our politicians and representatives accountable. While millions of Iranians will not be repaid for their lost health and lives, the opportunity to change the future of America’s relationship with Iran and its people does exist. Now is the time to end antagonistic and violent U.S. policies, abolish sanctions regimes, return to the nuclear deal, and take the diplomatic path toward multilateral peace agreements and development plans in the Middle East that truly benefit the human rights, health, and prosperity of ordinary people instead of the military-industrial complex.

Names have been changed to preserve subjects’ safety and anonymity.


Photo: Amir Mardani via shutterstock.com
Analysis | Washington Politics
Somalia
Top image credit: U.S. forces host a range day with the Danab Brigade in Somalia, May 9, 2021. Special Operations Command Africa remains engaged with partner forces in Somalia in order to promote safety and stability across the Horn of Africa. (U.S. Air Force photo by Staff Sgt. Zoe Russell)

Why the US can't beat al-Shabaab in Somalia

Africa

The New York Times reported earlier this month that recent gains by al-Shabaab Islamist militants in central and southern Somalia has prompted a debate within the State Department about closing the U.S. Embassy in Mogadishu and withdrawing most American personnel. At the forefront of some officials’ minds, according to the Times, are memories of recent foreign policy fiascos, such as the fall of the Afghan government amid a hasty American withdrawal in 2021.

There are good reasons to question why the U.S. has been unable to defeat al-Shabaab despite nearly 20 years of U.S. military involvement in the country. But the scale of the U.S. role is drastically different than that of Afghanistan, and the U.S. cannot necessarily be described as the most significant external security actor on the ground. At the same time, the Trump administration has given no indication that it will scale down drone strikes — meaning that the U.S. will continue to privilege military solutions.

keep readingShow less
Hegseth Guam
Top photo credit: Secretary of Defense Pete Hegseth departs Andersen Air Force Base, Guam, March 27, 2025. (DOD photo by U.S. Air Force Madelyn Keech)

Hegseth goes to 'spear point' Guam to prep for war with China

Asia-Pacific

The Guam headlines from the recent visit of the U.S. secretary of defense are only part of Secretary Hegseth’s maiden visit to the Pacific. It is Guam’s place in the larger picture - where the island fits into U.S. strategy - that helps us understand how the “tip of the spear” is being positioned. Perhaps overlooked, the arrangement of the “Guam piece” gives us a better sense not only of Guam’s importance to the United States, but also of how the U.S. sees the larger geopolitical competition taking shape.

Before he landed on Guam, the secretary of defense circulated a secret memo that prioritized U.S. readiness for a potential conflict with China over Taiwan. At the same time, it was reported that U.S. intelligence assessed that Guam would be “a major target of Chinese missile strikes” if China launched an invasion of Taiwan.

keep readingShow less
Pope Francis' legacy of inter-faith diplomacy
Top image credit: Pope Francis met with Grand Ayatollah Ali Al-Sistani, one of the Muslim world's leading authorities on March 6, 2021 in Najaf, Iraq. (Vatican Media via REUTERS)

Pope Francis' legacy of inter-faith diplomacy

Global Crises

One of the most enduring tributes to Pope Francis, who passed away this Easter, would be the appreciation for his legacy of inter-religious diplomacy, a vision rooted in his humility, compassion, and a commitment to bridging divides — between faiths, cultures, and ideologies — from a standpoint of mutual respect and tolerance.

Among his most profound contributions is his historic meeting with Grand Ayatollah Ali al-Sistani in Najaf, Iraq, on March 6, 2021. What made this meeting a true landmark in inter-faith dialogue was the fact it brought together, for the first time, the spiritual leader of the world’s 1.2 billion Roman Catholics and one of the most revered figures in Shia Islam, with influence on tens of millions of Shia Muslims globally. In a humble, yet moving ceremony, the meeting took place in al-Sistani’s modest home in Najaf. A frail al-Sistani, who rarely receives visitors and typically remains seated, stood to greet the 84-year-old Pope and held his hand, in a gesture that underscored mutual respect.

keep readingShow less

LATEST

QIOSK

Newsletter

Subscribe now to our weekly round-up and don't miss a beat with your favorite RS contributors and reporters, as well as staff analysis, opinion, and news promoting a positive, non-partisan vision of U.S. foreign policy.