The impact of international economic sanctions on Iranian cancer healthcare

Health Policy

Volumn 119, Issue 10, 2015, Pages 1309-1318

  Shahabi, Shohreh ^a,b   Fazlalizadeh, Hooman ^d   Stedman, Jennifer ^d   Chuang, Linus ^e   Shariftabrizi, Ahmad ^f   Ram, Regina ^c  

^a NORTHWESTERN UNIVERSITY   (United States)

^b Columbia University Mailman School of Public Health ^*  (United States)

^c DANBURY HOSPITAL   (United States)

^d MOUNT SINAI HOSPITAL   (United States)

^e UNIVERSITY AT BUFFALO   (United States)

^f SETON HALL UNIVERSITY   (United States)

Author keywords

International sanctions; Iran; Oncology

Indexed keywords

ARTICLE; CANCER CONTROL; CANCER THERAPY; ECONOMIC RECESSION; HEALTH CARE; HEALTH CARE COST; HEALTH CARE POLICY; HEALTH CARE SYSTEM; HEALTH PROGRAM; HEALTH SERVICE; IRAN; PALLIATIVE THERAPY; ECONOMICS; HEALTH CARE DELIVERY; HUMAN; INTERNATIONAL COOPERATION; NEOPLASMS; ORGANIZATION AND MANAGEMENT; POLITICS; SUPPLY AND DISTRIBUTION;

ANTINEOPLASTIC AGENT; DRUG;

ANTINEOPLASTIC AGENTS; DELIVERY OF HEALTH CARE; ECONOMICS; HEALTH SERVICES ACCESSIBILITY; HUMANS; INTERNATIONAL COOPERATION; INTERNATIONALITY; IRAN; NEOPLASMS; PHARMACEUTICAL PREPARATIONS; POLITICS;

EID: 84943815576     PISSN: 01688510     EISSN: 18726054     Source Type: Journal    
DOI: 10.1016/j.healthpol.2015.08.012     Document Type: Article

References (70)

1. Esfahani H.S., Oesaran M.H. The Iranian economy in the twentieth century: a global perspective. Iranian Studies [Internet] 2009, 42(April (2)):177-211. [cited 20.11.14].
2. Monshipouri M., Dorraj M. Iran's foreign policy: a shifting strategic landscape. Middle East Policy [Internet] 2013, 20(December (4)):133-147. [cited 24.12.14].
3. Mohammadi D. US-led economic sanctions strangle Iran's drug supply. Lancet [Internet] 2013, 381(January (9863)):279. [cited 20.11.14].
4. Golzari S.E., Ghabili K., Khanli H.M., Tizro P., Rikhtegar R. Access to cancer medicine in Iran. Lancet Oncology [Internet] 2013, 14(March (3)):e87. [cited 28.11.14].
5. Garfield R., Devin J., Fausey J. The health impact of economic sanctions. Bulletin of the New York Academy of Medicine [Internet] 1995, 72(January (2)):454-469. [cited 24.12.14].
6. Paul J. Sanctions: an analysis. Global Policy Forum [Internet]. Available from: [cited 24.12.14]. https://www.globalpolicy.org/component/content/article/202/41475.html.
7. Lopez G.A., Cortright D. Economic sanctions and human rights: part of the problem or part of the solution?. The International Journal of Human Rights [Internet] 1997, 1(June (2)):1-25. Taylor & Francis Group [cited 20.12.14].
8. Charter of the United Nations: Chapter VII: action with respect to threats to the peace, breaches of the peace and acts of agression. Available from: [cited 24.12.14]. http://www.un.org/en/documents/charter/chapter7.shtml.
9. Cheraghali A.M. Impacts of international sanctions on Iranian pharmaceutical market. Daru [Internet] 2013, 21(January (1)):64. Biomed Central Ltd [cited 11.12.14].
10. Crossette B.U.N. Chief Chides Security Council on Military Missions - New York Times. Published January 6 1995 [Internet]. Available from: [cited 24.12.14]. http://www.nytimes.com/1995/01/06/world/un-chief-chides-security-council-on-military-missions.html.
11. Iran GDP per capita PPP, Trading Economics [Internet]. Available from: [cited 11.12.14]. http://www.tradingeconomics.com/iran/gdp-per-capita-ppp.
12. Iran's Cities a Sea of Poverty. Frontline- Tehran Bureau. Available from: [cited 10.06.15]. http://www.pbs.org/wgbh/pages/frontline/tehranbureau/2011/03/irans-cities-a-sea-of-poverty.html.
13. Hajizadeh M., Nghiem H.S. Hospital care in Iran: an examination of national health system performance. International Journal of Healthcare Management [Internet] 2013, 6(August (3)):201-210. Maney Publishing [cited 16.01.15].
14. Mehrdad R. Health system in Iran. Japan Medical Association Journal [Internet] 2009, 52(1):69-73. Available from: http://www.med.or.jp/english/pdf/2009_01/069_073.pdf [cited 20.01.15].
15. Rouhollahi M.R., Mohagheghi M.A., Mohammadrezai N., Ghiasvand R., Ghanbari Motlagh A., Harirchi I., et al. Situation analysis of the National Comprehensive Cancer Control Program (2013) in the I. R. of Iran; assessment and recommendations based on the IAEA imPACT mission. Archive of Iranian Medicine [Internet] 2014, 17(April (4)):222-231. [cited 22.01.15].
16. Bandpey AM. Iran Health Insurance System. Regional Meeting on Strengthening the Implementation of Social Health Insurance (SHI) Schemes for Universal Health Coverage (UHC). Amman, Jordan, 1-4 Jun 2014 [Internet]. Available from: [cited 20.01.15]. http://ihio.gov.ir/portal/File/ShowFile.aspx?ID=aa143308-db81-41b5-beab-a42be4075b18.
17. Iran health insurance organization, History of Ministry of Cooperative labor, and social warfare. In Persian [Internet]. Available from: [cited 20.01.15]. http://ihio.gov.ir/portal/Home/Default.aspx?CategoryID=043cb554-f921-4092-ba4a-c6ae825dad71.
18. Ibrahimipour H., Maleki M.-R., Brown R., Gohari M., Karimi I., Dehnavieh R. A qualitative study of the difficulties in reaching sustainable universal health insurance coverage in Iran. Health Policy Plan [Internet] 2011, 26(November (6)):485-495. [cited 20.01.15].
19. Davari M., Haycox A., Walley T., The Iranian health insurance system; past experiences, present challenges and future strategies Iranian Journal of Public Health [Internet] 2012, 41(January (9)):1-9. [cited 24.12.14].
20. Global Health Expenditure Database, World Health Organization, NHA Indicators [Internet]. Available from: [cited 11.12.14]. http://apps.who.int/nha/database/ViewData/Indicators/en.
21. Rezaian, J. Iran faces possible health-care crisis. The Washington Post. 22 Nov 2012. [Internet]. Available from: [cited 24.12.14]. https://www.washingtonpost.com/world/iran-faces-possible-health-care-crisis/2012/11/21/fe6efb70-3026-11e2-9f50-0308e1e75445_story.html.
22. Abolhallaje M., Hasani S., Bastani P., Ramezanian M., Kazemian M. Determinants of catastrophic health expenditure in Iran. Iranian Journal of Public Health [Internet] 2013, 42(January (Suppl 1)):155-160. Tehran University of Medical Sciences [cited 20.01.15].
23. Ravangard R., Hatam N., Teimourizad A., Jafari A. Factors affecting the technical efficiency of health systems: a case study of Economic Cooperation Organization (ECO) countries (2004-10). International Journal of Health Policy and Management [Internet] 2014, 3(July (2)):63-69. Kerman University of Medical Sciences [cited 20.01.15].
24. Palmer S., Torgerson D.J. Economic notes: definitions of efficiency. British Medical Journal [Internet] 1999, 318(April (7191)):1136. [cited 19.01.15].
25. Hosseini S.A. Impact of sanctions on procurement of medicine and medical devices in Iran; a technical response. Archive of Iranian Medicine 2013, 16(12):736-738.
26. Davari M., Walley T., Haycox A. Pharmaceutical policy and market in Iran: past experiences and future challenges. Journal of Pharmaceutical Health Services Research [Internet] 2011, 2(March (1)):47-52. [cited 24.12.14].
27. Gorji A. Sanctions against Iran: the impact on health services [Internet]. Iranian Journal of Public Health 2014, 381-382. Available from: http://ijph.tums.ac.ir/index.php/IJPH/article/view/5437 [cited 20.11.14].
28. Moret E.S. Humanitarian impacts of economic sanctions on Iran and Syria. European Security [Internet] 2014, (February):1-21. Routledge [cited 24.12.14].
29. Timeline: Sanctions on Iran, ALJAZEERA, Middle East. 17 Oct 2012. [cited 24.12.14]. http://www.aljazeera.com/news/middleeast/2012/10/20121016132757857588.html.
30. United Nations Security Council Resolutions. U.S. Department of State [Internet]. Available from: [cited 24.12.14]. http://www.state.gov/e/eb/tfs/spi/iran/resolutions/index.htm.
31. Abidollah J. The impacts of sanctions on Iran from the viewpoint of human security doctrine [Internet]. Nationalpark-Forschung In Der Schweiz (Switzerland Research Park Journal) 2014, Available from: http://www.naukpublication.org/index.php/NATIONALPARK-FORSCHUNG-SCHWEIZ/article/view/549 [cited 24.12.14].
32. Iran - GDP Per Capita PPP. IEconomics [Internet]. Available from: [cited 11.12.14]. http://ieconomics.com/iran-gdp-per-capita-ppp-forecast.
33. Consumer Price Index 2015. Central Bank of the Islamic Republic of Iran [Internet]. Available from: [cited 10.06.15]. http://www.cbi.ir/category/1624.aspx.
34. U.S. Department of the treasuary. Iran sanctions, overview of sanctions [Internet]. Available from: [cited 2.12.4]. http://www.treasury.gov/resource-center/sanctions/Programs/pages/iran.aspx.
35. Karimi M., Haghpanah S. The effects of economic sanctions on disease specific clinical outcomes of patients with thalassemia and hemophilia in Iran. Health Policy 2015, 119(February (2)):239-243.
36. Mousavi S.M., Gouya M.M., Ramazani R., Davanlou M., Hajsadeghi N., Seddighi Z. Cancer incidence and mortality in Iran. Annals of Oncology [Internet] 2009, 20(March (3)):556-563. [cited 11.12.14].
37. Borger J, Dehghan SK. Iran unable to get life-saving drugs due to international sanctions [Internet]. Available from: [cited 10.06.15]. http://www.theguardian.com/world/2013/jan/13/iran-lifesaving-drugs-international-sanctions.
38. International Agency for Research on Cancer, Globocon 2012: Estimated Incidence and Mortality and Prevalence Worldwide in 2012. Population Fact Sheet Iran, Islamic Republic of [Internet]. Available from: [cited 10.12.14]. http://globocan.iarc.fr/Pages/fact_sheets_population.aspx?country=364.
39. WHO Regional Office for the Eastern Mediterranean. Cancer | Health topics [Internet]. Available from: [cited 24.12.14]. http://www.emro.who.int/health-topics/cancer/index.html.
40. Davari M., Yazdanpanah F., Aslani A., Hosseini M., Nazari A.R., Mokarian F. The direct medical costs of breast cancer in Iran: analyzing the patient's level data from a cancer specific hospital in Isfahan. International Journal of Preventive Medicine [Internet] 2013, 4(July (7)):748-754. [cited 24.12.14].
41. Globocan 2012, Cancer Incidence, Mortality and Prevalence Worldwide. Iran, Islamic Republic of, Number of new cancers in 2015 (all ages) [Internet]. Available from: [cited 10.12.14]. http://globocan.iarc.fr/.
42. Taghavi A., Fazeli Z., Vahedi M., Baghestani A.R., Pourhoseingholi A., Barzegar F., et al. Increased trend of breast cancer mortality in Iran. Asian Pacific Journal of Cancer Prevention [Internet] 2012, 13(January (1)):367-370. Asian Pacific Organization Cancer Prevention [cited 23.12.14].
43. Harirchi I., Karbakhsh M., Kashefi A., Momtahen A.J. Breast cancer in Iran: results of a multi-center study. Asian Pacific Journal of Cancer Prevention [Internet] 2004, 5(1):24-27. [cited 23.12.14].
44. Bastani P., Kiadaliri A.A. Cost-utility analysis of adjuvant therapies for breast cancer in Iran. International Journal of Technology Assessment in Health Care [Internet]. 2012, 28(April (2)):110-114. [cited 23.12.14].
45. Will B.P., Berthelot J.-M., Le Petit C., Tomiak E.M., Verma S., Evans W.K. Estimates of the lifetime costs of breast cancer treatment in Canada. European Journal of Cancer [Internet] 2000, 36(April (6)):724-735. [cited 23.12.14].
46. Butler D. Iran hit by drug shortage [Internet]. Available from: [cited 10.06.15]. http://www.nature.com/news/iran-hit-by-drug-shortage-1.14292.
47. Namazi S. Blocking medicine to Iran [Internet]. Available from: [cited 10.06.15]. http://www.nytimes.com/2013/03/02/opinion/blocking-medicine-to-iran.html?_r=1.
48. Gorji A. Medical supplies in Iran hit by sanctions. Nature [Internet] 2013, 495(March (7441)):314. [cited 20.11.14].
49. Nichols M, Charbonneau L. General Secretary Ban Ki Moon, U.N. chief says sanctions on Iran affecting its people. Reuters [Internet]. Available from: [cited 15.01.15]. http://www.reuters.com/article/2012/10/05/us-iran-sanctions-un-idUSBRE89412Z20121005.
50. FCNL: 25 Groups Call on Obama Not to Block Food, Medicine to Iran [Internet]. Available from: [cited 15.01.15]. http://fcnl.org/issues/iran/coalition_calls_on_obama_not_to_block_food_medicine_to_iran/.
51. Hamshahrionline, chemotherapy drugs cost for cancer patients would half. Topic code: 272223, In Persian [Internet]. Available from: [cited 23.12.14]. http://www.hamshahrionline.ir/details/272223.
52. Azizi M.H. Impact of traffic-related air pollution on public health: a real challenge. Archive of Iranian Medicine [Internet] 2011, 14(March (2)):139-143. [cited 23.12.14].
53. Perez L., Rapp R., Künzli N. The Year of the Lung: outdoor air pollution and lung health. Swiss Medical Weekly 2010, 18(November):140.
54. Ghorayshi A. Choking to death in Tehran. Newsweek. 20 Mar 2014 [Internet]. Available from: [cited 24.12.14]. http://www.newsweek.com/2014/03/28/choking-death-tehran-248027.html.
55. Iran's government steps up efforts to tackle pollution. The Guardian. 10 Mar 2014 [Internet]. Available from: [cited 21.06.15]. http://www.theguardian.com/world/iran-blog/2014/mar/10/irans-government-steps-up-efforts-to-tackle-pollution.
56. Keshavarzi B., Moore F., Najmeddin A., Rahmani F., Malekzadeh A. Quality of drinking water and high incidence rate of esophageal cancer in Golestan province of Iran: a probable link. Environmental Geochemistry and Health. 2012, 34(February (1)):15-26.
57. Golozar A., et al. Food preparation methods, drinking water source, and esophageal squamous cell carcinoma in the high-risk area of Golestan, Northeast Iran. European Journal of Cancer Prevention [Internet] 2015, (April).
58. Dehghan S. Iran Iran investigates health risks of jamming TV signals. The Guardian. 5 Feb 2014 [Internet]. Available from: [cited 21.07.15]. http://www.theguardian.com/world/2014/feb/05/iran-health-risk-jamming-signals-cancer.
59. Government committee to review satellite jamming signals' effects on public health. International Campaign for Human Rights in Iran. 5 Feb 2014. Available from: [cited 24.07.15]. http://www.iranhumanrights.org/2014/02/satellite-jamming/.
60. UN body warns governments about health hazards of jamming signals. International Campaign for Human Rights in Iran. 14 Jan 2015. Available from: [cited 21.07.15]. http://www.iranhumanrights.org/2015/01/un-resolution-jamming/.
61. Karami A. Iran official says satellite jamming can cause cancer. Al-Monitor. 2 Oct 2014 [Internet]. Available from: [cited 21.07.15]. http://www.al-monitor.com/pulse/originals/2014/10/iran-satellite-jamming-cancer.html.
62. Chingono H, Hove M, Danda SJ. Sanctions effectiveness in a globalized world. International Journal of Humanities and Social Science [Internet]. Available from: [cited 13.03.15]. http://www.ijhssnet.com/journals/Vol_3_No_21_%5BSpecial_Issue_December_2013%5D/33.pdf.
63. Morin K., Miles S.H., Lavizzo-Mourey R., Lynn J., Carroll R.J., Fleming D.A., et al. The health effects of economic sanctions and embargoes: the role of health professionals [Internet]. Annals of Internal Medicine 2000, 158-161.
64. ICRC databases on international humanitarian law. Convention (IV) relative to the Protection of Civilian Persons in Time of War. Geneva, 12 August 1949. Consignment of medical supplies, food and clothing. 2010 Mar 23 Available from: [cited 24.12.14]. https://www.icrc.org/applic/ihl/ihl.nsf/Article.xsp?action=openDocument%26documentId=4FBC9DEAB064E2B7C12563CD0051BB76.
65. The Universal Declaration of Human Rights. Available from: [cited 24.12.14]. http://www.un.org/en/documents/udhr/.
66. Neal A.W. Critical international relations theory after 25 years. International Affairs [Internet] 2008, 84(May (3)):555-556. [cited 24.12.14].
67. Laghaie S. Medicine shortage in Iran: sanctions or mismanagement? Your Middle East [Internet]. Available from: [cited 10.06.15]. http://www.yourmiddleeast.com/columns/article/medicine-shortage-in-iran-sanctions-or-mismanagement_11359.
68. Botenga M. Iran policy undermining europe's credibility on health. Iran Review [Internet]. Available from: [cited 10.06.15]. http://www.iranreview.org/content/Documents/Iran-Policy-Undermining-Europe-s-Credibility-on-Health.htm.
69. Congress Urges President to Ensure Sanctions Do Not Block Medicine for Iranians. National Iranian America Council [Internet]. Available from: [cited 10.06.15]. http://act.niacouncil.org/site/News2?page=NewsArticle%26id=10697%26security=1%26news_iv_ctrl=-1.
70. Namazi S. Sanctions and medical supply shortages in Iran. Woodrow Wilson Center [Internet]. Available from: [cited 1.06.15]. http://www.wilsoncenter.org/sites/default/files/sanctions_medical_supply_shortages_in_iran.pdf.