The impact of international economic sanctions on Iranian cancer healthcare.
BACKGROUND
In 2012, Iranian's economy collapsed under strain from sanctions instituted to stop Iran from violating the International Nuclear Non-Proliferation Treaty. Sanctions have indirectly led to serious healthcare concerns, specifically cancer treatment. This is the first report to evaluate Iranian cancer healthcare while under international economic sanctions.


METHODS
Data and information were identified by searches of MEDLINE, PubMed, and references from relevant articles using the search terms: "Iran", "health policy", "sanctions", "ethics", and "cancer". Articles published in the English language between 1966 and present were included, based on relevance to sanctions or the specific case of sanctions in Iran.


RESULTS
The Program of Action for Cancer Therapy evaluated Iran's National Cancer Control Program (NCCP), reporting it has substantial deficits, including prevention, diagnosis/treatment, palliative care, monitoring, and technology, with a serious drug shortage for cancer care. Sanctions have exemptions for medicines and food, but lead to disruption of health services through complications in transportation, transferring currencies or lack of money.


CONCLUSIONS
There is increasing evidence that sanctions harm vulnerable populations, while blocking globalization and not creating political or social change quickly. Improvement of Iran's NCCP is not feasible, and the health of cancer patients will continue to decline while the sanctions are in effect. The solution is complex, but a modern and innovative approach to diplomacy, which includes human rights, is necessary.
Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Prentice Women's Hospital, Northwestern University Feinberg School of Medicine, Chicago, USA; Columbia University Mailman School of Public Health, New York, USA. Electronic address: sshahabi@nm.org.
Shohreh
S
Shahabi
Department of Obstetrics and Gynecology, Division of Gynecology Oncology, Danbury Hospital, Danbury, USA.
Hooman
H
Fazlalizadeh
Department of Obstetrics and Gynecology, Division of Gynecology Oncology, Danbury Hospital, Danbury, USA.
Jennifer
J
Stedman
Department of Obstetrics, Gynecology and Reproductive Science, Mount Sinai Hospital, New York, USA.
Linus
L
Chuang
Department of Nuclear Medicine, State University of New York at Buffalo, Buffalo, USA.
Ahmad
A
Shariftabrizi
Seton Hall University School of Law, Newark, USA.
Regina
R
Ram
D000970:Antineoplastic Agents / Q000191:economics / Q000600:supply & distribution; D003695:Delivery of Health Care / Q000191:economics* / Q000458:organization & administration; D004467:Economics; D006297:Health Services Accessibility / Q000191:economics; D006801:Humans; D007391:International Cooperation; D038622:Internationality; D007492:Iran / Q000453:epidemiology; D009369:Neoplasms / Q000188:drug therapy / Q000453:epidemiology / Q000628:therapy; D004364:Pharmaceutical Preparations / Q000191:economics / Q000600:supply & distribution; D011057:Politics
D000970:Antineoplastic Agents; D004364:Pharmaceutical Preparations
International sanctions; Iran; Oncology