Since the 1979 revolution, the Iranian government has seen increasing levels of sanctions, with former President of the United States, Barack Obama taking the first step to expand sanctions, in response to increased potential nuclear weapon proliferation, passing the Joint Comprehensive Plan of Action or JCPOA (Library of Congress; CCMES). The JCPOA was notable for including “secondary sanctions,” limiting non-U.S. companies and individuals from interacting with the Iranian economy or government due to risk of seizure and compliance sanctions- a trend that rapidly tripled under President of the United States, Donald Trump’s “Maximum pressure” campaign bringing the sanctions from 370, under President Obama, to an international high of 1,500 (CCMES). Despite policy-maker arguments that sanctions are a humanitarian solution to diplomatic pressure (as under the Obama administration), the “Maximum Pressure” campaign was cited by former CIA director Mike Pompeo as a tool for collective punishment to create conditions to smother the Iranian population into overthrowing their government (HRW). While intended as political tools, these sanctions have significantly impacted the public health sector and exacerbated environmental conditions (AL Jazeera 1; HRW; Iran international 1,2).
Increased academic literature has argued that sanctions may be counterproductive, impacting Iranian healthcare. Studies increasingly demonstrate that sanctions substantially harm healthcare and medicine costs, access, and availability (IJPH; BMC; Al Jazeera 1; UN; MERIP). As “Maximum Pressure” sanctions kicked off, Iran’s food-insecure population went from 22 million to 50 million and 13 million Iranian’s went into poverty over the course of just three years (CCMES). The scale of such sanctions reflect difficulty for health officials especially since 70% of the nation’s medical equipment is imported, which is challenged by their price subsidization strategies (HRW). As Human Rights Watch warns, Iran’s nearly universal healthcare system already absorbs a significant share of treatment costs, and its potential failure, amid mounting financial strain, “will likely have devastating effects on millions of patients” (HRW). Despite Iran still gaining access to certain Asian markets, this comes with increased prices and decreased quality and availability for medications across a variety of health conditions, with secondary sanctions discouraging foreign firms, including suppliers of packaging or raw materials, from participating in pharmaceutical supply chains due to the risk of penalties (MERIP). A 2024 WHO study reported severely reduced availability of 13/26 drugs, used in treatment of health conditions from asthma to diabetes, cancer, or multiple sclerosis (WHO). Meanwhile, some antiepileptic drug rates shot up 300% (Al Jazeera 1). Studies reflecting an overall 50% skyrocket in 2014 drug pricing has now increased to 70% reported 2025, while shipping and insurance costs skyrocketed 50% since September and import timelines have gone up to 6 months (Iran International 1).
Amidst rising shortages and inflation for Iranian citizens, sanctions have also constrained Iran’s environmental innovation and public health (UN). Multilateral sanctions have limited the regime’s ability to secure trade deals and import new, cleaner technologies to address worsening air pollution, which is estimated to cause around 40,000 premature deaths annually (UN). Alongside old infrastructure and poor management, reduced communication, foreign energy contracts, and international collaboration have hindered Iranian scientists’ participation in joint environmental research and access to critical data (UN; Al Jazeera 2). Air quality has further deteriorated as authorities burn highly polluting fuel to compensate for gas shortages in electricity production, producing severe toxic smog in Tehran (Al Jazeera 2). Simultaneously, climate change and economic strain have intensified water scarcity, pushing Tehran’s dams to critical levels. One of the city’s five dams has run completely dry, while another has fallen below 8% capacity, raising national security concerns (Iran International 2).
While sanctions play a critical factor in the decline in Iranian public health conditions, corruption and embezzlement in government policies worsen impacts on the public sector as well (HRW). Human Rights Watch reports, “Iranian media outlets have reported alleged misallocation and misuse of government-subsidized dollars by Iranian corporate elites. Thirteen petrochemical industry executives are currently on trial for allegedly embezzling revenues from shell companies they had set up to circumvent pre-JCPOA sanctions” (HRW).
These factors produce compounding risks as sanctions, climate change, corruption, and a deteriorating economy threaten the most vulnerable in Iran (HRW, Iran International 1, 2). Taken together, the existing evidence suggests that while sanctions are framed as geostrategic tools for geopolitical leverage, their cumulative effects impact healthcare systems, environmental management, and daily living conditions (The Lancet; Iran International 1, 2; HRW). As economic isolation constrains access to medicine, technology, and environmental cooperation, some observers suggest the burden of diplomatic confrontation has been argued to disproportionately be borne by ordinary Iranian citizens, rather than the authorities these measures are designed to influence (AL Jazeera 1).
Sources:
Al Jazeera 1 2025: https://www.aljazeera.com/opinions/2025/11/12/sanctions-are-not-a-humane-alternative-to-war
Al Jazeera 2 2025: https://www.aljazeera.com/news/2025/11/24/tehran-shrouded-in-thick-smog-as-iran-burns-dirty-fuel-amid-energy-crisis
Al Jazeera 3 2025: https://www.aljazeera.com/news/liveblog/2026/2/17/us-iran-talks-set-to-begin-at-omans-embassy-in-switzerland
The Atlantic 2018: https://www.theatlantic.com/international/archive/2018/06/iran-sanctions-nuclear/562043/
BMC Health Services Research (BMC) 2024: https://pmc.ncbi.nlm.nih.gov/articles/PMC10913614/
Crown Center for Middle East Studies (CCMES) 2022: https://www.brandeis.edu/crown/publications/middle-east-briefs/pdfs/101-200/meb145.pdf
Human Rights Watch (HRW) 2019: https://www.hrw.org/report/2019/10/29/maximum-pressure/us-economic-sanctions-harm-iranians-right-health
Iran International 1 2025: https://www.iranintl.com/en/202511102505
Iran International 2 2025: https://www.iranintl.com/en/202511106916
Iranian Journal of Public Health (IJPH) 2014: https://pmc.ncbi.nlm.nih.gov/articles/PMC4419179/#ref5
The Journal of Development Studies (JDS) 2021: https://www.tandfonline.com/doi/full/10.1080/00220388.2020.1746277#abstract
The Journal of Peace Research (JPR) 2009: https://journals.sagepub.com/doi/pdf/10.1177/0022343308098404
The Lancet 2025: https://www.thelancet.com/action/showPdf?pii=S2214-109X%2825%2900278-5
Library of Congress (Congress): https://www.congress.gov/crs-product/IF12452
Middle East Research and Information Project (MERIP) 2020: https://www.merip.org/2020/03/voices-from-the-middle-east-us-sanctions-on-iran-devastate-the-health-sector/
The New York Times Opinions (NYT) 2014: https://www.nytimes.com/roomfordebate/2013/11/19/sanctions-successes-and-failures/in-iran-sanctions-hurt-the-wrong-people
Reuters: https://www.reuters.com/world/middle-east/what-is-status-irans-main-nuclear-facilities-2026-01-16/
United Nations (UN) 2022: https://www.ohchr.org/en/press-releases/2022/12/us-sanctions-violate-iranian-peoples-rights-clean-environment-health-and
World Health Organization (WHO) 2018: https://www.emro.who.int/emhj-volume-24-2018/volume-24-issue-1/impact-of-economic-sanctions-on-access-to-noncommunicable-diseases-medicines-in-the-islamic-republic-of-iran.html