A combination of international sanctions and mismanagement by the Iranian government are blamed  for the current state of medical chaos in Iran.
“It’s been five months now that we are looking for an anti-allergy vaccine for my brother,” says one person interviewed by Global Voices about Iran's public health situation. “One of our relatives with cancer cannot find his medicine,” remarked another. “I am struggling to find insulin,” says a diabetic man.
This has been the reality for Iranians since the middle of 2012 after American and European Union banking sanctions  were tightened, making it virtually impossible for Iranians to conduct foreign transactions.
Domestic news outlets have reported on the scarcity of medications for illnesses ranging from hepatitis to cancer to hemophilia and polio. Even the availability of anesthetics has been affected.
There have also been deaths from ailments that could have been treated with medication. The death of a 15-year-old hemophiliac boy  in November 2012 is one example.
While this indirect effect of sanctions is not yet widely known internationally, the cause has been championed by activists and netizens with artwork and petitions . In December 2012, the Iranian artist Sanaz Sohrabi even created a performance artwork in front of the United Nations in New York.
The daily struggle to find affordable medication
“Finding Insulin is so difficult,” says Shahla an Iranian who must use insulin on a daily basis. (Due to potential consequences of speaking to non-Iranian media, we mention people’s first names only). She says patients are forced to purchase insulin at free market prices that are 20 as high as those mandated by the state. Shahla says the Iranian Diabetes Society tries to address the problem by distributing free insulin to doctors that they can give away, but there is only a limited supply. “Whenever I get desperate, I call my doctor and he gives me one or two insulin containers and I use them each for a month,” she says.
In July, the US Treasury Department stated  that the U.S. allows for the sale and export of food, medicine and medical devices to Iran in spite of sanctions. Nonetheless, sanctions against banks make it impossible for importers to buy drugs and pharmaceuticals. “It’s as if they tell you that there is a spring from which everybody can drink, but you need to pass through so many obstacles to reach to the spring. It will indirectly stop you,” explains Arash, a businessman who imports pharmaceuticals to Iran.
According to Arash, many have switched to suppliers in Asia (mostly in China and India) to get around the sanctions. Others have continued trading with suppliers in the US and Europe through intermediaries (such as Turkish and United Arab Emirate banks) but Arash says the process is too complicated. “If you want to do it through currency exchange dealers, you need to spend a lot of money,” he complains.
“Of course in this situation you need to set the price [to the consumer] higher, otherwise you will lose money in the business, but then the government won’t let you increase the price. Therefore, in both cases, you won’t be able to distribute the medicine to the market as fast as needed,” explains Arash.
Several people online have shared the same concerns.
Leila Zadeh tweeted :
— Leila Zadeh (@leilazadeh) October 15, 2013 
Peter Tatchell tweeted :
— Peter Tatchell (@PeterTatchell) October 14, 2013 
Shortage of drugs
Besides high prices, the shortage of drugs is a major issue.
Sarah, an Iranian woman whose 6-year old son suffers from severe diabetes, says it has been more than a month since she has been trying to find a specific brand of Insulin for her son. “I went to dozens of pharmacies, but they do not have it, “ she says. “The last time I was finally able to find three insulin containers in one pharmacy.” She says each container is only enough for two to three weeks.
Another Iranian, Sahar, says her sister’s father-in-law suffers from cancer and at the moment finding medicine is a serious struggle. Others repeat her complaints.
In October of last year, Fatemeh Hashemi, the head of Iran’s Charity Foundation for Special Diseases, a non-governmental organization representing six million patients, said the shortage of medicine for a number of diseases such as cancer and multiple sclerosis is “serious” and that lives are at risk.
In March, Kheirollah Gholami, a leading pharmacist from Tehran University’s medical school said anesthetics have either vanished from the market or are difficult to find. “If the situation continues to be like this, we really don’t know what to do. You can’t use a hammer to make patients unconscious,” he told the semi-official Ilna News Agency.
The scarcity of medicine is not simply a problem for serious illnesses, but also affects patients with everyday allergies or pains. “You can only find domestic aspirin which may not be up to standard and can be very dangerous,” explains Amir. He says his doctor recently prescribed him 10 Vitamin D3 pills, which are produced domestically. “I had to buy these 10 pills from four different pharmacies,” says Amir.
The problem still exists
After the temporary nuclear agreement between Iran and the 5+1 world powers in Geneva, the West agreed to ease some sanctions in exchange for Iran agreeing to stop specific aspects of its nuclear program.
In the long run, lifting sanctions could alleviate the difficulties in importing medicine and pharmaceuticals. For now, the problem continues. Arash, the pharmaceutical importer, says that even after financial sanctions are lifted, it will take a long time for Iranian banks to rebuild trust to facilitate business.
But Arash is hopeful. He says finally at least some of the sanctions will be lifted and gradually medicine imports will get back to normal. Until then, the problem will continue to affect the ill and the infirm.