Right to health is recognized in International Covenant on Economic,Social and Cultural Rights (ICESCR) and in accordance with art.12 of ICESCR right to life include: “1. The States Parties to the present Covenant recognize the right of everyone to the enjoyment of the highest attainable standard of physical and mental health.2. The steps to be taken by the States Parties to the present Covenant to achieve the full realization of this right shall include those necessary for

:(a) The provision for the reduction of the stillbirth-rate and of infant mortality and for the healthy development of the child;(b) The improvement of all aspects of environmental and industrial hygiene;

(c) The prevention, treatment and control of epidemic, endemic, occupational and other diseases;

(d) The creation of conditions which would assure to all medical service and medical attention in the event of sickness”^[1].

Right to health is fundamental human right, regardless of who is the person in need  and where person come^[2] right to health is principal human right for all human beings .Sanctions can have direct effect on equitable  access to healthcare services for example in the case of US sanctions against Iran raw materials needed to produce  medicines in the country could not be  imported  for restrictions imposed in Iranian banking system and during outbreak of covid-19 pandemic  the effects of sanctions  on Iran has been exacerbated^[3]

After the withdrawal of the Trump administration from JCPOA(Joint Comprehensive Plan of Action), the US imposed a series of sanctions against Iran. What are the effects of US sanctions on enjoyment of the right to health?

In accordance with allegation of state in its comment on report of the Special Rapporteur on the negative  impact of unilateral coercive measures on the enjoyment of human rights on her visiting of Iran : “Unilateral coercive measures have created obstacles aplenty for the supply of equipment, medicine and vaccine needed to deal with the COVID-19 pandemic; and - Unilateral coercive measures have seriously disrupted the import of medical equipment urgently needed to diagnose, control and cure COVID-19 such as: ventilators, computerized tomography, dialysis, continuous renal replacement therapy, extracorporeal membrane oxygenation, digital radiology, electroconvulsive therapy, reverse transcription polymerase chain reaction, video laryngoscope and portable Eco nosography equipment as well as all personal protective equipment – including N95 and 3-ply masks and protective gowns, all of which were desperately needed upon the outbreak of the pandemic”^[4]

Allegations of state show negative impact of US coercive measures on enjoyment of the right to health specialty in the situation of outbreak of covid-19 for providing medical equipment and drugs. Furthermore, in accordance with allegations of state vulnerable groups such as epidermolysis bullosa and thalassemia patients suffered from negative impact of US unilateral coercive measures.^[5]

UN special Rapporteur on the negative impact of unilateral coercive measures on the enjoyment of human rights on her report about visiting Iran said: “special Rapporteur on the negative impact of unilateral coercive measures on the enjoyment of human rights death. Suffering can only be reduced by applying bandages produced by a single company in Sweden. She was informed about the challenges that the center has faced in procuring the specialized absorbent silicone dressings (bandages) owing to overcompliance by the Swedish producer, and about the center’s efforts to mobilize international stakeholders, including the specialized agencies of the United Nations, to help procure the bandages on an ad hoc basis, pending a more sustainable solution”^[6] and special rapporteur in her report stated that :'' The Special Rapporteur received numerous other examples of the reluctance of foreign companies to deliver essential equipment for the health-care sector, such as ambulances, and medicines, medical equipment and necessary spare parts, including plasma derived drugs, blood separation centrifuges, measuring and quality control equipment, diagnostic devices for prenatal diseases, cardiac and endoscopic equipment and materials for producing gloves and catheters. She was also informed that in some antiretroviral centers, the machines for tracking immunosuppression and initiating antiretroviral therapy (CD4 counting) could no longer function because of missing spare parts, with serious procurement delays and increased costs due to unilateral sanctions. Even the office of the United Nations Development Programme in the Islamic Republic of Iran reportedly faced serious problems in obtaining pediatric antiretroviral medicines from a foreign company, which refused to sell them.”^[7]

Special rapporteur on her report on visiting Iran confirmed the negative impact of unilateral coercive measures on enjoyment of the right to health.

UN special rapporteur on situation of human rights in Iran in his report on negative effect of US sanctions on right to health said: “The Special Rapporteur shares the Secretary-General’s concerns that sanctions and banking restrictions have had an adverse effect on the health sector (A/75/287), including with respect to addressing shortages of pharmaceutical and medical items as witnessed throughout the pandemic. However, the health sector had received only 27 per cent of the allocated $1.1 billion as at 29 September 2020. The Government stated that the allocation was being provided in stages. Health-care workers have not received wages for months, and had been working extra shifts and with limited protective equipment. As of 7 November 2020, more than 300 doctors, nurses and health-care workers had died of COVID_19, with many hospitals reaching maximum capacity. Sanctions limited the State’s access to its foreign currency reserves to purchase medical supplies and the raw materials needed to produce supplies locally. This disruption has led to issues of scarcity and affordability affecting the right to health. Medications produced overseas required for the treatment of life threatening or rare conditions remain scarce. Approximately 4.5 million diabetic patients, 600,000 of whom need daily shots, are reportedly affected by insulin shortages.”^[8]

Group of the UN independent expert include Alena Douhan, Special Rapporteur on the negative impact of the unilateral coercive measures on the enjoyment of human rights; Obiora C. Okafor, Independent  Expert on human rights and international solidarity said thalassemia patients do not have access to sufficient vital medication and humanitarian exemption in US sanction regulations are unclear and complex because US sanctions practice imposes high fine on companies which are selling medicines on Iran ^[9].

Economic sanctions have the potential to affect health in targeted countries, in case of US unilateral sanctions against Iran the result of literature review shows that unilateral coercive measures affected affordability, accessibility and quality of health services and medicine^[10].

Negative effects of the US unilateral coercive measures on enjoyment of the right to health is obvious and in accordance with documentary reports of UN independent experts US sanctions are in contrast with the right to health and these sanctions violate art.12 of ICESCR. 

Bibliography

Iran: Over-compliance with unilateral sanctions affects thalassemia patients say UN experts, available at : https://www.ohchr.org/en/press-releases/2023/02/iran-over-compliance-unilateral-sanctions-affects-thalassemia-patients-say seen 10/08/2023 

Kokabisaghi, Fatemeh, (2018), ‘Assessment of the Effects of Economic Sanctions on Iranians Right to Health by USING Human Rights Impact Assessment Tool: A Systematic Review’ in: International Journal of Health Policy and Management, vol 7(5), pp:374-393.

Report of the Special Rapporteur on the situation of human rights in the Islamic Republic of Iran, A/HRC/46/50, 

Report of the special Rapporteur on the negative impact of unilateral coercive measures on the enjoyment of human rights, A/HRC/ 51/33/add.

Report of the special Rapporteur on the negative impact of unilateral coercive measures on the enjoyment of human rights, Alena Douhan, on her visit to Islamic Republic of Iran, A/HRC/ 51/33/add. 4