Skip to main content

Paramedics work in a laboratory that tests samples taken from patients suspected of being infected with the new coronavirus, in the southwestern city of Ahvaz, Iran, March, 10, 2020. © 2020 AP

(Washington DC) – Broad US-imposed economic sanctions are negatively affecting the Iranian government’s ability to adequately respond to the mounting health consequences of the coronavirus (COVID-19) pandemic. The US should take immediate action to ease US sanctions and expand licensing of sanctions-exempt items to ensure Iran’s access to essential humanitarian resources during the pandemic.

According to official statistics, as of April 3, 2020, 53,183 people in Iran have contracted the virus and 3,294 have died, though the real number is most likely higher. On March 19, the spokesperson for Iran’s Health Ministry tweeted that every hour almost 50 people contract the virus and every 10 minutes one person dies because of COVID-19 across the country. As the burden on the country’s debilitated health care system has dramatically increased, the broad US economic sanctions resulting in severe international banking restrictions have drastically constrained the ability of the country to finance humanitarian imports, including medicines and medical equipment. 

“It’s bad enough that Iranians are saddled with a brutal, self-serving government that refuses to even release wrongfully detained people in crowded prisons despite the risk of coronavirus,” said Kenneth Roth, Executive Director at Human Rights Watch. “But it is wrong and callous for the Trump administration to compound Iranians’ misery by depriving them of access to the critical medical resources they urgently need.”

After the Trump administration announced its intention to leave the negotiated nuclear agreement in 2018, Iran’s currency, the rial, depreciated significantly. The restrictions on financing, combined with the sharp depreciation of the rial, have resulted in severely limiting Iranian companies and hospitals from purchasing essential medicines and medical equipment from outside Iran that residents depend upon for critical medical care. Moreover, renewed US sanctions have directly impacted families’ purchasing power, contributing to inflation rates of around 30 percent in the past year.

A doctor with close knowledge of the government’s response to the outbreak told Human Rights Watch that obtaining necessary medical equipment has become more difficult under sanctions: “The reality is that sanctions are exacerbating Iranian government’s crisis of incompetency. To manage a pandemic of this scale, a government needs the trust of people and health professionals as well as essential resources. The government has done a poor job of managing the public trust front, but sanctions have impacted their resources both in terms of available medical equipment for detection and treatment of the virus, as well as in terms of their capacity to support people’s needs during the crisis.”

While the US government has built exemptions for humanitarian imports into its sanctions regime, Human Rights Watch research in October 2019 found that in practice, these exemptions have failed to offset the strong reluctance of US and European companies and banks to risk incurring sanctions and legal action by exporting or financing exempted humanitarian goods. On January 30, the US Department of Treasury and the Swiss Secretariat for Economic Affairs announced the transfer of medicine through a newly established humanitarian channel as a “trial run.” The US Treasury had announced the establishment of the channel on October 25 after its designation of Iran’s central bank under its counterterrorism authority on September 20, a move that had seriously threatened the flow of exempted humanitarian trade to Iran.

On March 6, the US Treasury Department’s Office of Foreign Assets Control (OFAC) issued guidance that transactions involving Iran’s foreign exchange assets held abroad, when used to buy humanitarian items, would not face US sanctions. However, because waivers are no longer available for purchasing Iranian oil and sanctions against Iran’s Central Bank, Iran’s access to currency to purchase needed medical supplies on the international market has become further restricted.

OFAC has issued general licenses that permit the export of “certain food items, medicines, and basic medical supplies to Iran” without requiring further specific authorization. These provisions also authorize financial transactions to support Iranian imports of these categories of goods from the United States or from a third country. General licenses, however, are capped at $500,000.

But the definition of drugs under US export regulations – which includes prescription and over-the-counter medicines and medical devices – excludes certain vaccines, biological and chemical products, and medical devices – including medical supplies, instruments, equipment, equipped ambulances, institutional washing machines for sterilization, and vehicles carrying medical testing equipment. This means that some of the equipment crucial to fighting the virus, such as decontamination equipment, and full-mask respirators, require a special license.

The Washington Post reported that the rate of special licenses OFAC issued for the export of specific medicine and medical devices to Iran has significantly declined under the Trump administration, from more than 50 percent of requests during the first quarter of 2016 to 10 percent during the first quarter of 2019. If more licenses are not granted, or the rules are not changed to include this equipment under the general license, Iranians may not be able to obtain the medical equipment and drugs they need to help combat COVID-19 in a timely manner, Human Rights Watch said.

In a letter dated March 26, 11 US senators called on the Trump administration to release a “clear general license authorizing specific medical goods and equipment to facilitate international relief efforts” and to issue a “90-day waiver of sectoral sanctions that impede a rapid humanitarian response” among other efforts. In a bicameral letter dated March 31, 34 members of Congress called for a substantial suspension of sanctions on Iran in a “humanitarian gesture.”

Relief International, a nongovernmental organization that operates with an OFAC license in Iran, said that international aid – and therefore an adequate response during the first weeks of the crisis – was hampered by a need to clarify the legal issues related to sanctions to ensure that medical supplies and medicines can be brought into Iran.

On March 24, Michelle Bachelet, the UN high commissioner for human rights, said in a statement that for global public health reasons, and to support the rights and lives of millions of people in living in countries under economic sanctions that are battling against the outbreak of COVID-19, “Sectoral sanctions should be eased or suspended. In a context of global pandemic, impeding medical efforts in one country heightens the risk for all of us.”

Iranian authorities should make use of every available resource to respond to the outbreak in a way that respects human rights and minimizes harm to the health and well-being of all those living in the country, Human Rights Watch said.

While sanctions will inevitably diminish the capacity of the affected country to fund or support some of the necessary measures, Iran remains obligated to take steps “to the maximum of its available resources” to “provide the greatest possible protection” of the right to health of individuals within its jurisdiction.

At a time of crisis, this obligation is even more crucial, and the government should use all possible means, both domestic resources and negotiations with other countries to ensure the entire population’s access to the most urgent medical care, Human Rights Watch said. While Iran’s economy remains opaque and non-transparent, economic enterprises known as bonyads, some of which are under the direct supervision of Supreme Leader Ayatollah Khamenei, control a large amount of financial resources with little oversight.

Human Rights Watch has previously urged the Iranian authorities to facilitate the temporary release of all eligible prisoners and the unconditional release of people detained for peaceful dissent, due to the coronavirus (COVID-19) pandemic.

The Iranian government should also ensure everyone’s right to an adequate standard of living, which, in the context of responding to the COVID-19 outbreak, means taking measures to buffer the economic impacts of COVID-19 that affects certain groups, including lower-wage workers, first and hardest. Social distancing, quarantine, and the closure of businesses, all recommended by experts to reduce the chance of transmission, will most likely have enormous economic consequences.

The people at most risk are those who are already marginalized in society such as Afghan migrants and refugees, and people with disabilities, as well as low-wage workers in low-income households. The Iranian government should create programs so that such workers affected by COVID-19 do not suffer further loss of income that might deter them from self-isolating to contain the spread of the virus. Without assistance, these workers may face intense economic hardship, risking eviction. The government should take measures at a minimum to ensure that everyone continues to have access to, and can afford, adequate housing, food and water, and other elements of an adequate standard of living.

Under international law, a country or coalition of states enforcing economic sanctions should consider the impact on the human rights of the affected population, especially regarding their access to goods essential to life, including medicines and food.

“The US government should ensure that financial sanctions imposed on Iran are clearly and publicly interpreted to permit the shipment of anything the Iranian people need to protect themselves from the coronavirus,” Roth said.


This press release has been updated to reflect ventilators and CT scanners as among the equipment exempted after an expansion of the general license in November 2015.

Your tax deductible gift can help stop human rights violations and save lives around the world.

Region / Country