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19 May 2024

Iran’s healthcare sector hit by US sanctions

By VM Sathish



US-backed sanctions against Iran – especially on the export of radiation monitoring devices and nuclear technologies – are damaging the availability of life-saving equipment in nuclear medicine (NM) at Iranian hospitals, said a prominent Iranian doctor.


NM in the Middle East will grow further if the peaceful nuclear programme can create radiopharmacies and produce several life saving isotopes, said a leading nuclear medicine expert in the UAE.


Dr Hussain Tabatabai, a medical practitioner in Iran  and planning manager of Iran Medicine, an annual exhibition of medical equipment, said the sanctions are responsible for serious shortages of life-saving nuclear medicines and diagnostic equipment widely used in modern Iranian hospitals.


“NM are important in detecting and treating bone diseases, cardiovascular monitoring and observations of various internal organs such as the kidney, brain and liver, and for cancer treatment.
The import of NM to Iran has been seriously affected by the US sanctions,” said Tabatabai.


Dr Phong Nguyen, Head of NM Department, American Hospital Dubai, said peaceful nuclear programme will help develop radiopharmacy and the availability of life-saving nuclear medicines and isotopes currently shipped from abroad.


Speaking to Emirates Business, he said NM involves use of radioactive materials and isotopes produced either in a nuclear reactor or cyclotrons (a particle accelerator), classified as nuclear materials.


These radioactive drugs are either made in a nuclear reactor or from cyclotrons. While there are many radiopharmacies in the West, where isotopes and radioactive drugs are prepared; there is none in the Middle East.
While hospitals in the US get special isotopes within a day, patients in the Middle East wait for a week to ship such drugs.


“Iran’s main suppliers of these medicines and equipment were Germany and France, but now it’s difficult to source them from there.
The procedure to import NM  and radiation equipment  has been tightened,” said Tabatabai.


“The clampdown on NM may lead to serious problems in the long run and affect Iran’s plan to encourage medical tourism,” he added.


Many healthcare companies and hospitals in Iran are looking for sophisticated medical, laboratory and dental equipment, and the ban on nuclear medicines may harm these private sector projects, said Tabatabai.


Dr Nguyen said Iranian patients have been coming to Dubai hospitals for NM treatment because the isotopes and Positron Emission Tomography (PET) cameras needed for NM are treated as nuclear materials.


All the isotopes used in the Middle East hospitals are shipped from Holland or Europe every week because there is no reactor available within three kilometres of the hospital.


Many isotopes such as  molybdenum 99 used to make Technetium 99 and Iodine 131 used for thyroid treatment are made in nuclear reactors and their shipment is treated as nuclear materials.


Nguyen said the ban on NM is good to ensure public safety, because even a small amount of radiation can create panic and fear psychosis.


Nuclear drugs require strict documentation and civil defence permission.
PET scanners need a cyclotron to function. Saudi Arabia has three PET scans and three cyclotrons, while in the UAE, Dubai Hospital, American Hospital in Dubai, Al Qassimi Hospital in Sharjah and Tawam Hospital in Al Ain have one each.


 Before PET was introduced in the region, many chronic patients had to go to European or American hospitals to get the treatment. Nguyen said a peaceful nuclear programme in the UAE will help the availability of NM.


Diederik Zeven, General Manager Middle East at Philips Healthcare, a manufacturer of NM, said : “Our NM systems are used for medical purposes and not for producing radioactive materials.


Philips has no policy of prohibiting equipment sales to any country as long as we can successfully deliver the equipment and are sure that it will be maintained.


We meet the requirements of international regulations and local legislation in the countries we operate. NM only uses very small traces of radioactive compounds, which is then integrated with pharmaceutical agents, so it’s more linked with pharmaceutical industry than with nuclear programmes.”


“NM plays an essential role in the development of molecular imaging. We are going towards very early stages of diagnosis of pathological processes, where disease can be prevented instead of being treated,” Zeven added. 


“Iran with more than 120,000 doctors, 42 medical colleges and 30,000 specialists has attracted more than 40,000 patients from the GCC for cosmetic surgery, complicated kidney transplants, cardiology and spinal surgery.

The Iranian Social Security Organisation and the Ministry of Health are developing super specialty hospitals – there are already 700 hospitals with a total of 111,000 beds. Many more modern hospitals are being planned, which require  latest diagnostic kits using NM,” said Tabatabai.


He added that the world’s leading companies in the NM field, such as GE Healthcare, Siemens and Philips, are not allowed to export their nuclear medicine devices to Iran.


“Iran has made some advances in NM but for sophisticated monitoring devices we still depend on European and American companies.


The economic sanctions and the dispute over the country’s nuclear programme have made it difficult for Iranian hospitals to procure NM and equipment, which are vital for the effective treatment of many diseases,” said Tabatabai.


An accelerator is needed to make FDG – fluoro deoxy glucose F18 – an intravenous, diagnostic radiopharmaceutical for PET.
FDGs cannot be shipped because their life span is only between two and three hours and by the time the medicines reach the region, it will be useless.


Accelerators are mini reactors with a particle accelerator and cooling unit and some big ones occupy the space of an entire building floor.