Yesterday, the Iranian health authorities announced that another 54 people had died from the coronavirus in the previous 24 hours.

This, the highest toll in a single day since the start of the outbreak, brings the total number of deaths to nearly 300. Another 881 new cases have been confirmed, increasing the total infection count to 8,042.

At least 23 Iranian legislators and some senior government officials have caught the disease and two have died. Officials announced at the weekend that the virus had spread to almost all Iran’s provinces, warned that the number of cases could rise to more than 450,000 and that many might die.

Iran is the third worst infected country after China and Italy, with the highest death rate per reported case, leading to a widespread belief that the Iranian authorities have been underreporting the extent of the spread of the virus. Opposition groups inside and outside Iran claim that the number of deaths is far higher, with infections numbering in the tens of thousands. Iraj Harirchi, Iran’s deputy health minister, who has contracted the virus, denied any effort to downplay its spread.

Iran has shut down school and universities, cancelled public gatherings, including Friday prayers, concerts and sports events, and suspended flights to Europe. Last week, the government announced the mobilization of 300,000-strong teams in health centres, schools and bases across the country belonging to the Basij, Iran’s paramilitary security agency. It also said that it is setting up of 26,000 health centres in Iran’s cities, towns and villages that would test suspected patients and monitor them in their homes for three days. If patients’ health did not improve within three days, they would be taken to a hospital or receive in-home care.

The judicial authorities have released 70,000 prisoners, those serving less than five years, in an effort to combat the virus.

Iran also announced that it has produced a vaccine that is awaiting permits from Iran’s Food and Drug Organization to enter the clinical phase, while the Islamic Revolutionary Guards Corps (IRGC) said it is working to develop its own coronavirus testing kits.

Iran is struggling to cope with the virus, which has become a threatening political issue. Citizens and experts have accused the government of concealing information and failing to take action as soon as the contagion became known. This includes the failure to quarantine the epicentre of the disease—the city of Qom, Iran’s seventh largest and one of the holiest cities for Shia Muslims, where the disease and two deaths were first reported on February 19.

Regime opponents claim that the government refused to draw attention to the spread of the virus that must have occurred much earlier than February 19 in order not to turn the virus and lack of healthcare facilities into election issues and jeopardise the turnout for the February 21 elections.

Since then, the virus has spread from Iran to other Middle East and Central Asian countries as well as Canada and New Zealand as people have returned from Qom and other Iranian cities. Should the virus spread to impoverished Syria, Iraq and Lebanon, the consequences could be catastrophic.

Nevertheless, few commentators outside Iran have seen fit to mention the devastating humanitarian consequences of US sanctions—designed to exert “maximum pressure” on Iran to effect regime change—on the country’s beleaguered healthcare system.

Successive US administrations have employed sanctions as a key foreign policy tool to inflict untold suffering on innocent people in various countries. The United Nations Children’s Fund (UNICEF) estimated that an additional half a million Iraqi children had died between 1991 and 1998 as a result of the sanctions against the government of Saddam Hussein.

Washington’s relentless campaign against Iran since the 1979 Revolution has taken a terrible toll. The 2012-2015 sanctions under the Obama administration led to Iran’s oil and gas exports falling from over $9 billion in 2012 to under $3 billion in 2016 when sanctions were briefly, if incompletely, lifted after the signing of the 2015 nuclear accord. This shattered the country’s economy and access to critical food, pharmaceutical and industrial supplies.

At that time, the difficulty in obtaining export licenses for medicine and medical equipment led to acute shortages of some drugs and medical facilities, huge price rises, with a massive impact on six million people suffering from diseases such as haemophilia, multiple sclerosis, thalassemia, epilepsy, and various immunological disorders, as well as transplant and kidney dialysis patients and those being treated for cancer.

The re-imposition of much broader sanctions after the US unilaterally withdrew from the 2015 accord in 2018, and the threat of secondary sanctions against those countries supplying Iran, resulted in a cut-off of vital medicines, with reports that 80 important drugs were no longer available under the Iranian state’s drug insurance scheme.

According to a report by Human Rights Watch (HRW), although humanitarian trade is exempt from US sanctions, “broad restrictions on financial transactions, coupled with aggressive rhetoric from US officials, have drastically constrained the ability of Iranian entities to finance humanitarian imports, including vital medicines and medical equipment.” The US subsequently placed Iran’s central bank, along with some 20 other institutions, on its list of Specially Designated Global Terrorists.

These restrictions, along with the fall of the Iranian currency, have severely limited the ability of Iranian companies and hospitals to purchase essential medicines and medical equipment. Although Iran produces 97 percent of its medicines, a third of these drugs are made with imported ingredients. Most of the drugs needed to treat rare and chronic diseases, including cancers, are part of the three percent of essential medicines that must be imported. According to a list published by the Young Journalist Club news agency last year, 79 medications were no longer covered in Iran, meaning patients must pay for them.

Medical costs are likely to rise further with inflation running at 40 percent last year, and oil revenues plunging. According to OPEC, by October 2019, Iran’s crude oil production had fallen to 2.1 million bpd. Bloomberg reported that only 260,000 bpd on average was being exported. According to the International Monetary Fund, Iran’s GDP shrank by about 4.8 percent in the 2018 and another 9.5 percent in 2019, while unemployment rose from 14.5 percent in 2018 to 16.8 percent in 2019.

In October 2018, the United Nations’ International Court of Justice (ICJ) in The Hague unanimously struck down US sanctions against Iran. Iran had brought the case, arguing that the US was in breach of its 1955 Treaty of Amity with Iran. The ICJ ruled that Washington must let Iran use international financial payments systems to buy humanitarian supplies. It demanded that Washington not block trade in critical goods, making it clear that the US war drive against Iran—including the re-imposition of banking sanctions on Iran—violated international law.

The Trump administration responded by saying it would withdraw from the treaty and review all international agreements that could expose it to binding decisions by the ICJ.

On February 29, President Donald Trump offered aid to Iran to help it cope with the virus if the country asked for assistance. Iran’s President Hassan Rouhani rejected this, saying, “They’ve appeared with a mask of sympathy that ‘we also want to help the people of Iran’.” He added, “If you are really telling the truth, then lift sanctions from medicine.”

Foreign Ministry spokesperson Abbas Mousavi went further, saying that the US was using the coronavirus outbreak as part of its propaganda campaign against Iran. He told reporters, “Since the outbreak of the virus in Iran, we have been observing the US-led anti-Iranian propaganda campaign and know about the measures the Americans have taken to reduce Iranian nation’s morale.”