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Medicine shortages and rising costs threaten Iran's healthcare system

Maryam Sinaiee
Maryam Sinaiee

Iran International

Feb 19, 2025, 14:50 GMT+0Updated: 20:32 GMT+0

Iran’s healthcare system is facing mounting challenges, with medicine shortages and soaring costs reaching alarming levels.

In February, Iran’s Pharmaceutical Association sent a letter to Ali Ahmadian, Secretary of the Supreme National Security Council, highlighting the government’s failure to pay its debts to pharmacies—estimated in the hundreds of millions of dollars, according to media reports.

The financial strain has severely disrupted pharmacies’ cash flow, hindering medicine procurement and availability. The letter warned that the crisis poses a serious threat to public health.

The head of Iran’s Medical Council (IRIMC), the non-governmental body responsible for medical licensing and regulation, also recently wrote to President Masoud Pezeshkian, raising concerns over delayed government payments to pharmacies.

The issue stems from government agencies such as the State Welfare Organization failing to pay their share of the cost of medicines dispensed to patients.

To keep essential medicines affordable, the Iranian government tightly regulates pharmaceutical prices and provides subsidies.

In 2022, President Ebrahim Raisi’s administration increased the official foreign currency exchange rate for medicine and medical equipment imports from 42,000 to 285,000 rials per dollar—nearly a seven-fold rise. Current free market exchange rate is more than 900,000 rials per dollar.

Authorities defended the move as an effort to curb the smuggling of subsidized medicine to neighboring countries. Another price increase of at least 20% is expected in the next Iranian calendar year, starting March 20, when new government exchange rates take effect.

In January, Iran’s Central Bank reported that it had allocated $3.4 billion for medicine, medical equipment, and pharmaceutical ingredients since late March 2024. Of this amount, $2.4 billion was provided to importers at the preferential rate of 285,000 rials per dollar.

Since March, the rial has depreciated sharply, plummeting from approximately 600,000 to over 900,000 per dollar in the open market.

Pharmaceutical companies report that currency shortages and the depreciation of the rial have significantly increased the cost of both imported medicines and domestically produced drugs that rely on imported ingredients.

The shortage of foreign currency allocated for medicine imports has fueled a thriving black market, where vital medications—especially those for cancer and rare diseases—are sold at exorbitant prices.

Despite these rising costs, strict government price controls have rendered the production of certain medicines unprofitable, leading some companies to discontinue manufacturing essential drugs.

Annual inflation has risen by around 40 percent, each year in the past five years, and the rial has lost 95% of its value since 2018 when Donald Trump withdrew from the 2015 nuclear deal and re-imposed draconian sanctions on the country.

The economic strain has taken a heavy toll on Iranian households. The massive depreciation of the rial and high inflation have drastically increased the cost of living, including expenses for food, housing, and healthcare and driven over 30 percent of the population below the poverty line.

According to Iran’s Statistical Center, healthcare accounts for approximately 10% of urban household expenditures.

Health Minister Mohammad-Reza Zafarghandi recently acknowledged that high medical costs are pushing many families into poverty, with lower-income groups often forgoing necessary treatments due to financial constraints.

Further compounding the crisis, Iran’s healthcare system has been hit by a mass exodus of doctors and nurses in recent years. Many medical professionals have emigrated to countries like Oman in search of better wages and improved living conditions, exacerbating the strain on Iran’s healthcare sector.

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'We are not negotiating' says Iran, as war talk mounts

Feb 19, 2025, 11:42 GMT+0

With Iran maintaining its stance against talks with the United States, it is pressing ahead with plans to triple its military budget for the new Iranian year in March, signaling preparations for potential military scenarios.

While officials deny that war is imminent, they acknowledge that diplomacy is no longer on the table.

Ahmad Bakhshayesh, a member of the Iranian Parliament’s National Security and Foreign Policy Committee, addressed the military budget increase which was announced in October when President Masoud Pezeshkian submitted the budget plan to the parliament for approval.

“It cannot be interpreted exactly in that way, but a significant increase in the military budget means that we are not negotiating and negotiations are not on our agenda,” Bakhshayesh told Ruydad 24 website.

Fatemeh Mohajerani, the government spokesperson, had announced a 200% increase in the military budget during a press conference in October saying that the purpose of the is move was to "strengthen the country's defense capabilities."

The budget for Iran’s armed forces was 7,220 trillion rials in last year’s budget bill. Given the exchange rate defined in that budget (330,000 rials per dollar), Iran’s military budget the last year could be estimated at $15.7 billion.

Based on this, the allocated budget for Iran’s armed forces in the coming year will likely be around 21,660 trillion rials. Given the exchange rate defined in the new year budget (570,000 rials per dollar) Iran’s military budget could be estimated at $46 billion.

The announcement follows increasingly aggressive rhetoric from Supreme Leader Ali Khamenei and senior commanders of the Islamic Revolutionary Guard Corps (IRGC), who have repeatedly signaled readiness for military confrontation.

On Tuesday, IRGC Aerospace Force Commander Amir Ali Hajizadeh said another attack on Israel, dubbed True Promise III, is in the cards.

“Iran’s third attack on Israel, True Promise 3, will definitely take place, but officials have planned for it and will use it strategically—we will not waste it,” Hajizadeh said.

He also warned that an assault on Iran’s nuclear facilities would trigger widespread conflict in the region.

Hajizadeh’s comments came after US President Donald Trump threatened Iran with an Israeli military strike if it refused to halt its nuclear program.

Meanwhile, officials the Pezeshkian administration, who previously advocated diplomacy, have shifted their stance, aligning with Khamenei’s hardline position against negotiations with the US—a stance he emphasized in a speech earlier this month.

“Today, in terms of hard defense and military threats from enemies, we have no concerns or problems,” Khamenei also said in one of his recent speeches.

The new year’s budget bill projects 1.75 million barrels of oil exports per day, with 420,000 barrels allocated to the military—equivalent to 24% of total exports. In monetary terms, the armed forces will receive €11 billion worth of oil, up from €4 billion in the previous year.

This nearly threefold increase means the military’s oil revenue will exceed the government’s by 520 trillion rials ($565 million).

Hajizadeh acknowledged that the military buildup is a response to growing tensions. “War conditions don’t always mean attacking—we must also prepare for being attacked,” he said, adding that heightened tensions have secured increased government funding.

Iran’s two previous attacks on Israel cost an estimated 1,380 trillion rials ($1.5 billion)—or 16 million rials ($17) per citizen. Meanwhile, over 60 million Iranians—70% of the population—rely on government food coupons for essential goods, yet the budget for these subsidies has been cut by 33%, dropping from €16 billion to €12 billion for the next year.

At the same time, the government lacks the funds to finance the food coupons and has resorted to withdrawing from the National Development Fund with the Supreme Leader’s approval.

With military spending surging, funds for vital imports—including medicines, infant formula, and livestock feed—have been slashed, driving up prices. Even before the next fiscal year begins, over 400 Social Security-covered medicines have already seen price hikes.

At least one third of Iranians are already living below the poverty line while workers strikes continue demanding unpaid wages.

Iran's chief banker in Russia to boost monetary ties

Feb 19, 2025, 09:25 GMT+0

The Governor of Iran's Central Bank traveled to Yekaterinburg, Russia, to meet with his Russian counterpart and continue talks on advancing financial and banking cooperation between the two countries.

According to the Central Bank of Iran’s public relations office, Mohammad-Reza Farzin's trip, made at the invitation of Elvira Nabiullina, Governor of the Central Bank of Russia, focuses on furthering the bilateral banking agreements between Iran and Russia.

In January, Iran and Russia implemented a bilateral currency agreement to settle trade using their national currencies, according to Iran's Central Bank.

According to Farzin,Tehran and Moscow are also working to integrate the Russian Mir and Iranian Shetab card payment networks.

It is unclear if the measure was related to an Iranian-Russian comprehensive strategic partnership agreement signed in January by Russian President Vladimir Putin and his Iranian counterpart Masoud Pezeshkian.

While experts warn of war, Iranian hardliner threatens US

Feb 19, 2025, 09:02 GMT+0
•
Behrouz Turani

A radical vigilante group leader in Tehran has suggested that Iran should carry out an operation against the United States similar to its missile attacks on Israel last year.

The conservative Tehran-based website Tabnak quoted Hossein Allah-Karam, leader of the vigilante group Ansar Hezballah, as saying that US President Donald Trump and Israeli Prime Minister Benjamin Netanyahu cannot follow through on their threats against Iran.

Tabnak described Allah-Karam as a political science professor at the University of Tehran and quoted him as asserting that Trump has failed to back his threats against Hamas. He concluded, “His other threat about bombing Iran if we do not sign a paper for him also cannot materialize.”

The hardline figure further claimed, “Trump’s performance has forced the United States and Israel to kneel before Gaza.”

He added, "We have achieved this with the capabilities we already have, so why should we challenge ourselves by opting to upgrade our capabilities?" This was perhaps a veiled reference to producing nuclear weapons and more potent ballistic missiles.

Allah-Karam’s remarks align with recent statements from Supreme Leader Ali Khamenei and some IRGC commanders suggesting Iran is prepared for conflict with Israel.

Radical vigilante leader Hossein Allah-Karam. Undated
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Radical vigilante leader Hossein Allah-Karam. Undated

In a recent speech, Khamenei called for upgrading Iran's ballistic missiles. Meanwhile, IRGC deputy commander Ali Fadavi said on Monday that a third direct attack on Israel will happen in due course. "Operation True Promise 3 will occur at the right time," Fadavi said.

Fadavi made these remarks in response to statements by Israeli and US officials regarding Iran’s perceived weakness, as well as Trump’s threat that Israel would bomb Iran if Tehran refused to negotiate with the United States over its controversial nuclear program.

He stated, “Not a single day has passed without the world's evildoers—the Great Satan, America, and its allies—waging war against us.”

Reformist political commentator Ahmad Zeidabadi warned on Telegram that "Netanyahu has already made preparations for attacking Iran in the coming months." He appeared to be referring to Trump's backing of the plan, possibly alluding to the shipment of US-made bunker buster bombs to Israel and stationing of US B-52 bombers somewhere in the region.

Zeidabadi added that "all official statements and both direct and indirect remarks from Israeli and US officials suggest that such an attack is imminent." He cautioned that "while it might be a limited strike, its consequences could be extremely destructive and uncontrollable."

On Monday, Canadian-based military analyst Houshang Hassanyari and German-based political analyst Ali Sadrzadeh, both Iranian-born, stated on Iran International TV that the Islamic Republic appears to be preparing for war against Israel. Both analysts agreed that Iranian officials and military commanders' claims about the country's military capabilities are based on illusion rather than reality.

Hassanyari warned that "the Islamic Republic is under a dangerous illusion. Khamenei believes his forces can defend Iran and deliver heavy blows to Israeli and US forces. Even if he is not actively planning a war against Israel, his rhetoric is pushing Iran toward one."

He added that Iran lacks strong military capabilities and is destined for a major defeat in any war. If a conflict with Israel breaks out, the United States will undoubtedly intervene to support Israel.

Sadrzadeh, however, expressed skepticism about the likelihood of war. "I do not believe Iran is preparing for a war with Israel, as its commanders and top officials must have at least a basic understanding of their forces' limitations. US officials say Iran has no effective air defense, and as far as I know, Tehran no longer has allies or strategic depth in the Middle East."

He also noted that the situation has changed since the Iran-Iraq war of the 1980s. Given the protests in Iran in recent years, it is inconceivable that Iranians would rally behind Khamenei’s idea of war against Israel.

As economic pressure mounts, Iran’s parliament moves toward impeachments

Feb 18, 2025, 12:55 GMT+0
•
Behrouz Turani

The dramatic fall in the value of the Iranian currency over the past few months, particularly since President Donald Trump took office in the United States, is likely to claim victims from among the president's cabinet members.

The rial has depreciated by approximately 50% against the US dollar since September, a sharp decline that is expected to further drive up Iran’s already high inflation by increasing the cost of both domestic production and imports.

Iran’s hardliner-dominated parliament (Majles) appears determined to impeach Economy Minister Abdolnasser Hemmati and push Pezeshkian to dismiss Central Bank Governor Alireza Farzin. Energy Minister Aliabadi is also on the impeachment list, facing scrutiny over his ministry’s failure to secure adequate fuel for power plants during the winter months.

Amid Supreme Leader Ali Khamenei’s repeated calls for unity within the government and his criticism of discord between the president and parliament, lawmakers held a closed-door meeting on Tuesday to brief Pezeshkian on the rial’s depreciation—despite the president already being well aware of the deeper causes of Iran’s chronic economic crisis.

“The Majles has vowed to hasten Hemmati’s impeachment if he and Pezeshkian fail to convince parliament that they are taking effective action to address the crisis and improve people’s livelihoods,” Iranian media quoted parliamentary officials as saying on Monday.

A session of the Iranian parliament on February 18, 2024
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A session of the Iranian parliament on February 18, 2024

Media outlets in Tehran, including Khabar Online, reported that while the primary reasons for the motions against Aliabadi and Farzin are power shortages and rising exchange rates, respectively, some in parliament may also be pushing for their removal due to their ties to former President Ebrahim Raisi’s administration.

Pezeshkian has faced repeated criticism from the media for reinstating officials from the previous government. Given this, it is easy to conclude that he might not oppose their dismissal, as it could help project the appearance of the much-sought "change" in his administration.

However, Hemmati presents a different challenge. His outspoken approach, as demonstrated in the past, has the potential to create problems for both parliament and the president. During Raisi’s three-year tenure, he frequently criticized the government's economic performance, making him a persistent and vocal opponent.

Analysts and commentators in Iran have long argued that chronic inflation and declining economic indicators stem from US sanctions imposed since 2018 and the state-controlled nature of the economy. While officials occasionally attribute economic hardships to sanctions, they more often emphasize Iran’s ability to circumvent them through innovative measures. Less frequently discussed, however, is the country’s unique and intertwined political-economic system, which fosters monopolies and enables corruption among insiders.

Regarding Aliabadi’s case, Pezeshkian has acknowledged that he himself bears responsibility for the fuel and power shortages, admitting to mistakes in assessing the issue.

Hemmati, meanwhile, has partly attributed the rial’s decline to "regional developments." However, according to Khabar Online, most Iranian media outlets place the blame on Pezeshkian and his appointment of ultraconservatives to key positions as the main drivers of the country’s financial and energy crises.

The Rouydad24 website has noted that Trump's return to power has intensified Iran’s economic crisis. It reported that his renewed threats of "maximum pressure" on Tehran have contributed to rising exchange rates and soaring gold prices in the Iranian market.

Fathollah Tavassoli, a member of the Majles economic committee, insisted that "those pushing for Hemmati’s impeachment are independent MPs" and that the move is not driven by political or factional motives. However, another lawmaker, Mohammad Mehdi Shahryari, countered that "hardliners are pressuring independent MPs to support the impeachment motion."

So far, 89 lawmakers out of 290 have signed the motion—far exceeding the 10 signatures required for the Majles presidium to proceed with impeachment.

The Paydari Party: Iran’s ultra-hardliner powerhouse explained

Feb 18, 2025, 07:52 GMT+0
•
Maryam Sinaiee

The Paydari Party, positioned at the far right of the Islamic Republic's political spectrum, remains relatively small but has significantly expanded its influence in Parliament and key state institutions in recent years.

Who leads the Paydari Party?

Since its official registration with the Interior Ministry in October 2020, the Paydari Party has been led by Sadegh Mahsouli.

Yet, Mahsouli—a former Islamic Revolutionary Guard Corps (IRGC) officer and business tycoon—rarely makes public statements or represents the party in the media. He previously served in Mahmoud Ahmadinejad’s administration, first as Minister of Interior and later as Minister of Welfare and Social Security.

The party’s Central Council Chairman, Morteza Agha-Tehrani, is a mid-ranking cleric (Hojjat ol-Eslam) who has been a lawmaker multiple times since 2008. A former close associate of Ahmadinejad, Agha-Tehrani was once appointed as the president’s “ethics advisor.” Currently, he chairs the Parliament’s Cultural Committee and has played a key role in pushing controversial hardline bills, including the Hijab and Chastity Law.

What are the party’s origins?

The Paydari Party traces its roots to the Islamic Revolution’s Paydari Front, an electoral alliance formed ahead of the 2012 parliamentary elections. It emerged as a hardline faction that split from Ahmadinejad’s camp after his power struggle with Supreme Leader Ali Khamenei over the dismissal of intelligence minister Heydar Moslehi.

After Ahmadinejad refused to acknowledge Khamenei’s reinstatement of Moslehi, his once-loyal allies who later formed the Paydari Party turned against him, branding him and his inner circle as “the deviant current.”

What does the Paydari Party stand for?

The Paydari Party and its affiliates promote a radical, apocalyptic interpretation of Shiism, centering on the belief in the Mahdi, the Twelfth Imam. According to their doctrine, this messianic figure—believed to have been in occultation since 941 CE—will eventually reappear to rid the world of sin and corruption.

The party and its allies maintain very close ties with Ayatollah Mohammad-Mehdi Mirbagheri, a highly controversial cleric widely regarded as the successor to the late Ayatollah Mohammad-Taghi Mesbah-Yazdi.

Mesbah-Yazdi, often considered the spiritual father of the Islamic Republic's ultraconservatives, was held in very high esteem by Supreme Leader Ali Khamenei.

Politically, the party is staunchly opposed to:

  • Any nuclear agreement with world powers
  • Diplomatic engagement with the United States and other Western countries
  • Iran’s accession to Financial Action Task Force (FATF) anti-money laundering conventions
  • Lifting of internet restrictions and censorship
  • Leniency in the enforcement of hijab rules

Despite its hardline ideology, the Paydari Party has successfully expanded its grip on Iranian politics, shaping policies that increasingly isolate Iran on the international stage while tightening domestic repression.

How powerful is the Paydari Party?

In the current Parliament (inaugurated May 27, 2024), the Paydari Party and its allies—including the Iran Morning Front (Jebhe-ye Sobh-e Iran), led by ultra-hardliner Ali-Akbar Raefipour—form one of the three dominant factions.

The party frequently clashes with other conservatives aligned with Parliament Speaker Mohammad-Bagher Ghalibaf, as well as the much smaller faction of “independent” and “reformist” lawmakers who were permitted to run for office by the Guardian Council.

The March 2024 parliamentary elections, along with the May runoffs, saw historically low voter turnout amid widespread public and political boycotts following the 2022–2023 Women, Life, Freedom protests. The Guardian Council faced accusations of mass disqualifications—including some conservatives—allegedly to pave the way for Paydari-backed candidates.

In Tehran, for example, Mahmoud Nabavian, a Paydari candidate, secured the first place with less than six percent of eligible votes.

The party also backed former nuclear negotiator Saeed Jalili in the June 2024 snap presidential elections, another vote marked by boycotts and low turnout. Jalili ultimately lost to Masoud Pezeshkian, winning 44.3 percent of the vote in the runoff.

The party currently wields great influence in many state organizations including the state broadcasting organization, the IRIB. Vahid Jalili, Saeed Jalili’s brother, is the cultural deputy of IRIB.