Shahabi Shohreh, Fazlalizadeh Hooman, Stedman Jennifer, Chuang Linus, Shariftabrizi Ahmad, Ram Regina
Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Prentice Women's Hospital, Northwestern University Feinberg School of Medicine, Chicago, USA; Columbia University Mailman School of Public Health, New York, USA.
Department of Obstetrics and Gynecology, Division of Gynecology Oncology, Danbury Hospital, Danbury, USA.
Health Policy. 2015 Oct;119(10):1309-18. doi: 10.1016/j.healthpol.2015.08.012. Epub 2015 Aug 22.
In 2012, Iranian's economy collapsed under strain from sanctions instituted to stop Iran from violating the International Nuclear Non-Proliferation Treaty. Sanctions have indirectly led to serious healthcare concerns, specifically cancer treatment. This is the first report to evaluate Iranian cancer healthcare while under international economic sanctions.
Data and information were identified by searches of MEDLINE, PubMed, and references from relevant articles using the search terms: "Iran", "health policy", "sanctions", "ethics", and "cancer". Articles published in the English language between 1966 and present were included, based on relevance to sanctions or the specific case of sanctions in Iran.
The Program of Action for Cancer Therapy evaluated Iran's National Cancer Control Program (NCCP), reporting it has substantial deficits, including prevention, diagnosis/treatment, palliative care, monitoring, and technology, with a serious drug shortage for cancer care. Sanctions have exemptions for medicines and food, but lead to disruption of health services through complications in transportation, transferring currencies or lack of money.
There is increasing evidence that sanctions harm vulnerable populations, while blocking globalization and not creating political or social change quickly. Improvement of Iran's NCCP is not feasible, and the health of cancer patients will continue to decline while the sanctions are in effect. The solution is complex, but a modern and innovative approach to diplomacy, which includes human rights, is necessary.
2012年，伊朗经济在为阻止其违反《国际核不扩散条约》而实施的制裁压力下崩溃。制裁间接导致了严重的医疗保健问题，尤其是癌症治疗。这是首份评估国际经济制裁下伊朗癌症医疗保健情况的报告。
通过检索MEDLINE、PubMed以及相关文章的参考文献来识别数据和信息，检索词为：“伊朗”“卫生政策”“制裁”“伦理”和“癌症”。纳入1966年至今以英文发表的文章，依据其与制裁或伊朗制裁具体情况的相关性。
癌症治疗行动纲领评估了伊朗的国家癌症控制计划（NCCP），报告称该计划存在大量不足，包括预防、诊断/治疗、姑息治疗、监测和技术方面，癌症护理药物严重短缺。制裁对药品和食品有豁免，但通过运输并发症、货币兑换问题或资金短缺导致卫生服务中断。
越来越多的证据表明，制裁伤害弱势群体，同时阻碍全球化且无法迅速带来政治或社会变革。在制裁生效期间，改善伊朗的国家癌症控制计划不可行，癌症患者的健康状况将持续恶化。解决方案很复杂，但需要一种包括人权在内的现代且创新的外交方法。
