From: Health system to response to economic sanctions: global evidence and lesson learned from Iran
The targeted function of the health system | Mitigating measures | Source | Type of measure |
---|---|---|---|
Financing arrangement | 1. Mobilizing latent resources in education and health | [21] | Implemented |
2. Providing additional clarification that Iranian oil revenues can be freely used for medicines procurement without reservations | [9] | Proposed | |
3. Supporting local production | Implemented | ||
4. Price reduction of imported medicines | [22] | Implemented | |
5. Optimizing the domestic market | [15] | Proposed | |
6. Centralized and strategic purchasing | [23] | Proposed | |
7. Rationalization of the prices of medicines | [23] | Proposed | |
8. Strengthening the insurance system | [23] | Proposed | |
Governance arrangement | 9. Establishing uniform criteria and definitions for exemptions as well as operational criteria for sanctions committees to facilitate improved effectiveness of exemptions | [24] | Proposed |
10. Developing dual policies of equity and priority for vulnerable groups | [25] | Implemented | |
11. Mobilizing public participation to compensate for reduced access to capital goods | [21] | Implemented | |
12. The use of public systems to motivate behavioral change, with a focus on the needs of women and children | [21] | Implemented | |
13. Refocusing health policy toward maximizing scarce resources | [21] | Implemented | |
14. Professional organizations, especially those concerned with children's health, must advocate for children in countries experiencing economic sanctions | [26] | Proposed | |
15. Advocating for global health diplomacy to ensure that ongoing multilateral negotiations do not neglect public health and humanitarian need | Proposed | ||
16. Establishing regulatory export harmonization | [9] | Proposed | |
17. Amending the OFAC EAR99 classification system to make it easier for US companies to export medicines | [9] | Proposed | |
18. Exempting vaccine products from stringent export controls | [9] | Proposed | |
19. Allocating a protected SWIFT line specifically for humanitarian medicines trade | [9] | Proposed | |
20. Exempting medicine and medical commodities from “snap back” provisions; | [9] | Proposed | |
21. Providing a national policy with measures to prevent the suffering of people from the adverse effects of sanctions | [12] | Proposed | |
22. Preventing third parties; black market dealers, pharmacies, and health facilities that provided unsafe medicines, as well as smugglers who sent scarce medicine to neighbouring countries | Proposed | ||
23. Refraining from imposing embargos and other measures that restrict the supply of medicine and medical equipment | [12] | Proposed | |
24. Developing policies and laws to alleviate the negative impacts of their agreements on the human rights of the population in the target country | [12] | Proposed | |
25. Designing some international intermediate organizations and certain companies and financial institutions to facilitate the implementation of exemptions | [12] | Proposed | |
26. Permitting immediate release of medicines from customs by minimum financial documents | [22] | Implemented | |
27. Determining a memorandum of understanding (MOU) between the IFDA Iran’s Food and Drug Administration) and the Central Bank | [22] | Implemented | |
28. Determining a memorandum of understanding (MOU) between the IFDA and health insurance organizations for the extra financial protection of special, incurable, and chronic patients with high pharmaceutical expenditures and for allocating the additional budget to over-compensate unaffordable pharmaceutical products based on the equity-based criteria | [22] | Implemented | |
29. Developing the national essential medicines list | [22] | Proposed | |
30. Using use all available political and legal means, such as health diplomacy, to establish humanitarian channels to enhance global convention and remove possible barriers as the sanctions and reduce their adverse consequences for antimicrobial resistance control | [28] | Proposed | |
31. Creating efficient food assistance programs by the government and the international community, funding food banks with the assistance of charities and non-governmental organizations, and participating individuals in nutritional education programs and learning how to plan a cheap and balanced diet | [29] | Proposed | |
32. Boosting the morale, knowledge, skills, and innovation of managers can potentially increase resilience | [15] | Proposed | |
33. Creating mutual trust among different organizations | [15] | Proposed | |
34. Revisions in Iran’s health management | [23] | Proposed | |
35. Delegation and privatization | [23] | Proposed | |
36. Strengthening of inter-sectoral cooperation | [23] | Proposed | |
37. More attention to mass media | [23] | Proposed | |
38. Interactions with neighbouring countries | [23] | Proposed | |
39. Management and development of health tourism | [23] | Proposed | |
Information and evidence | 40. Improving means of monitoring the impact of sanctions on civilian populations in targeted countries, particularly concerning water purity, food availability, and infectious disease control | [24] | Proposed |
41. Advocating prospective studies to generate the data needed to provide better information and monitoring capacity than presently exists | [24] | Proposed | |
42. Strengthening health monitoring systems | Implemented | ||
43. Advocating for the integration of Health Impact Assessments (HIAs) that identify the health consequences of sanctions | [9] | Proposed | |
44. Monitoring human rights situations and utilizing the maximum resources available to eliminate suffering with low-cost programs, international assistance, and cooperation | [12] | Proposed | |
45. Assess the effects of the policies and international agreements on the health of people in the target country | [12] | Proposed | |
46. Observing the situation of human rights and implementing humanitarian and human rights laws | [12] | Proposed | |
47. Employing cost-effectiveness evidence for pricing and reimbursement | [22] | Proposed | |
48. Developing an integrated information system for monitoring the market | [22] | Proposed | |
49. Determining the exact magnitude of the impact | [30] | Proposed | |
50. Electronic health record | [23] | Proposed | |
51. Electronic prescription | [23] | Proposed | |
Service delivery arrangement | 52. Rationing, universal access to primary health care, a highly educated population, and preferential access to scarce goods for women and children | [25] | Implemented |
53. Emphasizing preventative over curative medicine | [21] | Implemented | |
54. Protecting vulnerable groups of the population, such as children and the poor | [12] | Proposed | |
55. Facilitating the delivery of necessary items for life and health, such as medicine, food, and medical equipment | [12] | Proposed | |
56. Proactive inventory control | [22] | Implemented | |
57. Providing clinical guidelines for rational prescribing | Proposed | ||
58. Proper implementation of the referral system | [23] | Proposed | |
59. Medication tracking | [23] | Proposed | |
60. Informing the medical community | [23] | Proposed | |
61. Use of alternative medicines and methods | [23] | Proposed | |
62. Consumer–patient collaboration | [23] | Proposed |