Economic sanctions on countries are indiscriminate weapons and should be banned
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ABSTRACT:
SUBMITTER: Choonara I
PROVIDER: S-EPMC8679062 | biostudies-literature | 2021 Jan
REPOSITORIES: biostudies-literature
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Project description:BackgroundSanctions have direct and indirect impacts on people's lives. Therefore, the health systems of countries targeted by sanctions must respond effectively. This study proposes a set of mitigating measures and response strategies to improve the health systems of countries under sanctions.MethodsThis three-stage study was conducted in Iran within the 2020-2021 period, in which a rapid review of evidence was carried out to identify the measures implemented or proposed to make the health system resilient in confronting sanctions. A qualitative approach was then adopted to determine how the health system could be improved to response to sanctions from the perspectives of 10 key experts. Semi-structured interviews and document analysis were conducted for data collection. Finally, a two-round Delphi technique was employed to help eleven experts reach a consensus on a set of mitigating measures, which were then prioritized.ResultsIn this research, 62 proposed or implemented mitigating measures were extracted from 13 eligible studies to improve the health system performance in confronting sanctions. Moreover, 18 measures were identified in interviews for a better health system response to sanctions. They were then classified as five categories: sustained financing, good governance, integrated and updated health information systems, qualified workforce, and efficient and equitable service delivery. In the first Delphi round, 28 mitigating measures were discovered. Nine measures were identified as more effective and feasible in both short and long runs. They were introduced as below: conducting proactive inventory control, developing the nationally essential list of medicines, providing additional clarification that oil revenues can be freely used for medicines procurement, defining tailored health service packages for vulnerable populations, establishing and enhancing an efficient surveillance system, reducing prices of imported medicines, developing dual policies of equity and priority for vulnerable groups, institutionalizing fair and effective resource allocations, and providing clinical guidelines.ConclusionsAccording to the findings, the most critical areas for the resilience of a health system in confronting sanctions include strengthening particular components of governance, improving efficiency, and caring for vulnerable populations. The experts collectively emphasized investment in domestic capacities, public participation, and health diplomacy. Despite the proposed measures, it is unclear how effective these are and, especially whether they can significantly affect the harsh impacts of sanctions on health. Moreover, intensive and long-term sanctions have significant irreversible outcomes that cannot be reversed easily or quickly.
| S-EPMC9797877 | biostudies-literature
Project description:BackgroundDue to political and security concerns, Iran has faced stringent sanctions in recent decades, significantly impacting vulnerable cancer patients. According to the latest statistics, the 5-year prevalent cases in Iran were 357,906 for both sexes combined. This study aimed to investigate the perspectives of cancer patients, their families, and non-governmental organizations (NGOs) regarding the ramifications of economic sanctions on cancer diagnosis and treatment.MethodsThis qualitative study was conducted by semi-structured interviews with 21 cancer patients and their family members, as well as representatives from relevant NGOs based in Tehran in 2020. The interviewees were selected using convenience sampling, and the data were classified and analyzed using qualitative content analysis in MAXQDA-2019 software.ResultsThe effects of economic sanctions on cancer patients were categorized into four themes: medicines, medical equipment, human resources, and financial resources. Medicines were further categorized into medicine price changes, scarcity, the complexity of dispensing medication, profiteering of drug manufacturers and distributors, and prolonged medical treatment subthemes. Medical equipment included price changes and difficulties in procuring medical devices and their accessories. Human resources comprised inadequate access to specialists and distorted doctor-patient relationships. Finally, financial resources were delineated by the diminished purchasing power of individuals and insufficient support extended to NGOs catering to patients' needs.ConclusionsThe findings underscore the urgency of addressing the multifaceted consequences of sanctions, which exacerbate vulnerabilities among cancer patients and hinder their access to timely and adequate care. Collaborative efforts between policymakers, healthcare providers, and NGOs are essential to mitigate these challenges and ensure equitable access to cancer treatment amidst ongoing sanctions. Furthermore, global health diplomacy could help reduce the effects of economic sanctions and facilitate the provision of medical equipment, medicines, and financial resources.
| S-EPMC11895320 | biostudies-literature
Project description:The economic sanctions imposed on Iran have had a significant impact on the country's healthcare system. The sanctions have affected the availability and affordability of cancer diagnosis and treatment services, leading to a range of challenges for patients with cancer. This study aimed to explore these challenges and gain a deeper understanding of the impact of economic sanctions on cancer care in Iran. The research method involved qualitative in-depth interviews with 53 experts, including clinical and basic sciences specialists, who were selected through purposeful sampling. The data were analyzed through qualitative content analysis using MAXQDA 2020. A total of 900 codes were identified, categorized into three primary groups-input, process, and output-and further divided into 13 subcategories. Within the input category related to health systems providing cancer care to patients, several critical issues emerged. These included instability in financing mechanisms and regulations, shortages of materials, low-quality imported materials, high material prices, and loss of human resources. Meanwhile, in the process of delivering diagnostic and treatment procedures to cancer patients, concerns centered around delayed and inadequate care, non-adherence to guidelines, limited international collaborations, and reduced provider satisfaction. Finally, during the output phase, the main subcategories extracted were lower effectiveness, increased adverse events, and increased equity gaps. Although economic sanctions against Iran have not officially targeted healthcare and access to drugs, they have restricted access to standard equipment and modern technologies, leading to increased delays, misdiagnosis, and diagnostic and therapeutic side effects in cancer patients to the point of death.
| S-EPMC11607833 | biostudies-literature
Project description: Not available
| S-EPMC10590471 | biostudies-literature
Project description:Fuzzy logic is one of the most widely used methods for quantifying qualitative studies. Because based on the fuzzy logic method, a wide range of verbal interfaces can be presented quantitatively. Fuzzy logic is a form of multi-valued logic. Quantitative indicators for qualitative events can be defined with its help. Iran has faced the phenomenon of economic sanctions since 1979 and after the victory of the Islamic Revolution. These sanctions have had different types and have affected different sectors of the Iranian economy. However, in most cases, studies on these sanctions have been limited and inefficient. In this study, based on the fuzzy method, an attempt has been made to define a quantitative index for economic sanctions during the years 1979-2019, using the opinions of economics experts on sanctions. This quantitative index can be utilized as a useful time series. Researchers in the field of Iranian economics and the economics of sanctions can help to study the impact of this economic phenomenon on different sectors of the Iranian economy. The results of this study showed the index of sanctions during 2011 and 2012, in which the most sanctions were imposed against Iran. The index was extracted and it was shown that it had the highest value.•In qualitative studies, to quantify the studied trends, the method of fuzzy logic and conversion of verbal propositions into numbers and figures can be used.•The index of economic sanctions is a useful time series for researchers in the field of sanction economics and the Iranian economy.•The index of economic sanctions can determine how each of the economic sanctions against Iran will work.
| S-EPMC8374288 | biostudies-literature
Project description:Taxation policies can explain the differences in countries' capacity to produce and export more sophisticated products. We develop a theoretical model considering elements from standard models of economic growth to highlight that a country's productive structure is implied by the appropriate fiscal policy that is necessary for the development of sophisticated products. We show that economies that rely less on capital relative to labor taxation tend to produce more complex products, while countries that rely more heavily on capital relative to labor taxation produce simple products. These relationships remain robust across alternative econometric specifications. Furthermore, we demonstrate the differential effect of a country's level of economic development on the nexus between the structure of taxation and economic sophistication. We show that the negative impact of capital taxes on economic sophistication becomes stronger for countries that are more developed.
| S-EPMC6426228 | biostudies-literature
Project description:ObjectiveThis study included 54-month-old children with a history of institutional care. Our goal was to: (1) examine differences in indiscriminate social behaviors in children with a history of institutional care compared with home-reared children; (2) test whether foster care reduces indiscriminate social behaviors in a randomized controlled trial; and (3) examine early predictors of indiscriminate behaviors.MethodsParticipants were 58 children with a history of institutional care and 31 never-institutionalized control (NIG) subjects enrolled in a randomized controlled trial of foster care for institutional care, assessed from toddlerhood to 54 months. Indiscriminate social behaviors were measured naturalistically by using the Stranger at the Door procedure.ResultsIn the Stranger at the Door procedure, children with a history of institutional care left with a stranger at higher rates than NIG subjects (33% vs. 3.5%; P < .001). Children in the care as usual group left more than NIG subjects (41.9% vs. 3.6%; P ≤ .001). The differences between the foster care group (24.1%) and the care as usual group and between foster care group and NIG were not significant. In a logistic regression, early disorganized attachment behaviors, baseline developmental quotient, and caregiving quality after randomization contributed to variance at 54 months. In the same analysis using only children with a history of institutional care, only disorganized attachment contributed significantly to 54-month indiscriminate social behaviors (Exp[B] = 1.6 [95% confidence interval: 1.1-2.5]).ConclusionsObserved socially indiscriminate behaviors at 54 months were associated with prolonged exposure to institutional care. Young children raised in conditions of deprivation who fail to develop organized attachments as toddlers are at increased risk for subsequent indiscriminate behaviors.
| S-EPMC3934326 | biostudies-literature
Project description:BackgroundFormal evidence regarding the effects of sanctions on population health status and the health system is scarse in Iran. Given the intricate and multifaceted nature of sanctions, a nuanced understanding of their impact is imperative. We aimed to investigate the magnitude and effects of sanctions on population health and healthcare system during the last two decades in Iran.DesignThis is a mixed-methods research. We quantified the impact of sanctions using 28 indicators, i.e. macroeconomic, healthcare resources and health outcomes indicators from 2000 to 2020. The concurrent qualitative study aimed to explore the pathway of the effect by considering perceptions of both patients and health policy makers towards sanctions; Interview data was analyzed using content analysis.SettingThis study was conducted in Iran at both national and sub-national levels.ResultsOur findings revealed that the trend of 11 indicators (39.2%) had changed after the change point in 2009; four indicators (14.2%) significantly deteriorated after the change point. Further, five indicators revealed significant increases during the sanctions period: Out-of-Pocket payment (OOP), household expenditure on food and mortality rates due to Chronic Obstructive Pulmonary Disease (COPD), thalassemia and hypertension. Our qualitative analysis revealed that patients identified availability, cost and quality of medicines and healthcare services as the most significant challenges that compromised population's health. From the policy makers' perspective, the effect of sanctions on health system functions and infrastructures, i.e. economic, political, social, educational and research had significant repercussions on population health.ConclusionWe could not find compelling evidence to establish significant associations between the imposition of sanctions and the trend of population health. Nevertheless, our qualitative study revealed people's deteriorating life experiences, e.g. increasing catastrophic health expenditure, limited access to necessary medicine, medical equipment, procedures and interventions, imposed by sanctions, with ultimate reducing impact on the overall quality of life. It seems that sanctions have negatively affected financial and physical access to medication and healthcare services. Nonetheless, Iran has demonstrated remarkable resilience against their highly detrimental effects, maybe due to its established economic infrastructure and healthcare system.
| S-EPMC11580230 | biostudies-literature
Project description:Children's blood lead levels have declined worldwide, especially after the removal of lead in gasoline. However, significant exposure remains, particularly in low- and middle-income countries. To date, there have been no global estimates of the costs related to lead exposure in children in developing countries.Our main aim was to estimate the economic costs attributable to childhood lead exposure in low- and middle-income countries.We developed a regression model to estimate mean blood lead levels in our population of interest, represented by each 1-year cohort of children < 5 years of age. We used an environmentally attributable fraction model to estimate lead-attributable economic costs and limited our analysis to the neurodevelopmental impacts of lead, assessed as decrements in IQ points. Our main outcome was lost lifetime economic productivity due to early childhood exposure.We estimated a total cost of $977 billions of international dollars in low- and middle-income countries, with economic losses equal to $134.7 billion in Africa [4.03% of gross domestic product (GDP)], $142.3 billion in Latin America and the Caribbean (2.04% of GDP), and $699.9 billion in Asia (1.88% of GDP). Our sensitivity analysis indicates a total economic loss in the range of $728.6-1162.5 billion.We estimated that, in low- and middle-income countries, the burden associated with childhood lead exposure amounts to 1.20% of world GDP in 2011. For comparison, in the United States and Europe lead-attributable economic costs have been estimated at $50.9 and $55 billion, respectively, suggesting that the largest burden of lead exposure is now borne by low- and middle-income countries.
| S-EPMC3764081 | biostudies-other
Project description: Not available
| S-EPMC10831441 | biostudies-literature