US Sanctions on Iran Are Devastating and Ineffective

US sanctions are causing crippling shortages for many Iranians. But far from bringing the Islamic Republic to its knees, the sanctions are an opportunity for elites to remodel the economy — and find new ways of profiting from misery.

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Women walk along a street in Tehran, Iran, on February 28, 2024. (Atta Kenare / AFP via Getty Images)


There are no Soviet-style queues in front of Tehran’s pharmacies, yet the shortage rages on. Nothing looks irregular on the shelves of medicine, which are full to bursting, and yet some basic necessities are missing.

“I’m sorry, we’ve run out of colistin.” In the center of the capital, a new customer, and another “no.” “It’s not the first today,” comments Ali (all first names have been changed), a night pharmacist who has just graduated from Tehran University. This antibiotic, like so many others, has been in short supply since sanctions against Iran were restored in 2018.

The US State Department does provide for a series of humanitarian exemptions. But when they are mentioned, pharmacists retort, “Today, 90 percent of medicines are produced in Iran,” whereas the country used to import most of them. An emblematic case of overcompliance: in theory, Western pharmaceutical players can legally trade with Iran, but they avoid doing so for fear of sending negative signals to the financial markets.

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