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Iran's Insulin Shortage Prompts Scrutiny

IRAN -- Iranians wait to get prescription drugs at the state-run "13 Aban" pharmacy in Tehran, February 19, 2020
IRAN -- Iranians wait to get prescription drugs at the state-run "13 Aban" pharmacy in Tehran, February 19, 2020

A widespread protest is underway on Persian social media against the shortage of insulin in Iran.

Eight months have passed since pharmacies in Iran have run out of insulin pens.

The lack of response from government officials prompted social media users to circulate the hashtag "no insulin" on Sunday to express their concern about the condition of diabetic patients, demanding the government address the crucial problem immediately.

Out of more than five million diabetic patients in Iran, at least 600,000 require daily insulin injections and the use of a blood glucose test strip to measure their blood sugar daily.

On September 17, 120 endocrinologists wrote in a letter to Iranian President Hassan Rouhani saying that, despite the diabetes associations' correspondences with the Central Bank and the Ministry of Health about the severe shortage of glucose test strips and insulin pens, Iranian senior officials have not yet realized the urgency needed to tackle the deficit.

The government can provide the required insulin, the specialists noted, "but the government has not yet recognized the necessity of providing insulin as an absolutely vital medicine."

Following the protest, President Rouhani's Chief of Staff, Mahmoud Vaezi, announced in a letter to the Minister of Health on September 30 that "act according to the President's order. Investigate and act immediately."

However, over a month after Vaezi's letter, the lack of insulin pens has not been addressed.

Government officials previously cited the "difficulty in securing hard currency and allocating it to pharmaceutical companies" as one of the main reasons for the shortage of insulin pen and glucose test strips.

According to the FDA's Director-General for drugs issues and a member of the parliamentary health commission, Homayoun Najafabadi, noted that the shortage could result from "reverse smuggling" of the two products to the neighboring countries.

Over the years, numerous drug trafficking reports have resulted from the smuggling of rare medicines from Iran, mainly to Iraq.

The most recent case was the seizure of nineteen trucks containing hundreds of thousands of medicines from Iran by Iraqi military intelligence.

Iraqi military intelligence disclosed the seizure on October 15, with Iranian officials bemoaning the impact of sanctions on drug imports to Iran.

A day after, Iranian authorities maintained the trucks were indeed carrying "Iraqi drugs" bought from the United Arab Emirates and passing through Iran. If true, it is not yet known why Iraqis seized their "own" shipments.

Speaking to the state-run Iran Students News Agency (ISNA), the Director-General of Medicine at the Food and Drug Administration, Haidar Mohammadi, also referred to the reverse smuggling of insulin and called on people with diabetes to use other types of insulin known as "regular."

"We have no shortage of insulin, but there is a shortage of foreign-made insulin pens," Mohammadi told Tasnim News, adding, "We have abundant supplies of regular and NPH (Neutral Protamine Hagedorn) insulin, and people can use them."

Simultaneously, a member of the National Diabetes Committee, Alireza Esteqamati, says that about eighty percent of people with diabetes use analog insulin pens only not for their easy application, but for their structural difference and effectiveness from the regular ones.

According to Haidar Mohammadi, currently, only two pharmaceutical companies are assembling insulin pens in Iran, which does not meet all patients' needs. They have promised that the shortage will be resolved by November.

However, during the peak of the novel coronavirus outbreak, patients with diabetes are among the most vulnerable groups to the deadly virus, and insulin deficiency can lead to fatal harm to these individuals.