Guidance

Country policy and information note: medical and healthcare issues, Iran, June 2024 (accessible)

Updated 23 July 2024

Version 3.0

June 2024

Country information

About the country information

This note has been compiled by the Country Policy and Information Team (CPIT), Home Office.

It provides country of origin information (COI) for Home Office decision makers handling cases where a person claims that removing them from the UK would be a breach of Articles 3 and/or 8 of the European Convention on Human Rights (ECHR) because of an ongoing health condition. It contains publicly available or disclosable COI which has been gathered, collated and analysed in line with the research methodology.

The note aims to be a comprehensive but not exhaustive survey of healthcare in Iran.

The note’s structure and content follow the terms of reference.

For general guidance on considering claims based on a breach of Article 3 and/or 8 of the ECHR because of an ongoing health condition, see the instruction on Human rights claims on medical grounds.

This note makes use of information compiled by Project MedCOI (MedCOI), which was set up and operated by the Belgium and Netherlands immigration authorities until 31 December 2020. Thereafter MedCOI was run by the European Union Agency for Asylum (EUAA), formerly known as the European Asylum Support Office (EASO).

MedCOI’s information gathering and quality assurance processes remain unchanged since December 2020 when the UK Home Office’s access stopped.

The EUAA website explains how the project currently operates:

‘EUAA MedCOI relies on a worldwide network of medical experts that provides up-to-date medical information in countries of origin. Based on this information and combined with desk research, the EUAA produces responses to individual requests from EU+ countries and maintains a portal with a specific database where the information can be found. The portal also allows for the continuous exchange of information between countries, and between countries and the EUAA. The database is only accessible to trained personnel in EUAA and the EU+ countries’ relevant administrations…The high quality and medical accuracy of the information is guaranteed by specifically trained medical advisors and research experts who also provide guidance to the users of the portal.

‘EUAA MedCOI is continuously subject to internal and external quality assurance activities such as validations, audits, and peer reviews.’^{[footnote 1]}

The UK Home Office’s access to MedCOI ended on 31 December 2020. However, copies of all MedCOI documents referred to in this note have been retained and are available on request.

Section updated: 14 May 2024

1. Costs and currency

1.1.1 This note includes the cost for various medications and treatments. These prices have been converted into British pounds whenever possible. The exchange rate as of 14 May 2024 was £1 = 52,293.46 Iranian rials^{[footnote 2]}.

Section updated: 4 June 2024

2. The healthcare system

2.1 Organisation of the healthcare system

2.1.1 The Landinfo (Norwegian COI research organisation) 2020 report, ‘Iran – The Iranian Welfare System’, citing various sources, stated:

‘Three categories of providers offer health services in Iran: public, private, and non-profit NGOs/charities. Public hospitals are either run by the MoHME [Ministry of Health and Medical Education] or by state institutions, such as the Social Security Organization (SSO). According to an official in the MoHME, there are a total of 1100 hospitals…The majority – 749 – of the hospitals are affiliated to the MoHME, while 166 are private. The SSO runs 73 of the hospitals, the military 32, and charity organizations manage 37 hospitals…

‘The Ministry of Health and Medical Education…is responsible for health policy formulation, resource mobilization, monitoring and evaluation, and regulating health service delivery throughout the health structure… The ministry’s health system is organized at three levels of governance. At the central level, the ministry operates in close coordination with two multisectoral bodies: one is the Supreme Council for Health and Food Products Security (SCHFP) and the other is the Supreme Council for Health Insurance (SCHI)…

‘The second level of health governance lies with the Board of Trustees at the medical universities, which have semi-autonomous control within their areas. The university hospitals are localized in the major cities and provide specialized medical services. General public hospitals, on the other hand, are under the supervision of the district health network…

‘The third level is the network of health centres and health houses, providing primary health care services across the country.

‘In addition to the services of the MoHME, the SSO offers services through their separate network of hospitals, health centres and clinics.’^{[footnote 3]}

2.1.2 The Landinfo report, Iran – The Iranian Welfare System, also stated:

‘Officials in the Ministry of Health and Medical Education explained that the primary health care system in Iran consists of a vast network of local clinics which are called health houses (khane-ye behdasht) in rural villages and health posts in cities. Each health house, which covers up to 2000 inhabitants in the rural area, is staffed with community health workers, called behvarz, who have received two years of health education in addition to 12 years in school. The behvarz provide not only medical treatment but also annual censuses, health education, family planning, maternal and child health care, elderly care, oral health and occupational health…

‘The health houses are connected to rural health centres (markaz-e behdasht), which cover between 5,000 and 10,000 people in a district. In a rural health centre, there are at least two, maybe three, general physicians, one staff nurse, and one technician…

‘Furthermore, in each district, there is one comprehensive district health centre (markaz-e khass) that functions as a headquarters for the district with the responsibility to oversee and support the rural health centres and health houses with logistics and resources…’^{[footnote 4]}

2.2 Provision of healthcare

2.2.1 A medical research study, ‘Public-private partnership in primary health care: an experience from Iran’, published in 2023 by Cambridge University Press, stated:

‘Healthcare services in Iran are provided at three levels. The first level includes units in which the first and the widest community contact the healthcare delivery system. Service provider units at this level include health houses, health posts and rural/urban comprehensive health centers (CHC). Healthcare providers in health houses include male and female Behvarz and in health posts include family health nurses. The Behvarzes are community health workers to provide PHC [primary health care] in rural areas. Community members with at least primary education are recruited to the Behvarz program based on their performance in an entrance examination… In urban/rural CHC, general physicians, sometimes dentists, nutritionists, psychologists and occupational and environmental health experts are usually working…The second level includes units that are able to provide more specialized healthcare services. It includes district health center, Behvarz training center, district hospitals and outpatient-specialized clinics. The set of the first- and second-level units in each district’s geographical area constitute the district health network…The third level includes specialty clinical and educational services which are supplementary to second level. Specialty and super subspecialty hospitals and province health center and various medical schools are involved in this level. The movement of patients through these levels is carried out in the form of the referral system…’^{[footnote 5]}

2.2.2 The Australian government Department of Foreign Affairs and Trade (DFAT) Country Information Report on Iran, published in July 2023, stated:

‘The government is the main provider of primary health care services and healthcare is a key government priority. Government spending on health has increased significantly over the last decade and is currently about 8.7 per cent of GDP according to the United Nations Development Programme.

‘All Iranian citizens are entitled to free healthcare, however quality and availability of services can be variable, especially in poorer rural areas. A survey by the World Health Organisation (WHO) in 2020 found that 98 per cent of Iranian children aged 24–35 months and 90 percent of non-Iranian children aged 24–35 months had received all necessary childhood vaccinations…In rural areas, healthcare is accessed at primary healthcare centres known as “Health Houses”. Major cities are well serviced with large public hospitals and health centres. Urban dwellers may have the option of private healthcare, but it can be expensive. NGOs may also provide specialist (for example, cancer) care.’^{[footnote 6]}

2.3 Public health insurance

2.3.1 The UNESCAP (United Nations Economic and Social Commission for Asia and the Pacific) 2019 report, ‘Iran’s Primary Health Care Network’, stated:

‘The Social Security Organisation (SSO) operates a compulsory and contributory insurance scheme for the formal sector and the self-employed with contributions at 7 per cent by the employee, 20 per cent by the employer and 3 per cent by the government. The SSO reaches 36 per cent of the population and provides full coverage at a network of 27 hospitals, 260 clinics, and access to State hospitals with 10 per cent of the cost shared by the claimant.’^{[footnote 7]}

2.3.2 The same source additionally stated:

‘In 1979 Iran introduced the Primary Health Care Network (PHCN) in order to provide free access to basic health care services at the district and village level…

‘The PHCN is complemented by two comprehensive health insurance schemes designed to provide higher levels of coverage to eligible claimants. The Medical Service Insurance Organisation (MSIO) offers contributory health insurance to the public sector, students and those in rural areas not covered under other schemes. The MSIO provides full coverage for all services not covered under PHCN, including diagnostic services, treatment of illness and disease and emergency services.’^{[footnote 8]}

2.3.3 The Landinfo report, ‘Iran – The Iranian Welfare System’, stated:

‘Public health insurance is provided by four main public funds that cover different categories of people, mainly according to professional and employment status. The basis of enrolment to these health insurance schemes is either mandatory, automatic, or voluntary…

‘The most encompassing health insurance scheme in Iran is provided by the Social Security Organization (SSO) and is called Social Security Medical Insurance (bimeh-ye darmani-ye ta’min-e ejtema’i). It covers mainly employees and self-employed workers in the private sector, as well as employees on short-term contracts in the public sector…

‘Then there is the Iran Health Insurance Organization (IHIO) that provides health insurance for government employees, students, and rural dwellers. This insurance is simply called “health insurance” (bimeh-ye salamat), while the new insurance in the framework of the HTP [Health Transformation Plan] is called “insurance for Iranians” (bimeh-ye iraniyan)…

‘The poorest segment of the population, which has traditionally lacked health insurance, has to some extent been supported by the Imam Khomeini Relief Foundation (IKRF). Although the IKRF is often referred to as an insurance provider, it is organized differently as it provides support on a need-based assessment and is funded not by premium but rather by private donations in addition to public funds…It is thus rather a charity organization that covers health costs and other social services for the vulnerable.

‘In addition to these large, public funds, there are around 17 smaller, semi-public health insurance schemes run by different state-owned enterprises.’^{[footnote 9]}

2.4 Private health insurance

2.4.1 The Landinfo report, ‘Iran – The Iranian Welfare System’, stated:

‘There are private and semi-public insurance companies that mainly offer supplementary insurance for costly inpatient services. Premium insurances offer additional coverage to the basic coverage…

‘Some people have private health insurance schemes in order to have access to treatment in private institutions. However, private institutions are not exclusively for patients with private insurance. Members of public health insurance schemes may choose to be treated in private institutions and will have part of the treatment covered by public insurance. They will then receive a refund of the same amount as the tariff of a given treatment at a public hospital and pay the exceeding amount if the tariff is higher in the private institution. The exceeding payment to the private institution could be covered by private insurance or paid by the patient…’^{[footnote 10]}

2.5 Number of healthcare facilities and personnel

2.5.1 The Mehr News Agency (Iranian news media outlet)^{[footnote 11]}, report, ‘Iran’s outcomes in healthcare over past 45 years’, dated 4 February 2024, stated:

‘Before the Islamic Revolution, up to 37 percent of cities had access to hospitals and medical centers, but now that figure has reached more than 97 percent. The number of hospital beds in the country has increased from 50,000 to 150,000 beds.

‘In addition, before the Islamic Revolution, there were 3 doctors per 10,000 people in the country, but now that figure has reached 16 doctors per 10,000. Physician per capita has increased 5 times in the last 45 years, while the population of the country has grown by 2.5 times.

‘The important development follows a nearly 12-fold increase in the number of doctors. Before the Revolution, there were about 14,000 physicians, including general physicians and specialists in various fields, a significant part of which included foreign doctors, but now there are 160,912 physicians in the country, which has grown over 11 times.’^{[footnote 12]}

2.6 Non-governmental organisations (NGOs) and other support

2.6.1 The Landinfo report, ‘Iran – The Iranian Welfare System’, stated: ‘Additionally, there are many NGOs and charities throughout the country running health institutions with access based on a needs assessment without any reference to prior insurance coverage.’^{[footnote 13]}

2.6.2 CPIT was unable to find information about the specific NGOs that run healthcare services in Iran, from the sources consulted (see Bibliography).

2.7 Availability and accessibility to medical treatment and drugs

2.7.1 The Borgen Project (non-profit organisation that is working to end poverty and hunger) article, ‘8 Facts About Healthcare in Iran’, dated 1 October 2020, stated:

‘Public facilities are the main provider of healthcare. During the 1980-1988 war with Iraq, the Islamic Republic of Iran was in miserable conditions and it was difficult to visualize progress in the Iranian health system, especially the access of health services to rural areas. Nonetheless, the Iranian government has made many efforts to reduce rural poverty, extend the healthcare structure through health houses and provide primary, secondary and tertiary services, especially to rural areas. Today, more than 90% of Iran’s 23 million rural population has access to free healthcare services such as prenatal care and vaccination.

‘Health houses are the principal access point for rural residents to receive health services. Health houses are small public medical facilities that provide health services to the rural areas surrounding them. Generally, trained medical workers that manage vaccinations, maternal health care and child health care integrate these facilities. There are approximately 17,000 health houses in Iran or one for every 1,200 residents. Health Houses have had a tremendous impact on Iranian rural societies since they have improved the health infrastructure and reduced the distance that people need to travel to receive medical care. Health Houses have become an efficient and cost-effective healthcare network that has met the needs of rural communities that can sometimes experience neglect.

‘Urban residents can choose between public and private services. In 2016, there were 773 hospitals in Iran, which is one for every 92,100 residents. These are located mainly in cities, so urban residents have the advantage of having access to specialized healthcare. Additionally, the private sector plays an important part in the healthcare provision, focusing principally on secondary and tertiary health services in urban areas. Urban residents can decide between public and private facilities, even if the private sector tends to offer higher quality care, it is still more expensive.’^{[footnote 14]}

2.7.2 The Iran International (Iranian news media outlet)^{[footnote 15]} article, ‘Iran Vows To Export Medicines To Hungary Amid Serious Shortages’, dated 18 November 2022, stated:

‘Most medicines in Iran are produced locally by quasi-governmental companies. When the Iranian currency began to nosedive in early 2018, the government offered a fixed exchange rate for essential goods, mainly food and medicines.

‘However, earlier this year, the new administration of President Ebrahim Raisi eliminated what was in fact a government subsidy. Now, food and medicine producers must buy dollars at rates seven times higher to import their raw materials, which has disrupted domestic production.

‘Reports from Iran say that people cannot even find painkillers, IV fluids, and antibiotics at pharmacies.’^{[footnote 16]}

2.7.3 The Iran Focus (Iranian news media outlet)^{[footnote 17]}article, ‘Iran’s Medicine Shortage Continues as Production of Sports Supplements Increase’, dated 31 May 2023, stated:

‘It is predicted that the price of medicine will increase by 30 to 40 percent due to inflation. However the price of medicine on the ground has already ballooned far beyond that. Skyrocketing prices are not the only issue. Nowadays, some medicines are not even available in reputable pharmacies, even the Red Crescent. Patients being denied insurance coverage for medicines is another problem they are facing these days.

‘A young lady, who requested to remain anonymous, says that she has been searching for Zoliver (an anti-anxiety medication) in central pharmacies. However no pharmacy has this medication. A middle-aged man went to a pharmacy to get Alendronic (a medication for increasing bone density) and the pharmacy staff told him they don’t have the prescribed medication and offered an alternative.

‘Currently, the shortage of medicine in Iran includes both routine medications and over the counter (OTC) drugs. A woman describes how she has been searching the city’s pharmacies for a week to find a package of Omeprazole (an OTC drug for stomach issues). She has been suffering from stomach pain for a week.

‘According to an interview with the regime’s Khabaronline website, Mohammad Taheri, a pharmacist, says, “Even domestically produced medications, simple and routine ones, are hard to find in pharmacies. Instead, domestic manufacturers are producing sports supplements. Nowadays, sports supplements, colorful and powerful, occupy the shelves of pharmacies, while medications for common colds and routine ailments are difficult to find.”

‘“The situation is even worse for people with specific diseases. It is challenging for patients to find medications like Melphalan, Thiotepa (chemotherapy medication) in reference pharmacies. For individuals with hemophilia, finding Factor 8 is impossible, and those with multiple sclerosis cannot find specific brands of Interferon Beta and Diphosel (MS medications) and are forced to use alternative brands…

‘According to Taheri, “The situation is even more critical for patients in need of organ transplants. Vital medications for this group have not been purchased for months to be imported into the country.”

‘On-the-ground evidence confirms this claim. For example, an elderly man sitting in a Red Crescent pharmacy is baffled at his latest receipt. Until last week, his medication, Protral Opas (a prostate medication), was covered by insurance. He no longer has such coverage and now has to pay three times as much as last week…

‘A middle-aged woman seeking to purchase heart medication, Elpidue, is facing similar issues as the price is increasing every week. She used to buy this medication for around 8,000,000 rials…[£152.82^{[footnote 18]}]. Now she has to pay around 10,600,000 rials [£202.60^{[footnote 19]}]. Taheri says, “Raw materials are needed to produce domestic medication. In 80 percent of the cases, they are imported from abroad…”’^{[footnote 20]}

2.7.4 The Iran News Update (Iranian news media outlet)^{[footnote 21]}article, ‘Most Iranians Struggle To Pay For Healthcare’, dated 2 November 2023, stated:

‘A recent report from the Iranian Statistics Center reinforces the fact that access to healthcare in Iran has turned into a matter of class and commodification over the years.

‘This report categorized the medical expenses of Iranian households in 2022 based on their monthly income. It revealed that urban households with an income of less than 12 million tomans [1 toman is equal to 10 rials^{[footnote 22]}] [£2,291.93^{[footnote 23]}] spent an average of 1.4 [million] tomans [£267^{[footnote 24]}] per month on healthcare expenses. This group includes wage earners and those earning the minimum wage, with monthly incomes of less than 7 million tomans [£1,334.20^{[footnote 25]}]…

‘This report unequivocally highlights that, as a consequence of the regime’s policies, healthcare has become a commodity in Iran, with access determined by one’s financial means. Wealthy families can afford the higher costs, but low-income families face the risk of inadequate healthcare, as even the 1.4 [million] tomans per month can be a challenging expense for them.

‘…Due to dwindling financial resources, a significant portion of the population has turned to self-therapy, a dangerous trend that experts have warned against. Ali Dehghankia, the head of Tehran’s Labor Retired Association, reveals that many retirees have been unable to afford proper medical treatment for a long time, forcing them to also resort to self-treatment.

‘…Recent reports from Iran’s domestic media further highlight the severe difficulties low-income families face in obtaining essential medicines. This situation has worsened, particularly after the removal of preferred currency rates for medications and subsequent price increases.

‘On October 5 [2023], Hammihan newspaper published a report titled “Patients’ Escape Plan”, indicating that many people either forgo treatment or leave the hospital after receiving medical services due to soaring prices, medication shortages, and high hospital fees…

‘Meanwhile, the exodus of doctors and medical staff from Iran continues to worsen the healthcare situation. Reports suggest a growing number of Iranians seeking medical treatment in neighboring countries.’^{[footnote 26]}

2.7.5 The Iran International article, ‘Iranian Drug Shortage Worsens Amid Currency Crisis’, dated 14 November 2023, stated:

‘The Food and Drug Organization of Iran has reported a shortage of approximately 100 types of essential drugs within the country.

‘Mohammad Peikanpour, the Director-General of Drugs and Controlled Substances, highlighted the severity of the situation, noting that certain medications are in short supply due to a lack of specific currency allocations.

‘Peikanpour further addressed the life-threatening challenges in the availability of plasma-derived drugs, including albumin, which comes amidst already dire nursing and doctor shortages…

‘The pharmaceutical industry in Iran, heavily dependent on the government for hard currency to import raw materials, is grappling with the impact of the shortages. Production of essential medicines has been disrupted, causing widespread concern among pharmaceutical companies. Local media reports indicate that various common medicines and drugs crucial for hospitals are now scarce or entirely unavailable.’^{[footnote 27]}

2.8 Emergency medical services

2.8.1 The 2024 medical research study, ‘The impact of the education program based on dimensions of quality of work life among emergency medical services providers’, published by BMC Health Services Research, stated:

‘The Iranian EMS [emergency medical services] system was founded in 1975 and offers free services across the country under the supervision of the Ministry of Health and Medical Education. The clinical setting for such services is offered in 3000 centers (viz., 1700 road centers, 1300 urban centers, and 50 Air medical emergency centers). Clients call “115” and speak with the emergency medical dispatcher, who takes a history and the caller’s address. The emergency medical dispatcher gives this information to a nearby base if a dispatch is deemed necessary. Emergency medical technicians evaluate the patient at the scene and may consult a physician in the dispatch center to determine whether the patient needs transport to a hospital. The emergency medical technicians then coordinate with the hospitals before arrival. There are 216 ambulance bases in Tehran, most with one ambulance and one motorcycle ambulance. Based on the dispatch call, one emergency medical technician drives the motorcycle ambulance to scenes where transport is not predicted to be necessary. The emergency medical technicians may provide limited medical care. A few bases have two ambulances, and a few have an ambulance bus, which is used for multiple casualties when air transport is limited. All bases are managed by one dispatch center.’^{[footnote 28]}

Section updated: 1 May 2024

3. Paediatric diseases and healthcare

3.1 Paediatric hospital care services

3.1.1 The Press TV (Iranian news media outlet)^{[footnote 29]}report, ‘Iran opens largest pediatric hospital in Middle East’, dated 31 July 2021, stated:

‘A 700-bed pediatric hospital has been inaugurated in the northwestern Iranian city of Tabriz making it the largest such facility in the Middle East region.

‘The Zahra Mardani hospital, a charitable facility to which the Iranian government has contributed by providing the required land, was inaugurated on Saturday [31 July 2021] during a video conference ceremony attended by the Iranian President Hassan Rouhani.

‘The hospital has been built in seven years, said a report by IRNA [Islamic Republic News Agency] news agency, adding that the facility would offer various pediatric treatments, including mental and rehabilitation services.

‘The hospital is the largest health facility built in Iran over the past decade, said Rouhani during the inauguration ceremony while adding that a 1,000-bed general hospital would officially open in the capital Tehran just after he leaves office in early August [2021].’^{[footnote 30]}

3.2 Paediatric cardiology and heart surgery

3.2.1 The Iran International report, ‘Iranian Medical Council Warns Of Pediatric Heart Surgeons’ Emigration’, dated 16 March 2024, stated:

‘Iran’s Medical Council warns of rising emigration of pediatric heart specialists and surgeons, leaving hundreds of sick children without care, sparking concerns.

‘In a report released on Friday [15 March 2024], the council highlighted the recent departure of yet another pediatric heart transplant surgeon from Iran, revealing that the waiting list for patients under this doctor’s care is already full for the next two years, with 638 children in need of surgery.

‘The concerning trend comes at a time when, according to the Iranian Medical Council’s statistics, between 10,000 to 15,000 children are born annually with congenital heart diseases in Iran. With 70 to 80 percent of the cases requiring surgical intervention, the shortage of specialized medical professionals poses a significant challenge.

‘The situation is compounded by the scarcity of doctors capable of performing complex infant surgeries, with the report indicating that the number of such specialists is less than five. Additionally, the waiting list for pediatric heart surgeries at Tehran’s Shahid Rajaei Hospital, the largest heart surgery center in Iran, is already filled until 2026.’^{[footnote 31]}

3.3 Paediatric cancer treatment

3.3.1 The 2021 medical research study, ‘Survivor and parent engagement in childhood cancer treatment in Iran’, published by PubMed Central (free full-text archive of biomedical and life sciences publications at the US National Institute of Health’s National Library of Medicine)^{[footnote 32]}, stated:

‘Children and adolescents with cancer in Iran are treated in 32 hospitals under the supervision of medical sciences universities and governmental medical centres across the country. Efforts have been made to create universal healthcare in the country, but it is not yet realised. Childhood cancer treatment costs are covered by a number of healthcare insurance companies and non-governmental organisations (NGOs). According to a recent study in Iran, families with a child with cancer are generally referred to insurance organisations and NGOs for financial support since they face substantial financial challenges. MAHAK Charity is an NGO founded in 1991, and supports all children (ages 0–16) with cancer in Iran.’^{[footnote 33]}

3.3.2 The Landinfo report, ‘Iran – The Iranian Welfare System’, stated:

‘Mahak Society to Support Children Suffering from Cancer, for instance, is a well-known charitable paediatric cancer research, hospital and rehabilitation centre. Patients are referred to Mahak by doctors across the country.

‘According to a representative of Mahak, any child who is diagnosed with cancer will receive treatment, either at the Mahak hospital or in other hospitals.

‘Mahak also covers treatment for patients in other hospitals in Iran. The treatment is free of charge, and the patients are not required to be insured to receive treatment. Even relatives can get funding for accommodation when accompanying their sick children. Mahak receives child cancer patients from several neighbouring countries…’^{[footnote 34]}

3.4 Paediatric nephrology (kidney disease)

3.4.1 A 2022 medical research study, published by the Orphanet Journal of Rare Diseases, stated that paediatric nephrologists were available in Iran at the time of the study, for example at the Ali Asghar Children’s Medical Center, and Mofid and Aboozar children’s hospitals^{[footnote 35]}.

Section updated: 4 June 2024

4. Cancer

4.1 General

4.1.1 The Tehran Times (Iranian news media outlet)^{[footnote 36]}report, ‘Advanced cancer treatment center inaugurated’, dated 17 March 2023, stated:

‘Some 12 trillion rials…[£223,878,406^{[footnote 37]}] has been spent on building the center which is specialized for diagnosing and treating stage 3 cancers…

‘For the first time in West Asia, some ultra-modern devices such as linear accelerator, CyberKnife, tomotherapy, and CT simulator have been used in this cancer treatment center.

‘The CyberKnife system is a non-invasive, robotic delivery system for radiation therapy that treats some cancerous and noncancerous tumors and other conditions.

‘Tomotherapy is a type of therapy in which radiation is aimed at a tumor from many different directions…

‘The purpose of the program is to reduce cancer prevalence and mortality while improving the quality of patients’ lives, which can serve as a model for other countries, especially in the Eastern Mediterranean region…

‘In November 2022, the first phase of a national project aiming to take advantage of gene therapy for the treatment of children with cancer, known as “CAR T-cell therapy”, came on stream.

‘Chimeric antigen receptor (CAR) T-cell therapy is a way to get immune cells called T cells (a type of white blood cell) to fight cancer by changing them in the lab so they can find and destroy cancer cells…

‘The method is currently in the clinical trial stage and was used on a child with leukemia who was resistant to all treatment methods, he highlighted.

‘In July 2021, Iran inaugurated an advanced ion therapy center for the first time in West Asia, with the aim of providing definitive treatment for all types of cancer.’^{[footnote 38]}

4.1.2 The Iranian Cancer Control Centre (MACSA) provides homecare services for cancer patients, as explained on its website:

‘As soon as you enter the home care program, a coordination team (consisting of various specialties involved in palliative and supportive care) get to maintain a contact with the patient and the family…

‘The home care network provides a wide range of services in respond [sic] to the patient needs, some of the most important of which are:

‘Medical and nursing services at home…

‘A trained general practitioner (palliative care physician) or specialist visits the patient. The palliative care physician, in addition to scheduling the next appointment, may prescribe medication, or perform other procedures to control various complications…

‘Basically, the team visits the patient in regular working hours however in the case of critical circumstances they are committed to visit the patient at any time of the day. Even though, MACSA medical home care service is not a replacement to emergency services provided by EMS, Generally the medical and nursing services provided to the patient and his/her family include the following:

‘Control of complications and symptoms of the disease

‘Cancer and its treatment are usually associated with complications and the home care medical team seeks to control such complications. Some of the most important activities done by the medical team to control the symptoms at home for the patient are as following:

• Pharmacological management of pain and other annoying complications of the disease

• Tap of ascites and pleural effusion at home (draining fluid from the abdomen and pleura)

• Antibiotic therapy

• Total parenteral nutrition (TPN) and partial parenteral nutrition (PPN)

‘Diagnostic procedures

‘…MACSA offers a range of diagnostic services such as Doppler ultrasound, Electromyography (EMG) and Electrocardiogram (ECG) in various locations, such as the patient’s home, palliative hospital ward and rehabilitation clinic. Some of the most important diagnostic procedures performed by the home medical team for the patient include:

• collection of blood sample for laboratory diagnosis

• Diagnostic ultrasound

• Diagnosis of deep vein thrombosis

• ECG

‘Family Education

‘[T]aking care of a cancer patient at home needs education. Palliative physicians and nurses train the caregivers about various needs of the patient. In addition, practical skills required for a quality physical care are being taught to the caregivers. Some of the most important trainings given to caregivers by the team are as the following

• Basic management of patient needs

• Monitoring of the vital signs

• Monitoring of other health indices (e.g., blood oxygen saturation, blood sugar)

• Simple care procedures (e.g., catheter flush, Enema, IM injection)

• Wound care

‘General nursing care

‘A wide spectrum of the home care patient needs are satisfied by nursing services, specifically the need that cannot be fulfilled by the caregivers.’^{[footnote 39]}

4.1.3 See also Nursing homecare.

4.2 Radiotherapy

4.2.1 The Negin Cancer Centre in Tehran can provide modern radiotherapy to people with cancer. The Centre also has oncologists (cancer specialists) available to treat people with cancer^{[footnote 40]}.

4.2.2 The Tehran University of Medical Sciences website stated that the institution has a Department of Radiotherapy that: ‘…offers a broad range of radiation and systemic therapy services to cancer patients, including External Beam Radiotherapy (EBRT), High-Dose Rate (HDR) brachytherapy, chemotherapy, hormone and targeted therapy. The department is equipped with three linear accelerators and one high does rate (cobalt 60) brachytherapy machines.’^{[footnote 41]}

4.3 Anti-cancer drugs

4.3.1 The 2021 medical research study, ‘Availability and affordability of anticancer medicines in Iran based on WHO/HAI [World Health Organisation/Health Action International] standard survey methods’, published by PubMed, stated:

‘Purpose: Cancer is the second leading cause of death in the world after cardiovascular disease. The present study aimed to investigate the affordability and physical access to chemotherapy drugs among patients with one of the three common cancers of the breast, stomach, and colon in the city of Mashhad, Iran, in 2021.

‘…Results: Out of 28 studied medicines from public and private drug stores, 15 (53.5%) received very low, 8 (28.5%) relatively high, and 2 (7%) high access scores. The generic docetaxel brand’s ultra-drug and trastuzumab (AryoTrust) were the most available drugs, but the doxorubicin (Ebewe), oxaliplatin (Mylan), and trastuzumab (Herceptin) were not available to the individuals with cancer.’^{[footnote 42]}

4.3.2 The Tehran Times report, ‘Iran world’s third producer of “ibrutinib” anti-cancer drug’, dated 25 September 2023, stated:

‘Now Iran, India, and China are the only three countries in the world that have the high-tech knowledge to produce ibrutinib and necessary raw material, IRNA reported.

‘Ibrutinib is a type of targeted therapy called a kinase inhibitor. A kinase is an enzyme that promotes cell growth. There are many types of kinases, which control different phases of cell growth.

‘This medication interferes with the function of Bruton’s tyrosine kinase (BTK), which is found in excess on cancerous B cells. By interfering with BTK, ibrutinib interferes with the growth of the cancerous B cells.

‘Beyond its role in B cell biology, BTK functions have been explored in the maturation, trafficking, and function of myeloid cells, T cells, and natural killer cells…

‘Ibrutinib is highly effective in the treatment of chronic lymphocytic leukemia (CLL), mantle cell lymphoma, and Waldenstrom’s macroglobulinemia.

‘The biggest advantage of this drug is its end price. A dose of 420 grams of medicine, which is used to produce 28 of this medicine, costs nearly 6,500 euros [£5,531.21^{[footnote 43]}].’^{[footnote 44]}

4.4 Lung cancer

4.4.1 CPIT was not able to find recent or current information about the availability of treatment for lung cancer in Iran, from the sources consulted (see Bibliography).

4.5 Breast cancer

4.5.1 The Iran Health Agency website stated: ‘The cost of breast cancer treatment in Iran may vary depending on the type, stage, and grade of the cancer, the choice of treatment, the hospital, the doctor, and the insurance coverage… The cost of breast cancer treatment in Iran includes all the related expenses, such as tests, medication, anesthesia, hospitalization, post-op care, follow-up, etc.’^{[footnote 45]}

4.6 Brain cancer

4.6.1 CPIT was not able to find recent or current information about the availability of treatment for brain cancer in Iran, from the sources consulted (see Bibliography).

4.7 Liver cancer

4.7.1 CPIT was not able to find recent or current information about the availability of treatment for liver cancer in Iran, from the sources consulted (see Bibliography).

4.8 Cervical cancer

4.8.1 The WHO 2021 Cervical Cancer Profile on Iran stated that a national cervical cancer screening programme and national guidelines on cervical cancer treatment management existed in 2021. The WHO Cervical Cancer Profile also stated that cancer surgery, pathology services, radiotherapy, and chemotherapy for cervical cancer patients, and other cancer patients, was available in 2021^{[footnote 46]}.

4.9 Cancer of the head and neck

4.9.1 CPIT was not able to find recent or current information about the availability of treatment for head and neck cancer in Iran, from the sources consulted (see Bibliography).

4.10 Thoracic surgery

4.10.1 CPIT was not able to find recent or current information about the availability of thoracic surgery in Iran, from the sources consulted (see Bibliography).

4.11 Urological cancers

4.11.1 The Iran Treatments website stated:

‘Urology is a field of medicine that focuses on diseases of the urinary tract and the male reproductive system. There are many types of urologic surgery in Iran. Here are a few:

1. Cystectomy: This is a surgical procedure that involves the removal of all or part of the urinary bladder. It is typically performed to treat bladder cancer.

2. Prostatectomy: This is the surgical removal of all or part of the prostate gland, typically to treat prostate cancer or benign prostatic hyperplasia (BPH).

3. Ureteroscopy: A type of minimally invasive procedure in which a small scope is inserted through the urethra and bladder to the ureter to diagnose and treat issues such as kidney stones or tumors.’^{[footnote 47]}

4.12 Gastroenterological cancers

4.12.1 Surgery to treat gastroenterological cancers is available in Iran, as stated on the Iran Treatments website^{[footnote 48]}.

4.13 Bone and skin cancers

4.13.1 CPIT was not able to find recent or current information about the availability of treatment for bone and skin cancer in Iran, from the sources consulted (see Bibliography).

4.14 Colorectal cancers

4.14.1 Surgery to treat colorectal cancers is available in Iran, as stated on the Iran Treatments website^{[footnote 49]}.

4.15 Blood cancers

4.15.1 The Sun (Malaysian news media outlet)^{[footnote 50]}report, ‘Iran unveils new gene therapy technology to treat blood cancer’, dated 15 November 2022, stated:

‘An official from the Iranian Presidency’s Office for Science and Technology said on Tuesday [15 November 2022] that Iranian researchers had spent some seven years developing the new gene therapy method for treating blood cancer.

‘Amir Ali Hamidieh said the success rate of the treatment stands at nearly 70 percent.

‘An Iranian startup company has developed the treatment method which had remained in the monopoly of two multinational companies, said Hamidieh.

‘He said the method has been tested for the first time on a blood cancer patient in Iran after it was approved by Tehran University of Medical Sciences.’^{[footnote 51]}

4.15.2 The Nour News (Iranian news media outlet)^{[footnote 52]}, ‘Iran among 3 countries producing anticancer drug Ibrutinib’, dated 26 September 2023, stated;

‘Iran has become the third country in the world to indigenize production of an anticancer drug known as ibrutinib, which is used to treat various types of blood cancer.

‘The R&D director of the Iranian knowledge-based company that has produced the drug said it is used to treat various types of leukemia and lymphoma, and is also used for patients who have received transplants.

‘Before its domestic production, Iran imported ibrutinib, but it is now produced inside the country. In addition to the drug itself, the Iranian company has also indigenized the technical know-how for the production of its raw materials..

‘Domestic production of the drug came after five years of intense research, and it inhibits an enzyme that speeds up proliferation of cancerous cells, thus preventing their growth.’^{[footnote 53]}

4.15.3 See also Haematological conditions.

Section updated: 4 June 2024

5. Cardiovascular diseases

5.1 Cardiology

5.1.1 The Jam Hospital (private facility) in Tehran has a cardiology clinic that can provide a wide range of treatment and tests for people with heart disease, as explained on its website:

‘As the most advanced diagnostic cardiovascular treatment center in the heart of Tehran and staffed by the most proficient cardiologists, the Cardiology Clinic at Jam Hospital is prepared to offer 24/7 services for esteemed clients throughout the year, given the prevalence of cardiovascular disease, especially in urban communities.

‘Services offered at this clinic include:

‘Clinical Services

• Conducting ECG tests round-the-clock

• Providing cardiac counseling for non-cardiac surgeries

• Nutrition clinic staffed by a nutritionist, specifying proper diet for cardiac and non-cardiac patients

‘Non-Invasive Testing Lab

1. Round-the-clock cardiac stress test by a cardiologist

2. Round-the-clock echocardiography by a cardiologist

3. Esophageal echocardiography by echocardiography fellowship holder

4. Echocardiography of congenital and fetal diseases by an echocardiography fellowship holder using the world’s state-of-the-art echocardiography machines

5. Holter monitoring of heart to diagnose heart arrhythmias

6. 24 hour Holter monitoring of blood pressure to determine mean daily arterial pressure

7. Tilt table test for syncope examination.’^{[footnote 54]}

5.1.2 The EUAA MedCOI database, in a 2020 response to an information request, stated that isosorbide dinitrate and isosorbide mononitrate (used for the treatment of angina pectoris) were available, for example at the Saha Private Pharmacy in Tehran^{[footnote 55]}.

5.2 Drugs used to treat high blood pressure and cholesterol levels

5.2.1 The EUAA MedCOI database, in a 2020 response to an information request, stated that the following drugs, used to treat high blood pressure, were available, for example at the Taleghani University Pharmacy, Tehran:

• Hydrochlorothiazide

• Amlodipine

• Diltiazem

• Valsartan

• Losartan

• Telmisartan^{[footnote 56]}.

5.2.2 The EUAA MedCOI database, in a 2020 response to an information request, stated that the following drugs, used to treat high blood pressure, were available, for example at the Gholhak Pharmacy in Tehran and the Helale Ahmar State Pharmacy:

• Chlortalidone

• Indapamide^{[footnote 57]}.

5.2.3 The EUAA MedCOI database, in a 2020 response to an information request, stated that the following drugs, used to treat high cholesterol levels, were available, for example at the Taleghani University Pharmacy, Tehran:

• Simvastatin

• Rosuvastatin^{[footnote 58]}.

5.2.4 The EUAA MedCOI database, in a 2020 response to an information request, stated that the following drugs, used to treat high cholesterol levels, were available, for example at the Helale Ahmar State Pharmacy in Tehran and the Taleghani University Pharmacy in Tehran:

• Fluvastatin

• Atorvastatin^{[footnote 59]}.

5.3 Drugs used to treat blood clots

5.3.1 The EUAA MedCOI database, in a 2020 response to an information request, stated that the following anti-blood clotting drugs, were available, for example at the Taleghani University Pharmacy, Tehran:

• Clopidogrel

• Dabigatran

• Apixaban

• Rivaroxaban^{[footnote 60]}.

5.4 Heart surgery

5.4.1 The Nodeh Gasht Aram (NGA) Medical Tourism (health tourism facilitator company)^{[footnote 61]}website stated:

‘More than 55 years have passed since the first modern heart surgery in Iran. In the last half century, in Iran, heart surgery has made significant progress. Today, about 550,000 to [600,000] heart surgeries are performed annually in Iran. Valve surgery, coronary heart bypass and aorta surgery are the most common types of heart surgery performed in Iran.

‘Iran is currently a leader in the field of cardiology in the Middle East due to its significant progress in the field of diagnosis, treatment and cardiovascular surgery and the comprehensive expertise of Iranian cardiologists. Iranian heart surgeons are able to perform the most difficult, complex and risky cardiovascular operations, including open heart surgery and minimally invasive heart surgery, using modern technologies.

‘Due to the fact that Iran offers low-cost and affordable service and treatment packages, countless heart patients from all over the world have become significantly interested in traveling to Iran for heart surgery…

‘Today, about 100 heart transplants are performed annually in several hospitals in Iran.’^{[footnote 62]}

5.4.2 The Shafa Hospital in Khorramabad has heart surgeons and heart-surgery facilities, as explained on its website:

‘So far, over 300 successful open-heart surgeries have been done using the best equipment and an advanced operating room, which exceeds records…This center improves treatment quality after surgery by admitting patients to the OH-ICU (open heart ICU [intensive care unit]) for the entire period of hospitalization.

‘Patients are introduced to the cardiac surgery unit after preliminary examination by cardiologists and are visited by a respected surgeon. If surgery is required, the patient is admitted to this unit. After the necessary actions for the operation (preoperative tests, CXR, etc.), the patient is prepared for surgery.

‘After surgery, the patient is transferred to a cardiac ICU to receive intensive care. Given a normal recovery process, the patient will be discharged after the necessary training for postoperative care. During this period, the patient undergoes respiratory physiotherapy, special diets, and various consultations.

‘Shafa Hospital’s open-heart surgery unit has up-to-date medical equipment and facilities and meets a high standard in terms of health. This unit’s staff receive monthly training in various medical and scientific areas to keep up to date with the medical world’s developments, and also seriously consider patient education.’^{[footnote 63]}

Section updated: 8 May 2024

6. Dental treatment and conditions

6.1.1 The Jam Hospital in Tehran has a Department of Dentistry clinic that can provide a wide range of treatment and tests for people with dental diseases, as explained on its website:

‘The Department of Dentistry at Jam Hospital offers services to the esteemed clients with the help of its team of specialists, experienced staff, and advanced equipment.

• Cosmetic crowns, laminates, zirconia and composite veneers
• Bleaching (tooth whitening)
• Fixed and flexible/removable dentures
• Root canal therapy (endodontic therapy) using rotary motor with apex locator, root canal re-treatment
• Implants and specialized implant surgeries including sinus lift, alveolar bone augmentation, alveolar bone graft
• Periodontal surgery and impacted wisdom tooth extraction
• Smile makeover and replacement of black fillings with white fillings
• Specialized pediatric treatments
• Fixed, removable, tooth-colored, and invisible denture and overdenture (in children)
• Central sterilization room (CSR) and Class B autoclaves
• New disinfectants and disposables (in a vacuum for each patient)
• Digital imaging technique with minimal radiation.’^{[footnote 64]}

6.1.2 The Iran Health Agency website provided the following information regarding the range of dental-care treatment available in Iran:

‘Diagnostic and Preventive Services

• Oral Exams: Check for dental health problems and develop treatment plans.

• Teeth Cleaning: Removes plaque and tartar to prevent gum disease.

• X-rays: Takes images of teeth and jaws to evaluate dental health.

• Fluoride Treatment: Coats teeth to prevent cavities and make enamel stronger.

• Sealants: Thin plastic coatings put on chewing surfaces of back teeth to avoid decay.

• Dental Veneers…

• Restorative Services…

• Endodontic Services…

• Prosthodontic Services…

• Orthodontic Services…’^{[footnote 65]}

Section updated: 4 June 2024

7. Diabetes

7.1.1 The EUAA MedCOI database stated, in a 2020 response to an information request, that glucose self-testing strips were available, for example, at medical supply shops in Tehran. Insulin, metformin, tolbutamide, and gliclazide (used to manage blood-glucose levels) were available, for example, at the Farvardin University Pharmacy, Tehran^{[footnote 66]}.

7.1.2 Iran Daily (Iranian news media outlet)^{[footnote 67]}report, ‘Iran inaugurates first-ever insulin production line’, dated 28 August 2023, stated:

‘On August 27 [2023] a momentous event took place in Tehran as the first-ever insulin production line in Iran was officially inaugurated…

‘Through collaboration with a multinational knowledge-based company and local young specialists, Iran has successfully realized domestic insulin production for the first time…

‘The newly-established production line has been made possible through collaboration with Vitane Pharmed, a knowledge-based company specializing in pharmaceuticals.’^{[footnote 68]}

7.1.3 The EUAA MedCOI database stated, in a 2020 response to an information request, that Hb1AC (blood-glucose level test) testing could be carried out in Iran, for example, at the Keyvan Laboratory in Tehran. There were also endocrinologists in Iran who could treat people with diabetes, for example at the Dey General Hospital in Tehran^{[footnote 69]}.

Section updated: 5 April 2024

8. Ear, nose and throat conditions (ENT)

8.1.1 The Jam Hospital in Tehran has an Otorhinolaryngology Clinic that can provide a wide range of treatment and tests for people with ear, nose, and throat conditions, as explained on its website:

‘Staffed by experienced specialists and equipped with the most advanced clinical, paraclinical and operating room equipment, the Otorhinolaryngology Clinic at Jam Hospital offers services for the esteemed patients. All the necessary tests, including audiometry, tympanometry, auditory brainstem response (ABR), otoacoustic emission (OAE) as well as various otorhinolaryngologic examinations and procedures such as removing foreign bodies are performed by otorhinolaryngologists and otolaryngology subspecialists.

‘Services offered at this clinic include:

• ‘Diagnostic measures for sinusitis, nasal and sinus endoscopy and nasal polyp removal surgery
• ‘Evaluation of respiratory nasal disorders, olfactory disorders, epistaxis, septoplasty, and rhinoplasty
• ‘Examination of laryngeal diseases, vocal cord disorders, and hoarseness
• ‘Examination of neck lumps, salivary glands and associated surgeries
• ‘Examination of the causes of hearing loss, tinnitus, dizziness and their treatment
• ‘Snoring causes, tonsillectomy, and oral lesions.’^{[footnote 70]}

Section updated: 14 May 2024

9. Epilepsy and other neurological conditions

9.1.1 The EUAA MedCOI database stated that there were neurologists and neurosurgeons available in Iran in 2020, for example at the Imam Hossein University Hospital in Tehran (public facility)^{[footnote 71]}.

9.1.2 The Jam Hospital in Tehran has a Neurosurgery Clinic that can provide a wide range of treatment and tests for people with neurological diseases, as explained on its website:

‘The Neurosurgery Clinic at Jam Hospital is staffed by leading neurosurgical specialists, benefits from advanced surgical equipment, and provides the following services.

1. Surgical treatment of cerebrovascular disorders like cerebral aneurysm

2. Brain and spinal cord tumors

3. Epilepsy

4. Neuro-oncology in a variety of malignancies

5. Spinal cord disorders

6. Various types of brain injuries and hemorrhage following accidents and falls (traumatic brain injury)

7. Congenital disorders

8. Maxillofacial problems

9. Nerve biopsy

10. Intraoperative neurophysiological monitoring (IONM)

11. Vertebral augmentation for compression fractures

12. Various types of intervertebral disc herniation.’^{[footnote 72]}

9.1.3 The Shafa Hospital in Khorramabad has a neurosurgery clinic that can provide a wide range of treatment for people with neurological diseases, as explained on its website:

‘Shafa Hospital’s neurology ward is ready to treat outpatient and inpatient visitors with experienced doctors and specialists, and covers non-surgical treatment of neurological diseases and headache and dizziness, seizures and consciousness disorders (fainting), loss or disruption of consciousness and neurological diseases such as stroke, MS [multiple sclerosis], epilepsy, Alzheimer’s, neuropathy, Parkinson’s, and more…

‘This hospital’s neurologists visit outpatients and provide electroencephalograms and electromyography for inpatients and outpatients and round-the-clock neurological consultations in various wards and emergency.’^{[footnote 73]}

Section updated: 9 May 2024

10. Eye conditions and diseases

10.1.1 The EUAA MedCOI database stated, in a 2020 response to an information request, that diabetes retinopathy testing could be carried out, for example at the Noor Ophthalmology Hospital in Tehran^{[footnote 74]}.

10.1.2 The Noor Eye Speciality Centre can provide the following eye surgeries:

• Eyelid surgery

• Cataract surgery

• Corneal transplant

• Dacryocystorhinostomy

• Deep Vitrectomy surgery

• Strabismus surgery

• Femto Lasik surgery^{[footnote 75]}.

10.1.3 The Iranian Eye Clinic in Tehran can provide the following eye-disease treatments, as explained on its website:

‘Topography (Eyesys Topo) for corneal evaluation

‘Orbscan II (B&L Tomography)

‘Aberrometry…

‘Lenstar 90 (for IOL power calculation)

‘OCT (Ziess); Retinal evaluation

‘Visual field…

‘Ultrasound A. Scan

‘High frequency ultrasound biomicroscopy (UBM) for anterior segment evaluation

‘Specular Microscopy for corneal endothelial evaluations…

‘The Latest Laser Systems

‘TENEO 317p Excimer Laser (Bausch & Lomb)

‘Femtosecond Laser Z6 (Ziemer)

‘Avedro KXLI for Corneal Cross Linking (CXL)

‘The services that has provided in clinic included:

‘Consultation in different field: Retina, Pediatrics, Plastics, Glaucoma, and Cornea and refractive surgeries, Optometry and Contact Lens…

‘Customized wave front guided laser surgery

‘PRK

‘LASEK

‘Femto LASIK

‘PTK

‘Femto-assisted intra corneal ring segment implantation (ICRS) Intacs SK and keraring

‘Presbyopia correction

‘KAMRA Inlay

‘Supracor

‘Corneal Cross Linking KXLI

‘Femto assisted arcuate keratotomy (FAAK)

‘Femto assisted anterior keratoplasty (F-ALK)

‘Femto assisted kerato pigmentation (FA-KPT)

‘Combined PRK+ Cross Linking for early KCN subjects.’^{[footnote 76]}

Section updated: 16 May 2024

11. Gastroenterology

11.1.1 The EUAA MedCOI database, in a 2020 response to an information request, stated that domperidone and metoclopramide (used for the treatment of nausea) were available, for example, at the Taleghani University Pharmacy in Tehran^{[footnote 77]}.

11.1.2 The Jam Hospital in Tehran has a General Surgery Clinic that can provide a wide range of treatment and tests for people with gastroenterological diseases, as explained on its website:

‘The General Surgery Clinic at Jam Hospital is staffed by specialist and experienced team of physicians who offer a wide range of surgeries. Some of these surgeries include the abdominal organs (esophagus, stomach, intestines, liver, pancreas and gallbladder), thyroid, parathyroid, abdominal wall, breast and skin.

‘Some surgeries are performed using laparoscopic techniques at Jam Hospital. The clinic is also well-known as one of the world’s HIPEC [hyperthermic intraperitoneal chemotherapy] surgery and modern PIPAC [pressurised intraperitoneal aerosol chemotherapy] surgery referral center.

‘[The] [f]ollowing are some of the common procedures performed by surgeons at the General Surgery Clinic at Jam Hospital:

• Gallbladder surgery
• Bile duct and liver
• Spleen and pancreas
• Abdominal wall hernia
• Adrenal glands
• Esophageal, stomach, and intestinal diseases
• Abdominal cysts
• Diagnostic laparoscopy

‘Abdominal emergencies including:

• Abdominal trauma, foreign bodies, visceral rupture, adhesions after abdominal surgery
• Laparoscopic hernia repair
• Bowel resection
• Cholecystectomy
• Appendectomy…
• Gastrointestinal diseases, abdominal wall sarcoma
• Excessive obesity, sleeve gastrectomy.’^{[footnote 78]}

Section updated: 8 May 2024

12. Gynaecology and obstetrics

12.1.1 The Mortaz Hospital in Yazd can provide a wide range of treatment for women with gynaecological conditions, including:

• Infertility treatment

• Investigation and treatment of sexually transmitted infections

• Cancer screening

• Removing ovarian cysts

• Endometriosis surgery

• Removing fibroids^{[footnote 79]}.

Section updated: 8 May 2024

13. HIV/AIDS

13.1.1 The medical research study, ‘Economic Burden of HIV/AIDS in Iran: A Modelling Approach’, published on 7 February 2023 by PubMed Central, stated: ‘In Iran, in line with many other WHO member states, Antiretroviral Therapy (ART) is the government’s main national free-of-charge plan to manage HIV/AIDS. ART mainly depends on a combination of drugs for long-term management, therefore, the patients’ adherence to the treatment is the main problem for policymakers.’^{[footnote 80]}

13.1.2 The medical research study, ‘Economic Burden of HIV/AIDS in Iran: A Modelling Approach’, also stated that the following anti-retroviral drugs, used to treat HIV/AIDS, were available in Iran:

• Efavirenz

• Lamivudine

• Zidovudine

• Nevirapine

• Tenofovir

• Rifampin^{[footnote 81]}.

13.1.3 The EUAA MedCOI database stated that the following ART drugs for the treatment of HIV/AIDS were available in Iran in 2020, for example, from the Helale Ahmar State Pharmacy, Tehran:

• Emtricitabine

• Raltegravir

• Tenofovir disoproxil

• Truvada^{[footnote 82]}.

Section updated: 16 May 2024

14. Liver diseases

14.1 Liver disease

14.1.1 The medical research study, ‘The hepatitis C virus in Iran: health policy, historical, ethical issues and future challenges’, dated 2 April 2020, published by PubMed Central, stated:

‘In Iran, the Ministry of Health and Medical Education (MoHME) has launched various programs – the last in 2017 – in order to eliminate new cases of infection in three major areas: prevention, screening and treatment. The educational programs are aimed at raising public awareness by providing appropriate information related to HCV [hepatitis C virus] prevention. Currently HCV screening is carried out passively in Iran.’^{[footnote 83]}

14.1.2 The EUAA MedCOI database, in a 2020 response to an information request, stated that laboratory research of liver function could be carried out at the Laboratory of the Torffe State Hospital in Tehran. Liver biopsies and tests for liver fibrosis could be carried out at the Dr Shariati University Hospital in Tehran^{[footnote 84]}.

14.1.3 A 2024 medical research study, published by BMC Gastroenterology, stated that the Middle East Liver Disease Centre in Tehran has medical professionals who can treat people with liver diseases, such as cirrhosis, autoimmune liver disease, primary biliary cholangitis, and primary sclerosing cholangitis. Prednisolone, azathioprine, and ursodeoxycholic acid – drugs used to treat liver diseases – were available in Iran at the time of the study^{[footnote 85]}.

14.1.4 The Tehran Times report, ‘Hepatitis B control program to be implemented’, dated 12 March 2024, stated:

‘The ministry of health is planning to eradicate hepatitis C across the country within a period of 2 to 3 years…

‘In August 2023, Saeid Karimi, the deputy health minister, said that free treatment for hepatitis C is provided for patients in the country…

‘So far, some 600 patients under insurance coverage have been treated free of charge, he noted…

‘Diagnosis of the disease under the health network is free for all, and treatment is also free for financially vulnerable families.’^{[footnote 86]}

14.2 Liver transplants

14.2.1 The Iran Surgery Centre website stated:

‘Since 1994, liver transplantation has been performed in Iran, and since 1997, liver transplantation has been performed from a living donor.

‘More than 6000 successful liver transplant[s] have been performed in Iran.

‘In 2022, after the end of the corona pandemic, an unprecedented 1000 successful liver transplant surgeries were performed. And more than 35,000 organ transplants were performed…

‘2000 liver transplants are performed in Iran every year. The success rate of Iranian doctors is on par with the surgeries of advanced countries, and the 3-year success rate is 85%.’^{[footnote 87]}

Section updated: 5 April 2024

15. Haematological conditions

15.1.1 The Jam Hospital in Tehran has a Haematology and Oncology Clinic that can provide a wide range of treatment and tests for people with blood diseases, as explained on its website:

‘Hematology and Oncology Clinic at Jam Hospital meets the needs of a large number of clients each year using its proficient specialists…

‘Jam Hospital is one of the leading medical centers in the diagnosis and control of a variety of blood disorders and problems. Specialists at the Hematology and Oncology Clinic are in constant cooperation with one another to treat adults and children suffering from a variety of diseases, including blood and bone marrow cancers.’^{[footnote 88]}

Section updated: 9 April 2024

16. Kidney diseases

16.1 Dialysis

16.1.1 The Jam Hospital in Tehran has a dialysis unit that can carry out dialysis on people with kidney diseases, as explained on its website: ‘[The] Dialysis unit provides services to clients with three active beds, Fresenius 4008B dialysis machines, and complete monitoring systems supervised by nephrologists and experienced nurses in dialysis. Services of this unit revolve around detoxification and removal of excess body fluids to prevent the increase of toxins in chronic renal failure (CRF) and acute renal failure (ARF) patients.’^{[footnote 89]}

16.2 Kidney transplants

16.2.1 The Iran Surgery Centre website stated:

‘Today, more than 2,500 successful kidney transplants are performed in Iran every year.

‘The average life expectancy of a kidney donor in Iran is higher than the average life expectancy of the society…

‘We did not have a single case of death in the surgeries where we had nearly 6,000 kidney transplants, and the life expectancy of these people in 40 years is the same as the rest of the people…

‘Our kidney transplant surgeons perform more than 500 surgeries annually, with a success rate of 99%, which is higher than the global average.

‘Among the advantages of the kidney transplant center in the Iran surgery center, the following can be mentioned:

‘Advanced surgical techniques: Minimally invasive and laparoscopic surgery increases the ease of surgery, shorter and easier recovery period, reduces the risk of infection and provides better results.

‘The possibility of paired kidney donation and cross transplants: Transplants where there is a kidney exchange between couples with greater compatibility are frequently performed in Iranian kidney transplant centers with excellent results.

‘Kidney transplantation of infants and children. Our transplant team has extensive expertise in pediatric kidney transplants.

‘Use of advanced technology: Advanced equipment is available in operating rooms, intensive care units, and laboratory facilities…’^{[footnote 90]}

Section updated: 9 May 2024

17. Thyroid diseases

17.1.1 The EUAA MedCOI database, in a 2020 response to an information request, stated that endocrinologists who could treat people with thyroid conditions were available, for example at the Taleghani University Hospital in Tehran. Endocrine surgery could also be carried out, for example, at the Taleghani University Hospital in Tehran^{[footnote 91]}.

Section updated: 4 April 2024

18. Palliative care

18.1.1 The medical research 2022 study, ‘The level of knowledge about palliative care in Iranian patients with cancer’, published on the BMC Palliative Care website, stated:

‘Iran’s health system is facing an increasing number of chronic patients, a shortage of manpower and intensive care units. Most people with incurable diseases in Iran are frequently hospitalized in the last days of life and receive specialized medication until the last moments of life, and eventually many of these patients die on hospital beds and in intensive care units, while in many cases, hospitalization of these patients has no effect on the patient’s recovery and…This increases the costs of the health system and patients’ families, dissatisfaction and burnout of health professionals. On the other hand, many patients prefer to spend the last days of their lives in the family and in close contact with their relatives. Evidence suggests that palliative care in Iran is provided as an island and in a limited number of centers. Most patients are deprived of this type of care and home-based palliative care in the country does not have any place in the health system and patients are confused to receive palliative care and reduce the pain and suffering caused by their illness and in most cases appropriate services And [sic] is not given to these patients in a timely manner.’^{[footnote 92]}

Section updated: 4 June 2024

19. Tuberculosis (TB) and other lung diseases

19.1.1 The EUAA MedCOI database stated that the following drugs, used to treat asthma, were available in Iran (from pharmacies in Tehran):

• Salbutamol

• Salmeterol + fluticasone

• Formoterol + budesonide^{[footnote 93]}.

19.1.2 The medical research 2023 study, ‘Patient experience with chronic obstructive pulmonary disease: a nationally representative demonstration study on quality and cost of healthcare services’, published on the Frontiers^{[footnote 94]} website, stated:

‘The most utilized services [used by people with chronic obstructive pulmonary disease (COPD) in the study] were pharmacy services with monthly use of 258 times (189 times for males and 69 times for females), followed by outpatient services with 142 times per month (99 times for males and 43 times for females). The most prescribed medications among patients with COPD were salbutamol inhaler (173 (73.6%)), tiotropium inhaler (98 (41.7%)) and ipratropium inhaler (95 (40.4%)). The outpatient services were utilized less than four times a year. Almost none of the participants utilized the rehabilitation services.’^{[footnote 95]}

19.1.3 The same 2023 medical research study also stated: ‘Therapeutic services consisted of inpatient and outpatient visits; diagnostic services consisted of laboratory, testing, and imaging services; and patient support services included rehabilitation, home care, medical equipment utilization, and pharmacy services. In addition, all medications that were available in the Iranian Pharmacopoeia and were used to treat COPD were included in the survey.’^{[footnote 96]}

19.1.4 The Jam Hospital in Tehran has a pulmonary clinic that can provide a wide range of treatment and tests for people with lung diseases, as explained on its website:

‘Clinical evaluation and diagnostic, and therapeutic procedures of respiratory diseases are among the objectives of this clinic.

‘The diagnostic procedures include:

1. Patient medical history

2. Preliminary examinations

3. Basic chest radiography

4. Pulmonary function tests

5. Spirometry

6. CT lung screening

7. Bronchoscopy

8. Spectral biopsy

‘…Diagnosis, control and, in some cases, the treatment of pulmonary symptoms and diseases such as asthma, acute and chronic bronchitis, chronic coughs, pulmonary malignancies, tuberculosis, dyspnea, and bloody sputum are among the objectives of this clinic.’^{[footnote 97]}

19.1.5 The Tehran Times report, ‘Free-of-charge tuberculosis diagnosis, treatment for all’, dated 7 February 2023, stated:

‘The Ministry of Health provides diagnosis and treatment services for people infected with tuberculosis regardless of their nationality.

‘The infected person will be examined with tests and X-rays, and will receive treatment services completely free of charge, IRNA (Iranian news media outlet) quoted Mahshid Nasehi, a health ministry official, as saying.

‘The important thing is that this issue is not limited to non-Iranians, that is, 30-40 percent of the people who may be covered by vaccination or TB treatment in this program are Iranians, she explained.’^{[footnote 98]}

Section updated: 14 May 2024

20. Musculoskeletal conditions

20.1.1 The EUAA MedCOI database, in a 2020 response to an information request, stated that orthopaedic surgery of the spine was available, for example, at the Akhtar Orthopaedic University Hospital in Tehran (public facility)^{[footnote 99]}.

20.1.2 The EUAA MedCOI database, in a 2020 response to an information request, stated that rheumatologists were available, for example, at the Dr Shariati University Hospital in Tehran (public facility)^{[footnote 100]}.

20.1.3 The Tehran University of Medical Sciences website stated:

‘The Department of Orthopedics has been active in training of medical students and orthopedic residents for nearly four decades…Our fellowship programs are as follows:

• Knee Sport Surgery and Arthroplasty

• Pelvic and Hip Reconstruction Surgery

• Hand and peripheral nerves surgery

• Spine surgery

‘In addition, our [d]epartment is active in other subspeciality subjects in Musculoskeletal Tumor Surgery, Shoulder, Foot and Ankle, and trauma surgery.’^{[footnote 101]}

20.1.4 The Jam Hospital in Tehran has an Orthopaedic Clinic that can provide a wide range of treatment and tests for people with musculoskeletal diseases, as explained on its website:

‘The specialist and subspecialist team at the orthopedic clinic attempts to diagnose and treat motor system disorders using surgical and non-surgical methods. Among such disorders are:

• Injuries to the bones and joints such as fractures, dislocations, sprains and strains, and ruptured tendons and ligaments, etc.

• Sports injuries

• Damaged joints such as arthritis and joint wear

• Organ infection

• Bone and soft tissue tumors

• Congenital diseases of the organs.’^{[footnote 102]}

Section updated: 4 June 2024

21. Painkiller medication

21.1.1 The Press TV report, ‘Iran self-sufficient in making active ingredient of acetaminophen’, dated 7 March 2023, stated:

‘Iran has announced self-sufficiency in making the active ingredient needed to manufacture acetaminophen drugs [used as painkillers] amid efforts in the country cut back reliance on foreigners for medical supplies.

‘Deputy head of Iran’s syndicate of active pharmaceutical ingredients said on Tuesday [7 March 2023] that researchers in the country had managed to launch domestic production of para-aminophenol which is the active ingredient needed to make acetaminophen drugs.

‘Mohammad Reza Mousavi said Iran used to rely on China and India for imports of para-aminophenol supplies…

‘He [Mousavi] added that para-aminophenol is being manufactured in a pharmaceutical company in Shazand in the central Markazi province, adding that the project has cost some $10 million [£7,971,864.31^{[footnote 103]}] and more than 30 months of research work.’^{[footnote 104]}

21.1.2 The EUAA MedCOI database stated that the following painkiller drugs were available in Iran (from pharmacies in Tehran) in 2020:

• Amtriptyline

• Gabapentin

• Nortriptyline

• Pregabalin^{[footnote 105]}.

Section updated: 17 April 2024

22. Antibiotic medication

22.1.1 A medical 2021 research study, ‘Antibiotic prescribing in inpatient and outpatient settings in Iran: a systematic review and meta-analysis study’, stated:

‘Antibiotic usage is high in Iran which is a developing country. Some studies reported antibiotic prescribing prevalence of 45-72% in inpatients and outpatients in this country…

‘The most common antibiotic classes prescribed in inpatient settings were cephalosporins, penicillins, and carbapenems, while in outpatient settings, they were penicillins, cephalosporins, and macrolides. Furthermore, the most frequently prescribed antibiotics were ceftriaxone and cefazolin in inpatient settings and amoxicillin, penicillin, co-amoxiclav, and cefixime in outpatient settings.’^{[footnote 106]}

Section updated: 16 May 2024

23. Geriatric care

23.1.1 The EUAA MedCOI database stated, in a 2020 response to an information request, that 24-hour geriatric care in a nursing home was available in 2020, for example, at the Erfans Homecare Services in Tehran (private facility), Hosseinzadeh Nursing Services (private facility) in Tehran, and the Javaher Dashti Nursing Services in Tehran (private facility)^{[footnote 107]}.

23.1.2 The Borgen Project article, ‘Time for Action: Elderly Care in Iran’, dated 25 February 2019, stated:

‘One-third of the Iranian elderly population is not covered by any health insurance; meanwhile, the Iranian government diminished the elderly retirement pension - only one-third of the elderly population receives a pension - while 20 percent of families are economically dependent on the senior householder. The elderly demographic has a very low socioeconomic status and basic insurance policies fail to cover most elderly care costs. Without the money to afford the extra costs, older people often fail to receive the help they need.

‘There are currently five main governmental organizations taxed with elderly care in Iran:

The Social Security Organization

The State Welfare Organization

The Red Crescent

The Imam Khumeini Relief Foundation

The Martyrs Foundation

‘However, there are no clear developed policies on elderly care, and no single organization responsible for addressing this crucial societal need. As a result, ambiguity and uncertainty surround specific organizational responsibility.’^{[footnote 108]}

23.1.3 The same source additionally stated:

‘In regards to access, there are no transportation facilities and many of the elderly are entirely stuck at home due to physical reasons or an inability to pay for transportation costs.

‘Also, 70 percent of elderly people in Iran are illiterate, which impacts their awareness of access to resources. Currently, Iran does not have the physical, human and informational resources to implement an elderly care policy…

‘The country does have community-based services for the elderly such as nursing homes, adult daycare centers, cultural centers and meals on wheels; unfortunately, the distribution is sparse and these services are intended for mainly elderly people with disabilities.’^{[footnote 109]}

23.1.4 CPIT was unable to find more up-to-date information about geriatric care in Iran, from the sources consulted (see Bibliography).

Section updated: 15 May 2024

24. Nursing homecare

24.1.1 The 2023 medical research study, ‘Challenges of Home Care in Iran: A Focus on the Functions of the Health System’, published by PubMed Central, stated:

‘Home care is a new phenomenon in the health system in Iran, and the first laws for establishing home care centers were defined about 20 years ago. However, no standard executive processes or instructions have been yet defined for home care provision, and these services are not implemented clearly and transparently in the formal structure of the Iranian health system. Home care services are often provided in private and charitable centers and less frequently at medical sciences universities.’^{[footnote 110]}

24.1.2 The same study additionally stated: ‘Concerning the financing and resource creation categories, home care challenges include the lack of resources and equipment, lack of trained human resources, lack of home care centers, rise in the service prices and costs, caregiver payments, and insurance-associated problems of home care.’^{[footnote 111]}

Section updated: 14 May 2024

25. Mental healthcare

25.1 Availability of facilities and treatment

25.1.1 The EUAA MedCOI database stated, in a 2020 response to an information request, that psychiatric care for mentally ill people was available, including treatment for PTSD and people at suicide risk, for example, at the Iran Psychiatric Hospital in Tehran^{[footnote 112]}.

25.1.2 The Iranian Psychiatric Hospital in Tehran has psychiatrists who can treat people with mental illnesses, and can provide the following psychiatric-care services:

• Psychotherapy

• Ketamine therapy for the treatment of depression

• EEG testing

• Magnetic stimulation of the brain

• Electroshock therapy^{[footnote 113]}.

25.1.3 The Borgen project report, ‘The State of Mental Health in Iran’, dated 24 March 2021, stated:

‘Over 60% of Iranians do not receive any [mental healthcare] treatment, and only 15-25% get proper treatment. Many do not seek treatment, and resources are currently limited to treating disorders for those who do.

‘While 64% of the population reside in urban areas, mental health is nearly identically prevalent in rural areas. Iran aims to aid urban and rural areas accordingly…Part of the initiative is lessening the disparity of primary health care between urban and rural areas. The gap has decreased significantly, and Iran has begun integrating mental health treatment into its primary care system.

‘Therefore, rural areas are obtaining near-equal access to mental health treatment as urban areas.’^{[footnote 114]}

25.1.4 The AeroLeads (business contacts and network website)^{[footnote 115]}website stated:

‘There are several mental health care companies in Iran that offer a range of services to individuals seeking treatment for various mental health conditions. These companies provide services such as psychiatric assessments, counseling, therapy, medication management, and rehabilitation programs. Some of the leading mental health care companies in Iran include the Iranian Psychiatric Association, the Iranian Mental Health Association, and the Razi Psychiatric Hospital. These companies employ trained and licensed mental health professionals who work with patients to provide personalized treatment plans and support.’^{[footnote 116]}

25.2 Availability of medication

25.2.1 The EUAA MedCOI database stated that the following drugs, used to treat psychiatric conditions, were available in Iran in 2020 (from pharmacies in Tehran):

• Fluoxetine (anti-depressant)

• Escitalopram (anti-depressant)

• Venlafaxine (anti-depressant)

• Aripiprazole (anti-psychotic)

• Clozapine (anti-psychotic)^{[footnote 117]}.

25.2.2 The EUAA MedCOI database stated that the following drugs, used to treat psychiatric conditions, were available in Iran in 2020 (from pharmacies in Tehran):

• Risperidone (anti-psychotic)

• Paliperidone (anti-psychotic)

• Clotiapine (anti-psychotic)

• Quetiapine (anti-psychotic)

• Olanzapine (anti-psychotic)

• Duloxetine (anti-depressant)

• Trazodone (anti-depressant)

• Mirtazapine (anti-depressant)^{[footnote 118]}.

25.2.3 The EUAA MedCOI database stated that the following drugs, used to treat psychiatric conditions, were available in Iran in 2020 (from pharmacies in Tehran):

• Oxazepam (anti-anxiety)

• Lorazepam (anti-anxiety)

• Diazepam (anti-anxiety)

• Citalopram (anti-depressant)

• Sertraline (anti-depressant)^{[footnote 119]}.

Research methodology

The country of origin information (COI) in this note has been carefully selected in accordance with the general principles of COI research as set out in the Common EU [European Union] Guidelines for Processing Country of Origin Information (COI), April 2008, and the Austrian Centre for Country of Origin and Asylum Research and Documentation’s (ACCORD), Researching Country Origin Information – Training Manual, 2013. Namely, taking into account the COI’s relevance, reliability, accuracy, balance, currency, transparency and traceability.

All the COI included in the note was published or made publicly available on or before the ‘cut-off’ date(s). Any event taking place or report/article published after these date(s) is not included.

Sources and the information they provide are carefully considered before inclusion. Factors relevant to the assessment of the reliability of sources and information include:

• the motivation, purpose, knowledge and experience of the source
• how the information was obtained, including specific methodologies used
• the currency and detail of information
• whether the COI is consistent with and/or corroborated by other sources

Wherever possible, multiple sourcing is used and the COI compared and contrasted to ensure that it is accurate and balanced, and provides a comprehensive and up-to-date picture of the issues relevant to this note at the time of publication.

The inclusion of a source is not, however, an endorsement of it or any view(s) expressed.

Each piece of information is referenced in a footnote.

Full details of all sources cited and consulted in compiling the note are listed alphabetically in the bibliography.

Terms of Reference

A ‘Terms of Reference’ (ToR) is a broad outline of what the country information note (CIN) seeks to cover. They form the basis for the country information section. The Home Office’s Country Policy and Information Team uses some standardised ToRs, depending on the subject, and these are then adapted depending on the country concerned.

For this particular CIN, the following topics were identified prior to drafting as relevant and on which research was undertaken:

• Healthcare system
  • Overview of healthcare structure
  • Financing of healthcare and health insurance schemes (costs of these/contributions)
  • Non-government organisations providing healthcare and assistance
  • Doctors, hospitals, pharmacies, emergency care (the number of each of these, locations and any cost to access these services if relevant)
  • Specific diseases/conditions:
  • Cancer treatment (oncology)
  • Cardiology
  • Diabetes
  • Ear, nose and throat conditions
  • Eye treatment (ophthalmology)
  • Gastroenterological conditions
  • Gynaecological conditions
  • Obstetrics
  • Haematology (blood diseases)
  • Hepatitis
  • HIV/AIDs
  • Kidney diseases
  • Liver transplants and liver conditions (hepatology)
  • Lung diseases
  • Musculoskeletal conditions
  • Mental health, psychiatry (including type of facilities that can deal with mental health issues and locations, any costs)
  • Neurological conditions
  • Paediatrics
  • Palliative care, nursing homecare and geriatric care

Bibliography

Sources cited

AeroLeads,

• ‘Home’, no date. Last accessed: 4 June 2024

• ‘Top Mental Health Care companies In Iran’, no date. Last accessed: 18 April 2024

AveHeal, ‘Noor Eye Specialty Center’, no date. Last accessed: 9 April 2024

Biomed Central,

• ‘Antibiotic prescribing in inpatient and outpatient settings in Iran: a systematic review and meta-analysis study’, 14 January 2021. Last accessed: 17 April 2024

• Orphanet Journal of Rare Diseases, ‘Development and pilot implementation of Iranian Hemolytic Uremic Syndrome Registry’, 16 June 2022. Last accessed: 9 May 2024

• BMC Gastroenterology, ‘Evaluation of autoimmune liver disease natural history in patients referred to Middle East Liver Diseases (MELD) center’, 4 January 2024. Last accessed: 9 May 2024

• BMC Health Services Research, ‘The impact of the education program based on dimensions of quality of work life among emergency medical services providers’, 28 February 2024. Last accessed: 2 May 2024

• BMC Palliative Care, ‘The level of knowledge about palliative care in Iranian patients with cancer’, 2022. Last accessed: 4 April 2024

Borgen Project,

• ‘Time for Action: Elderly Care in Iran’, 25 February 2019. Last accessed: 10 April 2024

• ‘8 Facts About Healthcare in Iran’, 1 October 2020. Last accessed: 10 April 2024

• ‘The State of Mental Health in Iran’, 24 March 2021. Last accessed: 10 April 2024

Cambridge University Press, ‘Public–private partnership in primary health care: an experience from Iran’, 9 January 2023. Last accessed: 4 April 2024

Department of Foreign Affairs and Trade (Australian government), ‘Country Information Report – Iran’, 24 July 2023. Last accessed: 4 April 2024

Frontiers,

• ‘About Frontiers’, no date. Last accessed: 4 June 2024

• ‘Patient experience with chronic obstructive pulmonary disease: a nationally representative demonstration study on quality and cost of healthcare services’, 15 June 2023. Last accessed: 16 May 2024

Jam Hospital, Tehran,

• ‘Cardiology Clinic’, no date. Last accessed: 5 April 2024

• ‘Department of Dentistry’, no date. Last accessed: 5 April 2024

• ‘Dialysis’, no date. Last accessed: 5 April 2024

• ‘Haematology and Oncology Clinic’, no date. Last accessed: 5 April 2024

• ‘General Surgery Clinic’, no date. Last accessed: 5 April 2024

• ‘Neurosurgery Clinic’, no date. Last accessed: 5 April 2024

• ‘Orthopaedic Clinic’, no date. Last accessed: 5 April 2024

• ‘Otorhinolaryngology Clinic’, no date. Last accessed: 5 April 2024

• ‘Pulmonary Clinic’, no date. Last accessed: 5 April 2024

International Cancer Control Partnership, WHO, ‘2021 Cervical Cancer Profile Iran 2021’, 2021. Last accessed: 2 May 2024

Investopedia, ‘Iranian Rial (IRR): Overview, Conversion, FAQ’, 29 December 2023. Last accessed: 14 May 2024

Iran Daily,

• ‘Home’, no date. Last accessed: 4 June 2024

• ‘Iran inaugurates first-ever insulin production line’, 28 August 2023. Last accessed: 4 June 2024

Iran Focus,

• ‘Homepage’, 4 June 2024. Last accessed: 4 June 2024

• ‘Iran’s Medicine Shortage Continues as Production of Sports Supplements Increase’, 31 May 2023. Last accessed: 10 April 2024

Iran Health Agency, ‘Cosmetic Dentistry in Iran’, no date. Last accessed: 8 May 2024

Iran International,

• ‘Iranian Medical Council Warns Of Pediatric Heart Surgeons’ Emigration’, 16 March 2024. Last accessed: 9 April 2024

• ‘Iran Vows To Export Medicines To Hungary Amid Serious Shortages’, 18 November 2022. Last accessed: 9 April 2024

• ‘Iranian Drug Shortage Worsens Amid Currency Crisis’, 14 November 2023. Last accessed: 10 April 2024

• ‘Homepage’, 4 June 2024. Last accessed: 8 May 2024

Iran News Update, ‘Most Iranians Struggle To Pay For Healthcare’, 2 November 2023. Last accessed: 4 April 2024

Iran Surgery Centre,

• ‘Kidney Transplant in Iran’, no date. Last accessed: 9 April 2024

• ‘Liver Transplant in Iran – Ultimate Guide plus Prices’, no date. Last accessed: 10 April 2024

Iran Treatments,

• ‘Urology surgery in Iran – types & Procedures 2023’, no date. Last accessed: 18 April 2024

• ‘Gastric cancer Surgery in Iran by Dr. Shahryar Azizi’, no date. Last accessed: 7 May 2024

Iranian Cancer Control Centre, ‘Home Care Network’, no date. Last accessed: 15 May 2024

Iranian Eye Clinic, ‘About us’, no date. Last accessed: 8 May 2024

Iranian Psychiatric Hospital, ‘Iranian Psychiatric Hospital’, no date. Last accessed: 14 May 2024

Landinfo, ‘Iran – The Iranian Welfare System’, 12 August 2020. Last accessed: 10 April 2024

Mortaz Hospital, ‘Obstetrics and gynecology services in Iran’, no date. Last accessed: 8 May 2024

MEHR News Agency,

• ‘Iran’s outcomes in healthcare over past 45 years’, 4 February 2024. Last accessed: 4 April 2024

• ‘About Us’, no date. Last accessed: 4 April 2024

Negin Cancer Centre, Tehran, ‘Negin Azadi Introduction’, no date. Last accessed: 4 April 2024

NGA Medical Tourism,

• ‘General Heart Surgery in Iran’, 2022. Last accessed: 4 April 2024

• ‘About’, no date. Last accessed: 4 June 2024

Nour News,

• ‘Iran among 3 countries producing anticancer drug Ibrutinib’, 26 September 2023. Last accessed: 17 April 2024

• ‘Home’, no date. Last accessed: 4 June 2024

Press TV,

• ‘Iran self-sufficient in making active ingredient of acetaminophen’, 7 March 2023. Last accessed: 10 April 2024

• ‘Iran opens largest pediatric hospital in Middle East’, 31 July 2021. Last accessed: 18 April 2024

• ‘Iran’, no date. Last accessed: 4 June 2024

PubMed Central,

• ‘About PMC’, no date. Last accessed: 4 June 2024

• ‘The hepatitis C virus in Iran: health policy, historical, ethical issues and future challenges’, 2 April 2020. Last accessed: 8 May 2024

• ‘Survivor and parent engagement in childhood cancer treatment in Iran’, 19 April 2021. Last accessed: 10 April 2024

• ‘Availability and affordability of anticancer medicines in Iran based on WHO/HAI standard survey methods’, 27 December 2022. Last accessed: 15 May 2024

• ‘Challenges of Home Care in Iran: A Focus on the Functions of the Health System’, 11 July 2023. Last accessed: 15 May 2024

• ‘Economic Burden of HIV/AIDS in Iran: A Modelling Approach’, 7 February 2023. Last accessed: 9 April 2024

Shafa Hospital,

• ‘Neurology’, no date. Last accessed: 8 May 2024

• ‘Open-Heart Surgery’, no date. Last accessed: 15 May 2024

Sun,

• ‘Iran unveils new gene therapy technology to treat blood cancer’, 15 November 2022. Last accessed: 30 May 2024

• ‘Home’, no date. Last accessed: 4 June 2024

Tehran Times,

• ‘Free-of-charge tuberculosis diagnosis, treatment for all’, 7 February 2023. Last accessed: 8 April 2024

• ‘Advanced cancer treatment center inaugurated’, 17 March 2023. Last accessed: 17 April 2024

• ‘Iran world’s third producer of “ibrutinib” anti-cancer drug’, 25 September 2023. Last accessed: 14 May 2024

• ‘Hepatitis B control program to be implemented’, 12 March 2024. Last accessed: 15 May 2024

• ‘Home’, 4 June 2024. Last accessed: 4 June 2024

Tehran University of Medical Sciences,

• ‘Department of Orthopedics’, no date. Last accessed: 10 April 2024

• ‘Department of Radiotherapy’, no date. Last accessed: 10 April 2024

UN Economic and Social Commission for Asia and the Pacific, ‘Iran’s Primary Health Care Network’, 2019. Last accessed: 4 April 2024

XE Currency Converter,

• ‘Iranian rials to GBP’, 30 May 2024. Last accessed: 30 May 2024

• ‘USD to GBP’, 14 May 2024. Last accessed: 14 May 2024

• ‘Euros to GBP’, 30 May 2024. Last accessed: 30 May 2024

Sources consulted but not cited

Foreign, Commonwealth, and Development Office, ‘Foreign travel advice - Iran’, 29 April 2024. Last accessed: 13 May 2024

Iran Focus, ‘Statistics of Mental Disorders in Iran’, 12 November 2019. Last accessed: 16 May 2024

Iran International, ‘Healthcare Headed For Crisis As 10k Doctors Left Iran In Two Years’, 29 May 2023. Last accessed: 16 May 2024

Iran News Update, ‘The Crisis in Iran’s Healthcare System’, 14 May 2024. Last accessed: 16 May 2024

Iran Wire, ‘Iran’s Healthcare Crisis: Six Nurses Emigrate Every Day’, 24 October 2023. Last accessed: 16 May 2024

Radio Free Europe/Radio Liberty, ‘Iran Grapples With Exodus Of Health-Care Professionals’, 26 August 2023. Last accessed: 16 May 2024

World Health Organisation, ‘WHO in Islamic Republic of Iran’, no date. Last accessed: 16 May 2024

Version control and feedback

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• valid from 10 June 2024

Official – sensitive: Not for disclosure – Start of section

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1. EUAA, ‘Country of Origin Information’ (Medical country of origin information), no date ↩

2. XE Currency Converter, ‘GBP to Iranian rials’, 14 May 2024 ↩

3. Landinfo, ‘Iran – The Iranian Welfare System’ (page 10), 12 August 2020 ↩

4. Landinfo, ‘Iran – The Iranian Welfare System’ (pages 11-12), 12 August 2020 ↩

5. Cambridge University Press, ‘Public–private partnership in primary health care…’, 9 January 2023 ↩

6. DFAT, ‘Country Information Report – Iran’ (page 10), 24 July 2023 ↩

7. UNESCAP, ‘Iran’s Primary Health Care Network’, 2019 ↩

8. UNESCAP, ‘Iran’s Primary Health Care Network’, 2019 ↩

9. Landinfo, ‘Iran – The Iranian Welfare System’ (pages 13-14), 12 August 2020 ↩

10. Landinfo, ‘Iran – The Iranian Welfare System’ (page 23-24), 12 August 2020 ↩

11. MEHR News Agency, ‘About Us’, no date ↩

12. MEHR News Agency, ‘Iran’s outcomes in healthcare over past 45 years’, 4 February 2024 ↩

13. Landinfo, ‘Iran – The Iranian Welfare System’ (page 24), 12 August 2020 ↩

14. Borgen Project, ‘8 Facts About Healthcare in Iran’, 1 October 2020 ↩

15. Iran International, ‘Homepage’, 4 June 2024 ↩

16. Iran International, ‘Iran Vows To Export Medicines To Hungary Amid…’, 18 November 2022 ↩

17. Iran Focus, ‘Homepage’, 4 June 2024 ↩

18. XE Currency Converter, ‘GBP to Iranian rials’, 14 May 2024 ↩

19. XE Currency Converter, ‘GBP to Iranian rials’, 14 May 2024 ↩

20. Iran Focus, ‘Iran’s Medicine Shortage Continues as Production of Sports…’, 31 May 2023 ↩

21. Iran News Update, ‘News Digest’, 4 June 2024 ↩

22. Investopedia, ‘Iranian Rial (IRR): Overview, Conversion, FAQ’, 29 December 2023 ↩

23. XE Currency Converter, ‘GBP to Iranian rials’, 14 May 2024 ↩

24. XE Currency Converter, ‘GBP to Iranian rials’, 14 May 2024 ↩

25. XE Currency Converter, ‘GBP to Iranian rials’, 14 May 2024 ↩

26. Iran News Update, ‘Most Iranians Struggle To Pay For Healthcare’, 2 November 2023 ↩

27. Iran International, ‘Iranian Drug Shortage Worsens Amid Currency Crisis’, 14 November 2023 ↩

28. BMC Health Services Research, ‘The impact of the education program based…’, 28 February 2024 ↩

29. Press TV, ‘Iran’, no date ↩

30. Press TV, ‘Iran opens largest pediatric hospital in Middle East’, 31 July 2021 ↩

31. Iran International, ‘Iranian Medical Council Warns Of Pediatric Heart…’, 16 March 2024 ↩

32. PubMed Central, ‘About PMC’, no date ↩

33. PubMed Central, ‘Survivor and parent engagement in childhood cancer treatment…’, 19 April 2021 ↩

34. Landinfo, ‘Iran – The Iranian Welfare System’ (page 24), 12 August 2020 ↩

35. Orphanet Journal of Rare Diseases, ‘Development and pilot implementation…’, 16 June 2022 ↩

36. Tehran Times, ‘Home’, 4 June 2024 ↩

37. XE Currency Converter, ‘Iranian rials to GBP’, 30 May 2024 ↩

38. Tehran Times, ‘Advanced cancer treatment center inaugurated’, 17 March 2023 ↩

39. MACSA, ‘Home Care Network’, no date ↩

40. Negin Cancer Centre, Tehran, ‘Negin Azadi Introduction’, no date ↩

41. Tehran University of Medical Sciences, ‘Department of Radiotherapy’, no date ↩

42. PubMed, ‘Availability and affordability of anticancer medicines in Iran based…’, 27 December 2022 ↩

43. XE Currency Converter, ‘Euros to GBP’, 30 May 2024 ↩

44. Tehran Times, ‘Iran world’s third producer of “ibrutinib” anti-cancer drug’, 25 September 2023 ↩

45. Iran Health Agency, ‘Breast Cancer in Iran’, no date ↩

46. International Cancer Control Partnership, WHO, ‘2021 Cervical Cancer Profile Iran 2021’, 2021 ↩

47. Iran Treatments, ‘Urology surgery in Iran – types & Procedures 2023’, no date ↩

48. Iran Treatments, ‘Gastric cancer Surgery in Iran by Dr. Shahryar Azizi’, no date ↩

49. Iran Treatments, ‘Gastric cancer Surgery in Iran by Dr. Shahryar Azizi’, no date ↩

50. The Sun, ‘Home’, no date ↩

51. The Sun, ‘Iran unveils new gene therapy technology to treat blood cancer’, 15 November 2022 ↩

52. Nour News, ‘Home’, no date ↩

53. Nour News, ‘Iran among 3 countries producing anticancer drug Ibrutinib’, 26 September 2023 ↩

54. Jam Hospital, Tehran, ‘Cardiology Clinic’, no date ↩

55. EUAA, MedCOI, BMA-14265, 4 December 2020 ↩

56. EUAA, MedCOI, BMA-13769, 2 July 2020 ↩

57. EUAA, MedCOI, BMA-13807, 13 July 2020 ↩

58. EUAA, MedCOI, BMA-13787, 2 July 2020 ↩

59. EUAA, MedCOI, BMA-13807, 13 July 2020 ↩

60. EUAA, MedCOI, BMA-13769, 2 July 2020 ↩

61. NGA Medical Tourism, ‘About’, no date ↩

62. NGA Medical Tourism, ‘General Heart Surgery in Iran’, 2022 ↩

63. Shafa Hospital, Khorramabad, ‘Open-Heart Surgery’, no date ↩

64. Jam Hospital, Tehran, ‘Department of Dentistry’, no date ↩

65. Iran Health, ‘Cosmetic Dentistry in Iran’, no date ↩

66. EUAA, MedCOI, BMA-13769, 2 July 2020 ↩

67. Iran Daily, ‘Home’, no date ↩

68. Iran Daily, ‘Iran inaugurates first-ever insulin production line’, 28 August 2023 ↩

69. EUAA, MedCOI, BMA-13807, 13 July 2020 ↩

70. Jam Hospital, Tehran, ‘Otorhinolaryngology Clinic’, no date ↩

71. EUAA, MedCOI, BMA-14247, 28 November 2020 ↩

72. Jam Hospital, Tehran, ‘Neurosurgery Clinic’, no date ↩

73. Shafa Hospital, ‘Neurology’, no date ↩

74. EUAA, MedCOI, BMA-13807, 13 July 2020 ↩

75. Ave Heal, ‘Noor Eye Speciality Centre’, no date ↩

76. Iranian Eye Clinic, ‘About us’, no date ↩

77. EUAA, MedCOI, BMA-14265, 4 December 2020 ↩

78. Jam Hospital, Tehran, ‘General Surgery Clinic’, no date ↩

79. Mortaz Hospital, ‘Obstetrics and gynecology services in Iran’, no date ↩

80. PubMed Central, ‘Economic Burden of HIV/AIDS in Iran: A Modelling Approach’, 7 February 2023 ↩

81. PubMed Central, ‘Economic Burden of HIV/AIDS in Iran: A Modelling Approach’, 7 February 2023 ↩

82. EUAA, MedCOI, BMA-13297, 18 March 2020 ↩

83. PubMed Central, ‘The hepatitis C virus in Iran: health policy, historical, ethical…’, 2 April 2020 ↩

84. EUAA, MedCOI, BMA-13594, 14 May 2020 ↩

85. BMC Gastroenterology, ‘Evaluation of autoimmune liver disease natural history…’, 4 January 2024 ↩

86. Tehran Times, ‘Hepatitis B control program to be implemented’, 12 March 2024 ↩

87. Iran Surgery Centre, ‘Liver Transplant in Iran – Ultimate Guide plus Prices’, no date ↩

88. Jam Hospital, Tehran, ‘Haematology and Oncology Clinic’, no date ↩

89. Jam Hospital, Tehran, ‘Dialysis’, no date ↩

90. Iran Surgery Centre, ‘Kidney Transplant in Iran’, no date ↩

91. EUAA MedCOI, BMA-13558, 26 April 2020 ↩

92. BMC Palliative Care, ‘The level of knowledge about palliative care in Iranian patients…’, 2022 ↩

93. EUAA, MedCOI, BMA-13787, 2 July 2020 ↩

94. Frontiers, ‘About Frontiers’, no date ↩

95. Frontiers, ‘Patient experience with chronic obstructive pulmonary…’, 15 June 2023 ↩

96. Frontiers, ‘Patient experience with chronic obstructive pulmonary…’, 15 June 2023 ↩

97. Jam Hospital, Tehran, ‘Pulmonary Clinic’, no date ↩

98. Tehran Times, ‘Free-of-charge tuberculosis diagnosis, treatment for all’, 7 February 2023 ↩

99. EUAA MedCOI, BMA-14247, 28 November 2020 ↩

100. EUAA MedCOI, BMA-14193, 8 November 2020 ↩

101. Tehran University of Medical Sciences, ‘Department of Orthopedics’, no date ↩

102. Jam Hospital, Tehran, ‘Orthopaedic Clinic’, no date ↩

103. XE Currency Converter, ‘USD to GBP’, 14 May 2024 ↩

104. Press TV, ‘Iran self-sufficient in making active ingredient of acetaminophen’, 7 March 2023 ↩

105. EUAA, MedCOI, BMA-14247 ↩

106. Biomed Central, ‘Antibiotic prescribing in inpatient and outpatient settings…’, 14 January 2021 ↩

107. EUAA, MedCOI, BMA-14265, 4 December 2020 ↩

108. Borgen Project, ‘Time for Action: Elderly Care in Iran’, 25 February 2019 ↩

109. Borgen Project, ‘Time for Action: Elderly Care in Iran’, 25 February 2019 ↩

110. PubMed Central, ‘Challenges of Home Care in Iran: A Focus on the Functions…’, 11 July 2023 ↩

111. PubMed Central, ‘Challenges of Home Care in Iran: A Focus on the Functions…’, 11 July 2023 ↩

112. EUAA, MedCOI, BMA-14193, 8 November 2020 ↩

113. Iranian Psychiatric Hospital, ‘Iranian Psychiatric Hospital’, no date ↩

114. Borgen Project, ‘The State of Mental Health in Iran’, 24 March 2021 ↩

115. AeroLeads, ‘Home’, no date ↩

116. AeroLeads, ‘Top Mental Health Care companies In Iran’, no date ↩

117. EUAA, MedCOI, BMA-13947, 22 August 2020 ↩

118. EUAA, MedCOI, BMA-14060, 22 September 2020 ↩

119. EUAA, MedCOI, BMA-14193, 8 November 2020 ↩