Iran’s hepatitis elimination programme is under threat

On May 8, 2018, the USA withdrew from the Iran nuclear deal and re-imposed a list of sanctions that target Iran’s economy and companies from third-party countries that continue to trade with Iran. Both US and non-US business partners have been winding down their economic activities in Iran. These sanctions will have a detrimental effect on the country’s viral hepatitis elimination programme. In 2016, WHO adopted a resolution to eliminate viral hepatitis by 2030 by decreasing the incidence of chronic infection and mortality through improving interventions such as screening, universal vaccination, and access to antiviral therapies.1 However, these elimination targets are only achievable if sufficient resources are available. In Iran, viral hepatitis is the main cause of hepatocellular carcinoma,2 and almost 2 million people are infected with hepatitis B virus (HBV) or hepatitis C virus (HCV).3 Data indicate that Iran is among the countries that are working towards elimination of HCV and is on track to decrease HBV prevalence to 1% or less by 2030.4 The HBV vaccines and antiviral medicines for HBV and HCV are produced domestically, but local manufacturing still relies on the importation of raw materials. Furthermore, the Iranian blood transfusion organisation imports all its viral hepatitis screening kits. Acquiring these supplies will be difficult if not impossible under a regime of economic sanctions.

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