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When Iran's supreme leader banned U.S. and other Western-made COVID-19 vaccines this month, he did so even as his country's pandemic death toll nears 60,000 and its total caseload surpasses 1.3 million, making it one of the Middle East’s worst-hit country and the 16th-most afflicted nation in the world.
The coronavirus has surged this winter, pushing Iran to the brink of a humanitarian disaster as hospitals and healthcare networks fail to keep up. With the economy savaged by U.S. sanctions, drugs and medical equipment are in short supply, leaving thousands without vital care and scores dying every day. Many doctors believe that the pandemic’s death toll in Iran is three to four times higher than the official figure.
But another factor in the crisis has been Iran’s leadership, which many in the country say is playing politics with what should be purely a public health matter and complicating a vaccine rollout for the nation's 82 million people.
It started this month when Supreme Leader Ayatollah Ali Khamenei directed the government to eschew American, British and French vaccines. “Sometimes they want to test the vaccine on other nations,” Khamenei warned of the U.S. in particular.
In response, Iran’s Red Crescent Society canceled an order for 150,000 doses of the Pfizer-BioNTech vaccine, saying it would import vaccines from non-Western countries. Other officials vowed that Iran would press on with developing a homegrown alternative.
Khamenei's decision has sparked outrage, with a group of opposition politicians and activists insisting that a decision on the quality of available vaccines “should be the sole domain of the country’s experts,” according to an open letter addressed to government authorities Saturday.
“Relying on domestic vaccines for vaccination of millions of people is very unlikely in the near future. Therefore, in order to achieve mass immunity, 75% of the population must be vaccinated immediately,” the letter said.
It warned that any delay would “definitely result in public dissatisfaction,” and urged authorities to use diplomatic channels to get better vaccines. “If international sanctions are a major obstacle in the way of buying vaccines … try to remove any such obstacle through smart diplomacy."
That sentiment had already been growing on social media, especially on Twitter, where tens of thousands of Iranians have tweeted under the hashtag "voksan_bikhayetd," meaning "purchase vaccine," while others mocked officials for their proclaimed trust of Russian and Chinese COVID-19 shots. Major reformist figures were also emboldened to defy Khamenei, including Mostafa Tajzadeh, a former deputy minister who had run afoul of authorities and was imprisoned for eight years.
“Healthcare of the citizens is the topmost priority of the government. No official, not even the supreme leader, is entitled to make decisions on how to fight COVID other than the experts in the field. Immediate curbing of the COVID pandemic must be the first priority,” he tweeted. Besides, he reminded Khamenei, the supreme leader had previously exhorted Iranians to adhere to the national COVID-19 committee’s directives.
“Therefore, it would be wise that the leader announce his comments were just some nonbinding guidelines,” Tajzadeh said, “and that the ultimate decision on vaccine purchase will rest with the COVID committee.”
Authorities insist that Iranian researchers are making progress on a domestic vaccine and that it’s part of a wider drive aimed at independence from the West, said Tara Sepehri Far, Iran researcher for Human Rights Watch.
Iran’s 137 drug manufacturers are racing to develop a COVID-19 inoculation. Last month, COVIran-Barekat, a vaccine candidate developed by state-owned Shifa Pharmed, cleared animal trials and began testing on humans, the first of eight locally developed vaccines to do so.
“Many experts are saying it doesn’t make sense to use limited resources on a project of this scale, but the idea plays into a broader theory of national security,” Sepehri Far said.
“The system’s priority has been this idea of 'economic resistance,' and vaccines play into the same narrative.”
As part of that narrative, Iran’s Pasteur Institute and Cuba’s Finlay Vaccine Institute announced last week that they were joining forces to develop a COVID-19 vaccine, Soberana 02. (The name means “sovereign" in Spanish.)
“This synergy will enable both countries to advance more rapidly in the immunization against the SARS-CoV-2 virus,” the Finlay institute said of the collaboration on its Twitter account.
Cuba, like Iran, is staggering under a bevy of U.S. sanctions that have crushed its medical sector, despite exemptions meant to allow medicines to pass through unimpeded.
On Saturday, Iranian President Hassan Rouhani vowed that the government would “spare no effort” to begin vaccination drives before the end of the Iranian year March 20.
“In addition, we are finalizing the Pasteur vaccine together with another country, and this vaccine will be available to the public in the spring,” Rouhani said, referring to the joint Cuban-Iranian vaccine.
The following day, Alireza Raisi, spokesman for the Iranian National Headquarters for Combating the Coronavirus, said Tehran had paid $52 million to buy 16.8 million doses of COVID-19 vaccines from COVAX, an international consortium set up by the World Health Organization and the Geneva-based Gavi vaccine alliance to ensure widespread vaccine access for all countries. However, it's unclear whether Iran would be able to order only non-Western-developed vaccines from COVAX.
A Gavi spokesperson said the consortium anticipates "being able to provide each participating economy with the first tranche — enough to protect approximately 3% of the population — in the first half of 2021." Distribution could begin as early as February.
Some argue that the real power to fight Iran's coronavirus crisis lies in Washington's hands, not Tehran's. Senior Iranian officials are hoping that President-elect Joe Biden will break with the Trump administration's "maximum pressure" campaign by unblocking a loan from the International Monetary Fund and easing sanctions on Iranian banks to facilitate imports of medicine.
The Iranian rial has surged 20% in value against the dollar in the last two weeks, partly in anticipation of a friendlier occupant in the White House.
This story originally appeared in Los Angeles Times.