Prolonged airstrikes against military and civilian targets in Iran have put the country’s fragile health care system under growing strain, multiple reports say.
Iranian officials and the World Health Organization (WHO) say several pharmaceutical factories and medical facilities have been damaged since US and Israeli strikes began in late February. WHO chief Tedros Adhanom Ghebreyesus confirmed that the Tofigh Daru facility, which produces cancer treatment drugs, was hit, and said bombs also damaged the Pasteur Institute, a psychiatric hospital and another hospital outside Tehran. The WHO has verified more than 20 attacks on health-care facilities with at least nine deaths.
More than 100 US-based international law experts — including professors from Harvard, Yale and Stanford — condemned strikes that they say hit schools, health facilities and homes. Citing Iranian Red Crescent reports, they noted that about 236 health centers had been bombed three weeks into the conflict and described the attacks as a “clear violation of the United Nations Charter,” raising concerns about breaches of international humanitarian law and potential war crimes.
What happened at Tofigh Daru
Iran’s Deputy Health Minister Mehdi Pirsalehi said Tofigh Daru suffered a “direct missile strike.” He described the plant as a leading manufacturer of active ingredients for hospital medications and surgical drugs, saying production lines and R&D departments were destroyed.
Israel acknowledged the attack but accused Tofigh Daru of using its civilian status as a cover while “systematically supplying chemicals” to Iran’s Organization of Defensive Innovation and Research. The Israeli military claimed the chemicals included fentanyl, which it said was used for research and development on chemical weapons. These claims could not be independently verified. International pharmaceutical registries list Tofigh Daru as a maker of pharmaceutical ingredients, including oncology medications and anesthetics.
Impact on patients and supply chains
Two Iran-born doctors and activists interviewed by DW warned of immediate and long-term consequences. Vienna-based Dr. Hassan Nayeb-Hashem said Tofigh Daru produced a broad range of essential medicines and had localized about 50 strategic active ingredients. He warned that a massive volume of medicines has disappeared from the domestic supply chain and that obtaining equivalent supplies from abroad will be difficult under current circumstances.
Cancer medicine is particularly vulnerable: it is expensive in Iran — often equal to one or two monthly salaries — and health insurers frequently refuse to cover imported drugs. Many patients already have limited access to necessary medications. Nayeb-Hashem and his colleague Hamid Hemmatpour said deliberately targeting medical and pharmaceutical facilities would violate the Geneva Conventions and WHO rules, unless a facility is credibly shown to be used for military purposes.
“The emergency is dire,” Hemmatpour said, recounting a case in which a cancer patient could not get even basic painkillers or anti-dizziness medication through a charity because supplies had run out.
Health workforce and service collapse
Beyond physical damage, the war has driven many experienced doctors out of the country or prevented them from returning, further weakening the system. At the start of the conflict, many doctors with dual nationalities left via neighboring borders. Iranian authorities have tried to stop others from leaving, but many private practices in Tehran are closed.
The result is severe overload for remaining medical staff. Hemmatpour said in parts of Tehran a single doctor is treating 200 to 300 patients a day, with conditions much worse outside the capital. He described a case of a protest-injured patient who was shuttled between four cities and ultimately lost a leg because required specialists were not available locally; most specialists are concentrated in major cities such as Tehran, Mashhad, Shiraz and Isfahan.
Long-term consequences
Both doctors warned the damage will stretch into the future. Rebuilding priorities after a conflict often favor military facilities over health care, Nayeb-Hashem said, meaning the effects on public health could persist even if hostilities end. The combined loss of production capacity, medicine shortages and a depleted workforce could amount to a “death blow” for Iran’s health care system, they warned.
Edited by: Srinivas Mazumdaru