Sustained airstrikes against military and civilian sites in Iran have increasingly strained the country’s already fragile health system, multiple reports say.
Iranian authorities and the World Health Organization say a number of pharmaceutical factories and medical facilities have been damaged since strikes by US and Israeli forces began in late February. WHO Director-General Tedros Adhanom Ghebreyesus confirmed the Tofigh Daru plant, which produces cancer drugs, was struck, and said the Pasteur Institute, a psychiatric hospital and another hospital outside Tehran were also damaged. The WHO has verified more than 20 attacks on health-care facilities and reports at least nine deaths linked to those strikes.
More than 100 US-based experts in international law—including academics from Harvard, Yale and Stanford—have condemned strikes that reportedly hit schools, health facilities and homes. Citing Iranian Red Crescent figures, they said about 236 health centers had been bombed three weeks into the conflict and described the strikes as a potential violation of the UN Charter, raising concerns about breaches of international humanitarian law and possible war crimes.
What happened at Tofigh Daru
Iran’s Deputy Health Minister, Mehdi Pirsalehi, said Tofigh Daru suffered a direct missile strike that destroyed production lines and R&D sections. He described the site as an important domestic manufacturer of active ingredients for hospital drugs and surgical medications.
Israel acknowledged the strike and accused Tofigh Daru of disguising military support as civilian activity, alleging the facility supplied chemicals to Iran’s Organization of Defensive Innovation and Research. The Israeli military said some of the chemicals included fentanyl, which it claimed was used in research linked to chemical weapons. Those specific allegations have not been independently verified. International pharmaceutical registries list Tofigh Daru as a producer of pharmaceutical ingredients, including oncology medicines and anesthetics.
Impact on patients and supply chains
Two Iran-born doctors and activists interviewed by DW warned of immediate and longer-term effects on patients and drug supplies. Vienna-based Dr. Hassan Nayeb-Hashem said the plant made a wide range of essential medicines and had localized about 50 strategic active ingredients. He warned that a large volume of domestically produced medicines has been lost from the supply chain and that replacing them from abroad will be difficult under current conditions.
Cancer medicines are especially vulnerable: they are costly in Iran—often equal to one or two monthly salaries—and insurers frequently refuse to cover imported drugs. Many patients already had limited access to necessary treatments. Both Nayeb-Hashem and his colleague Hamid Hemmatpour said intentionally attacking medical and pharmaceutical facilities would violate the Geneva Conventions and WHO protections unless a facility is credibly proven to be used for military purposes.
Hemmatpour described the situation as an emergency, recounting a cancer patient who could not get basic painkillers or anti-dizziness medication from a charity because supplies had run out.
Health workforce and service collapse
Beyond physical damage, the conflict has driven many experienced physicians out of the country or prevented them from returning, further weakening services. At the start of hostilities, many doctors with dual nationalities left via neighboring borders. Iranian authorities have tried to block departures, but many private practices in Tehran remain closed.
The remaining staff face severe overload: Hemmatpour said in parts of Tehran one doctor is treating 200 to 300 patients a day, with conditions far worse outside the capital. He described a protest-injured patient who was transferred across four cities and eventually 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 could have lasting effects. Reconstruction after conflict often prioritizes military infrastructure over health care, potentially prolonging public-health impacts even after hostilities cease. The combined loss of production capacity, drug shortages and a depleted workforce could severely weaken Iran’s health system for years to come.