Impact of the Iran War on Global Health Care Systems

The ongoing Iran war has significantly exposed vulnerabilities within the U.S. health care system, particularly through disruptions in the pharmaceutical supply chain and increased cyber threats. The U.S. relies heavily on imports for its pharmaceutical needs, with 47% of generic drugs sourced from India, which is dependent on shipping routes through the Strait of Hormuz. Since the onset of military operations, tanker traffic through this critical passage has decreased by approximately 90%, raising concerns about the availability of essential medications. Additionally, U.S. hospitals are facing a surge in cyberattacks, with 444 incidents reported in 2024 alone, including 238 ransomware attacks. These attacks have been linked to groups from North Korea and Iran, resulting in a decrease in hospital capacity and increased patient mortality rates.

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The conflict has not only strained the supply of pharmaceuticals but has also highlighted the fragility of the health care workforce. The National Council of State Boards of Nursing reported that over 100,000 registered nurses left the profession during the COVID-19 pandemic, exacerbating staffing shortages. The Veterans Administration has also seen a significant reduction in personnel, further complicating the situation. The Hospital Preparedness Program, which provides crucial funding for emergency readiness, faces potential elimination in the 2026 budget, raising alarms about the U.S. health care system's ability to respond to crises.

Bulletin of Atomic Scientists

Experts in the UK warn that the ongoing conflict could lead to medicine shortages within weeks, affecting a wide range of treatments from painkillers to cancer therapies. The war has disrupted the supply of essential raw materials, and the reliance on air transport has become increasingly problematic due to the conflict's impact on Middle Eastern airspace. Mark Samuels, CEO of Medicines UK, noted that while the situation is not yet a crisis, it poses a serious risk if the conflict continues. The potential for increased drug prices and the burden on public health systems, such as the NHS, is a growing concern.

The Guardian

Critics argue that the current approach to health care cybersecurity and emergency preparedness is inadequate. Senator Ron Wyden has described the reliance on self-regulation as "woefully inadequate," emphasizing the need for more robust measures to protect health care infrastructure. The Cybersecurity and Infrastructure Security Agency has also faced workforce reductions, raising questions about its capacity to defend against ongoing threats.

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• “We have the conflict in the Gulf that caused the strait of Hormuz to shut down, and India is known as the pharmacy of the world.” — David Weeks, Director of Supply Chain Risk Management, Moody’s

The Guardian

• “We’re not in a crisis currently but it’s still a serious situation,” — Mark Samuels, CEO of Medicines UK

The Guardian

• “Ron Wyden, the Oregon Democrat, said the current approach to health care cybersecurity was “self-regulation and voluntary best practices,” calling it “woefully inadequate,” in a 2024 letter the Health and Human Services Department.” — Sen. Ron Wyden, U.S. Senator

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The Iran war has underscored critical vulnerabilities in global health care systems, particularly in the U.S. and the UK. As supply chains falter and cyber threats escalate, the need for immediate and comprehensive action to safeguard health care infrastructure becomes increasingly urgent. The potential for widespread medicine shortages and increased mortality rates highlights the interconnectedness of geopolitical conflicts and public health outcomes.

Bulletin of Atomic Scientists