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Public Health and Policy in Contemporary Iran

This panel was compiled by the Conference Program Team from independently submitted paper proposals

Presentations

Pills and Pens: The Impact of Rural Family Planning on Literacy of Rural Women in Iran
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This paper examines the impact of Iran's rural family planning program on the literacy of adult rural women and on the gender gap in literacy. The rural family planning program was the largest and by all accounts the most successful social program launched in Iran after the revolution. It has been credited with the rapid decline of fertility that has transformed the lives of rural women. As the program comes under criticism from conservatives in Iran for having slowed the rate of population growth too much, it is time evaluate its impact on other aspects of women's lives, in particular on education. This paper focuses on a specific aspect of the program -- the rural health clinics -- that lends itself to impact evaluation. These clinics were the most important part of the family planning program in rural areas; they numbered about 18,000 and their services reached more than 90% of all rural women. Using data on the timing of the construction of about 14000 clinics, I create two subsamples of village, a treatment group that received a clinic during 1986-96 and a control group that did not have a clinic by the end of this period. I then compare the rate of increase in female and male literacy and the gender gap in literacy between these groups. I control for observable differences between villages in the two groups that may have in influenced their selection into the treatment group. The evidence shows that villages that received a health clinic during 1986-1996 experienced a 4-8% faster increase in adult female literacy compared to villages that received it after 1996. No similar impact is detected for male literacy. Thus the clinics contributed to the narrowing of the gender gap in literacy, accounting for about 50% of its decrease over the period of study. The results suggest that the elimination of family planning support that started in 2014 may have undesirable effects beyond affecting fertility.

Ethical Discussions on Premarital / Prenatal Diagnosis: Case Studies of the Thalassemia Prevention Programme in Iran
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Abstract
The purpose of this paper is to investigate the social policy of preventive genetic medicine in Iran, by following the legalisation process of abortion law and the factors affecting the process in wider Iranian contexts. In this paper, ethical discussions of premarital / prenatal diagnosis and selective abortion in Iran will be presented, and Iranian social policy of intervention, to control genetic diseases, especially a genetic hemoglobin disorder called Thalassemia will be explored. Ethical dilemmas in the application of genetic medicine to social policy will be focused upon.
In order to examine the role of the policy for prevention of genetic diseases and selective abortion in Iran, various resources have been studied, not only academic articles, but also discussion in the Parliament and documents related to a court case, as well as ethnographic data on the living conditions of Thalassemia patients.
Firstly, discussions of prenatal diagnosis and selective abortion is overviewed from the viewpoints of ethics, disability rights activists, and public policy for lower-resources countries. As a result, it should be noted that the most important point in the discussion on prenatal diagnosis and selective abortion in Iran is the allocation of medical resources.
Secondly, the process of implementation of national the National Thalassemia Screening Programme and legalisation of ‘Therapeutic Abortion Law’ is analysed, through scrutinizing documents such as the Majlis record, government documents and related laws and regulations. Although some western academics suggest that Iranian policy of selective abortion seems to be akin to eugenic public policy, the Iranian government is careful to avoid any portrayal of the policy as ‘eugenic’.
Thirdly, in order to provide an ethnographic discussion of this issue, practices of vasectomy seen among the Thalassemia patients will be introduced. In addition the restricted environments of Thalassemia patients and the carriers are described. This is aimed at understanding certain disabling social factors for people with genetic diseases in the local contexts of Iran.

In the Name of Drugs: Security, Morality and Contested (Dis)engagements in Iran’s Drug Diplomacy with the EU
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The EU and the UN have often praised Iran’s fight against drug trafficking, because Iran is the country in the world seizing the highest amount of opium. This paper will discuss the trajectories of drug diplomacy between Iran and the EU after 1997, and the political and moral agendas, which the drug cooperation has legitimized and fueled. Using Ghassan Hage’s notion of crisis as a governing principle it will discuss how drug control turned from being an arena for cooperation to a contested field of disengagement.

With the 1997 reform movement drug control became a political tool to break Iran’s political isolation, and calling for international cooperation against drugs was one of the ways in which President Khatami enabled his ‘dialogue among civilizations’. The intensified drug diplomacy also opened up human rights related interventions on treatment of drug users and debates about state responses towards the socially marginalized.

However, the presidency of Ahmadinejad changed the status of drug diplomacy. As the nuclear negotiations collapsed in 2005 and the EU-Iran human rights dialogue came to an abrupt hold, cooperating on drug control became one of the few remaining, relatively neutral arenas for the EU to sustain a dialogue with Iran. The urgency to do so was further stressed by the deteriorating security situation in Afghanistan, which also escalated its opium production dramatically.

However, after 2009 drug control also became a much more contested policy field. This was partly due to the sanctions imposed on Iran’s dual-use technology, explicitly challenging cooperation on border control. Partly it was due to a mounting critique in the Western media of Iran’s escalating use of capital punishment (coinciding with the clampdown on the Green Movement and the securitization of domestic politics). At present no EU countries support Iran’s fight against drug trafficking. The paper will explore what the drug diplomacy between Iran and EU has implied and how the issue of drugs, once termed a relatively neutral avenue for cooperation, has become a heated and morally charged arena for mutual human rights accusations.

[[The paper is to be submitted to the panel organized by Rouzbeh Parsi called "The foreign relations of the Islamic Republic: self-perception and reception". But it didn't appear on the list of panels.]]