US-Iranian Relations and Imprisoned Doctors

The current H1N1 swine flu epidemic demonstrates the critical need to promote international cooperation in combating infectious diseases. Without open communication among scientists and public health specialists, lethal pandemic disease can unexpectedly erupt. In Iran, however, participating in such scientific exchange can land a doctor in jail.The Iranian Revolutionary Court recently sentenced Arash and Kamiar Alaei, brothers who are world-renowned HIV/AIDS physicians, to six and three years imprisonment, respectively, for fomenting a “velvet revolution” while garnering Western support at international conferences. Both physicians participated in global health symposia, but neither ever spoke of politics or security or revolution. Instead, they acted as public health ambassadors and celebrated their love of Iranian culture.The Alaei doctors won praise from the World Health Organization (WHO) for helping pioneer HIV treatment and prevention in Iran, particularly among injecting drug users. According to the United Nations, 2.8% of Iranian adults are heroin addicts—the world’s highest rate. Sharing needles fuels the spread of HIV. The Alaei brothers championed harm reduction and worked with Iran’s drug addicts, prisoners and sex workers to prevent transmission. To combat the spread of HIV, they distributed sterile needles and prescribed methadone to treat opioid dependence. They also dispersed condoms and counseled their patients in safe-sex practices.In addition to their work in Iran, the Alaei brothers trained Afghan and Tajik medical workers and encouraged regional cooperation among 12 Middle Eastern and Central Asian countries. Their efforts improved the practice of doctors in the region, advanced HIV medical science, and helped earn Iran recognition as a model of best practice by the WHO. Forward-thinking clerics within the Government of Iran even extolled their work on harm reduction and HIV prevention.What then is behind the imprisonment of two Iranian doctors whose public health expertise the global community desperately needs? Tenuous US-Iranian relations.During a one-day secret trial in January 2009, the Iranian government charged the Alaei brothers under article 508 of the Islamic Penal Code for having “communications with an enemy government”—that is, the United States. The judicial court condemned the Alaei doctors of having ties to the CIA and being funded by the State Department—accusations that both the US government and the Alaei brothers deny. Similarly, despite US pleas to the Iranian government, the same judicial court last month convicted American journalist, Roxana Saberi, for espionage (but unexpectedly released her on Monday). Further, the Iranian government contends that the US has illegally detained two of its diplomats since December 2006, when US forces raided an Iranian consulate in Iraq.As the Obama Administration attempts to engage the Islamic Republic of Iran, President Mahmoud Ahmadinajad seems intent on undermining any diplomatic overtures. In the meantime, Kamiar and Arash have languished in Tehran’s Evin prison since June 2008 awaiting their final appeal, due this week.Mr. Ahmadinejad would do well to heed his own advice as when he asked the newly elected President Obama “to eradicate oppression and to do justice” at home. The Iranian government must release Drs. Kamiar and Arash Alaei so they may continue their vital work in promoting an international cooperative response to HIV/AIDS prevention and saving the lives of many Iranians living with this disease.

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