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In simple terms, even when Iran can get its hands on dollars or euros to buy medical supplies, it cannot find a banking avenue to clear the trade. A senior representative at one American pharmaceutical company told me about a $60 million order for an anti-rejection drug for liver-transplant patients that fell through even though the sale was fully legal, all the needed licensing from the U.S. Treasury was in place, and Iran had allocated the needed hard currency. No bank would perform the transaction.