Editor’s Note: Dr. James Miller is a pioneer in health diplomacy with Iran, having used Iran’s rural primary health care model to try to improve the well-being of poor people in Mississippi. The other two authors are Iranian academics who have also worked on primary health care and health diplomacy.
By Barbara Slavin, Distinguished Fellow, Middle East Perspectives
The four-decade-old geopolitical rivalry between Iran and the United States has been marred by mutual distrust, occasional violence, and punitive sanctions. Ongoing negotiations between these two countries to replace the defunct Joint Comprehensive Plan of Action (JCPOA) present an opportunity for détente, but significant hurdles must be overcome. A key first step could be Track II diplomacy—meaning meetings between unofficial actors such as academics and former officials—in the realms of health and science.
Health and science diplomacy can improve the potential for a sustainable, peaceful relationship between the U.S. and Iran, especially in light of a new focus on regional cooperation by the countries of the Gulf Cooperation Council (GCC). Similar collaboration has proven effective in helping dismantle decades of mistrust during the Cold War and could catalyze sustainable breakthroughs in this case as well, combining the scientific strengths of Iran, Saudi Arabia, Qatar, Oman and other GCC states.
The Polio Precedent
Track II diplomacy is a low-risk, high-impact tool for trust-building, non-political engagement, and mutually respectful collaboration. Historical precedents are illuminating. In the 1950s, for example, Dr. Albert Sabin developed an oral polio vaccine at the University of Cincinnati, which was superior to the alternative form. However, so many in the U.S. had already been vaccinated that Dr. Sabin could not run enough clinical trials for licensing. Enter, the Soviet Union (USSR).
Stalin’s death made room for Moscow and Washington to quietly explore avenues of cooperation. One of the first opportunities for engagement proved combatting the significant rise in Soviet polio cases. With the blessing of both governments, Soviet scientists met with American colleagues, including Dr. Sabin. This resulted in Sabin visiting the Soviet Union and running clinical trials for the vaccine at scale, which drastically reduced the case numbers in the USSR, and eventually enabled the global eradication of polio. The collaboration led to one of the greatest medical achievements of the 20th century — an oral polio vaccine which saved countless lives and helped build the lines of communication that led to reducing the threat of nuclear weapons.
Track II efforts like these in the height of the Cold War culminated in a groundbreaking commencement address by President John F. Kennedy on June 10, 1963. Known as the “Peace Speech,” Kennedy’s remarks at American University in Washington were a precursor to a partial nuclear Test Ban Treaty later that year between the U.S. and the Soviet Union. “Let us not be blind to our differences,” Kennedy said, “but let us also direct attention to our common interests and the means by which those differences can be resolved.”
From Past to Present Possibilities
The ongoing nuclear talks of today in many ways mirror pre-1963 U.S.-Soviet nuclear negotiations in terms of the ideological divides, mutual distrust, and popular disapproval of proposed agreements. In Washington, hawks are demanding increased sanctions while President Trump has threatened bombs and additional secondary tariffs if no deal is reached. In Tehran, hardliners are objecting to stringent verification protocols and limits on uranium enrichment, with some even publicly advocating for the development of nuclear weapons. These cleavages underscore the limitations of pure Realpolitik and the need for parallel diplomatic pathways to establish a more sustainable relationship between the two nations.
Just imagine the possibilities — joint labs on renewable energy in Riyadh, the reopening of Qatar’s humanitarian channel for procurement of U.S. medical products for Iran, pharmaceutical joint ventures in Oman, the development of advanced medical applications for A.I. in Dubai, or Iranian oncologists training at MD Anderson Cancer Center in Houston. Building on Kennedy’s principle of “peace through shared action,” we propose the establishment of a Center for Global Health and Science Diplomacy in a GCC state to oversee cooperative initiatives on pandemic preparedness, health system strengthening, climate resilience, and sanctions mitigation.
Experiments in Science Diplomacy
Projects administered through the Center could include Iran-US-GCC task forces on zoonotic diseases (e.g., MERS, avian influenza), training programs for Iranian medical professionals, and the delivery of U.S. manufactured medical devices and pharmaceuticals to Iranian hospitals, collaborative research on Persian Gulf water scarcity and sandstorm mitigation, and facilitating access to chemical reagents, laboratory consumables, and specialized equipment for Iranian researchers to sustain active domestic research projects affiliated with the National Institute for Medical Research Development (NIMRD) and the Iranian National Science Foundation (INSF).
Reviving scientific collaboration between the two countries is another way the Center can bolster relations. In this respect, sanctions relief for US-Iran medical research on radiation therapy could be a promising test-case.
Through such activities, the Center presents significant economic benefits for the U.S. For instance, if Tehran and Washington agree to the purchase of U.S. medical devices and pharmaceuticals, a procurement framework administered by the Center could utilize the billions of dollars in frozen Iranian oil revenues that have accumulated since the U.S. withdrawal from the JCPOA in 2018.
Similarly, under the auspices of the Center, the U.S. and Iran could establish exploratory committees for foreign investment opportunities in the Iranian health sector. Joint ventures in peaceful nuclear applications—such as cobalt-60 production for cancer treatment or isotope hydrology for agriculture—could be particularly potent efforts. This would be further enhanced by a U.S.-Iran commission on nuclear safety protocols, directly addressing nonproliferation concerns while showcasing the power of Track II diplomacy.
The Center also could facilitate Saudi-Iranian cooperation via health and science diplomacy, as advocated by Iran’s former foreign minister Mohammad Javad Zarif, who led negotiations on the JCPOA. One way this could be achieved is by transferring knowledge gained by the Saudi Health Sector Transformation Program. By leveraging technology and bureaucratic processes, this would allow Iran to expand access to medical services, particularly critical care. For Iran’s part, it could leverage its successes in Primary Health Care (PHC) delivery to help GCC countries reconstruct a health system for the Palestinians.
Transforming Stagnation into Momentum
The proposed Center for Global Health and Science Diplomacy could transform the GCC region, making it safer for US interests while welcoming Iran back into the international community. The measures outlined here do not need to wait until nuclear talks are concluded. By prioritizing health and science diplomacy, the U.S. and Iran can replicate the Cold War playbook, where grassroots collaboration softened adversarial narratives. If possibilities are seized to their fullest, the proposed GCC Center offers a blueprint to transform stagnation into momentum.
As President Kennedy noted, “Our problems are man-made—therefore, they can be solved by man.”
James Miller is Managing Director of Oxford International Development Group, an international health system research company specializing in global health diplomacy based in Oxford, Mississippi. He has been engaged with Iran on health diplomacy initiatives since 2009.
Seyed Mohammad Reza Hashemian is president of the Iranian Critical Care Society and professor of critical care at Shahid Beheshti University of Medical Sciences, Tehran, Iran. He also is an ICU doctor at Maseeh Daneshvari Hospital in Tehran.
Amin Talebi Bezmin Abadi is an Associate Professor at Tarbiat Modares University, Tehran, where his research focuses on science diplomacy in the medical field. He is co-author with Zarif on Reviving Iran’s Science Diplomacy: New Horizons Opened by President Pezeshkian