A bus crash on the Esfahan-Natanz highway killed 13 people after an intercity coach allegedly veered into the opposite lane and slammed into a taxi on Tuesday, with Iran’s road police blaming suspected driver fatigue for the accident.
Emergency services said two passengers in the taxi and nine bus passengers died shortly after the accident. The crash also injured at least 11 others with multiple traumas, all of whom are currently in urgent care.
The Scania intercity bus, operated by the Royal Safar Isfahan company and travelling from Esfahan toward Tehran, overturned around 22:10 local time near kilometer 80 of the Esfahan–Natanz route, then collided with a passenger car, official media cited local police and provincial officials as saying.
The Iranian Red Crescent said the remaining occupants suffered injuries of varying severity and were taken to hospitals in Natanz, Shahinshahr and Isfahan.
Police account
A senior traffic police official told state media that the preliminary hypothesis is that the driver’s drowsiness and loss of control caused the bus to veer into the opposite lane, overturn and strike the car, but added that the final conclusion will depend on full technical and safety assessments.
Authorities said the scene has been cleared and traffic restored, while forensic and road-safety teams continue to inspect the vehicle, road conditions and possible mechanical factors.
Officials have said that if any negligence by the bus company, driver or other parties is confirmed, the case will be pursued through legal channels.
Iran’s Vice President on Tuesday in Tehran recalled a similar deadly accident in October in northern Iran, rejecting the driver fatigue theory.
“Is the driver to blame, when it’s apparently noted that this accident occurred about 20 minutes after he passed the police station? That would mean drowsiness, which is being raised as the issue, was not involved,” Mohammad Reza Aref said in a speech.
“A few months ago in Semnan we had a similar case, when they were going from the dormitory to class and the same thing happened and students were killed,” he added.
At least 26 students have died in 13 accidents involving university buses across Iran over the past decade, the daily Ham-Mihan reported earlier this year, reviving concerns about road safety and vehicle standards.
Iran’s Revolutionary Guards confirmed an armed clash on the Zahedan-Fahraj road, saying “three law enforcement personnel and one ordinary citizen” were killed.
In a statement issued early Tuesday, the Guards’ Qods Ground Forces headquarters said security and intelligence agencies were investigating the incident.
The IRGC headquarters for the southeast is one of ten regional commands and oversees the largest geographic area, covering the provinces of Sistan-Baluchestan and Kerman, and commanding multiple provincial Guards units and key combat brigades in the region.
The rights group Haalvsh, which monitors unrest in the region, earlier reported that the Fahraj incident occurred at a checkpoint in neighboring Kerman province and said four security personnel – two intelligence officers and two police – were killed, with several others wounded. The group published video footage showing injured officers and bodies being transferred from the scene.
At the same time, a second confrontation involving armed assailants and Iranian forces was reported in the city of Iranshahr, also in Sistan-Baluchestan province.
In Iranshahr, Haalvsh said gunmen targeted three military vehicles in the early hours of Tuesday, killing and wounding an unspecified number of security personnel.
The group cited local sources and said roads leading toward Zahedan were blocked by military forces, leaving travelers stranded with no indication of when routes would reopen.
Iranian authorities have not released casualty figures for the Iranshahr attack, nor have they commented on the identity or motives of the attackers. No group has officially claimed responsibility for either incident.
The attacks are the latest in a series of armed confrontations in Iran’s impoverished southeast, which borders Pakistan and Afghanistan and has long been plagued by violence involving Sunni Baluch militant groups and Iranian security forces.
Pattern of attacks and militant regrouping
In recent months, similar clashes have intensified. Last week, the Guards said four of their members were killed and three wounded in an attack by what they described as “terrorist and hostile groups” in the Lar area near Zahedan.
A day later, Haalvsh reported that a newly formed coalition calling itself the “Popular Fighters Front” claimed responsibility, saying it had ambushed a Guards convoy.
The Popular Fighters Front announced its formation earlier this month, presenting itself as a merger of several Baluch political and militant factions, including the PADA Baluch Movement, Harakat Nasr Balochistan, Jaish al-Adl, the Mohammad Rasulallah group led by Haji Vahed Bakhsh, and self-described “spontaneous Baluch fighters.”
In a video message posted online, a masked spokesman identified as Mahmoud Baluch said the coalition aimed to increase the effectiveness of resistance against what he described as oppression by Iran’s ruling system.
While the group’s manifesto emphasized civil, media and political action, it did not renounce armed operations and claimed responsibility for recent attacks.
Jaish al-Adl – designated a terrorist organization by both Iran and the United States – has emerged as the dominant force within the coalition, analysts say.
The group formed around 2012 after the execution of Abdelmalek Rigi, the leader of its predecessor, Jundullah, and has since carried out bombings, ambushes and suicide attacks against Iranian police, border guards and the Revolutionary Guards.
Iranian state-linked media have sought to downplay the significance of the merger, portraying it as a rebranding of weakened factions aimed at attracting foreign backing. Some outlets have alleged links to Israeli intelligence, a claim the groups deny.
Shift in strategy
Security analysts say the emergence of the Popular Fighters Front reflects an attempt by Baluch militants to broaden their appeal beyond a narrowly defined Sunni ethnic insurgency.
Recent statements from the group have adopted more inclusive language, addressing Kurds, Arabs, Turks and other minorities and framing their struggle in terms of shared political and economic marginalization.
The shift follows years of intensified counterinsurgency operations by Iranian forces in Sistan-Baluchestan, including arrests, cross-border pressure near Pakistan, and heightened surveillance. Despite this, militant groups have continued to demonstrate the capacity to stage deadly attacks.
Iran’s southeast remains one of the country’s poorest regions, with longstanding grievances over discrimination, underdevelopment and heavy-handed security policies.
These tensions flared during the nationwide protests of 2022, when security forces carried out lethal crackdowns in Baluch and Kurdish areas.
According to an article by US-based Al-Monitor news website this week, while transforming a Baluch-based insurgency into a national movement would require organizational depth and cross-ethnic networks that militant groups have historically lacked, the new coalition “adds a layer of political complexity” for Tehran.
While authorities say medicines remain available for now, they acknowledge that delays in transferring allocated foreign exchange, growing arrears to suppliers and shrinking inventories have pushed the sector close to a breaking point, raising the risk of shortages in the final months of the year.
Mehdi Pirsalehi, head of Iran’s Food and Drug Administration, said on Tuesday that worsening currency constraints in recent months had left the industry in a sensitive position.
“There are significant foreign-currency debts to overseas suppliers, and resolving them requires serious cooperation from the government, parliament and other decision-making bodies,” he said, according to ISNA.
Pirsalehi apologized to the public for shortages of even “a single item” of medicine and said the agency considered itself accountable.
He added, however, that without adjusting drug and medical equipment prices in an inflationary environment, “it is not possible for manufacturers to sustain stable operations.”
He said that if prices had not been increased last year, “a significant part of the country’s pharmaceutical industry would have exited the production cycle by now.”
Officials argue that in an economy grappling with chronic inflation and currency volatility, holding drug prices steady shifts pressure onto manufacturers and ultimately threatens national drug security.
Price adjustments, they say, are an economic necessity to prevent factory shutdowns and protect domestic production, a move that could nonetheless increase pressure on patients unless insurers reimburse costs on time.
According to ILNA on Tuesday, a month-on-month rise in medicine prices, uneven insurance approvals and gaps in access to original drugs are pushing patients toward out-of-pocket purchases, leaving wealthier households able to buy on the open market while poorer patients increasingly walk away empty-handed.
Debts, FX delays and thinning stocks
Alongside currency shortages, accumulated government and insurance arrears have emerged as one of the most serious challenges facing the market.
Ebrahim Hashemi, chairman of the board of the Association of Pharmaceutical Distribution Companies, said recently that debts to drug distributors had reached 1.57 quadrillion rials (about $1.2 billion at today’s rates) by November 2024, warning that failure to settle them could severely disrupt the production and import of essential medicines.
According to figures cited by industry representatives, distributors’ claims on medical universities alone exceed 31 trillion rials ($240 million), while total government liabilities – including those linked to social security and insurance funds – amount to about 47 trillion rials ($360 million).
“Which economic sector can survive more than a year without receiving its payments?” Hashemi asked, warning that the final three months of the year (ending on March 20) would be among the toughest for the drug sector.
Pharmacies, the frontline of access for patients, are also under acute liquidity pressure. Shahram Kalantari, head of Iran’s Pharmacists Association, has said insurers owe private pharmacies, and warned that each wave of currency volatility inflicts tens of trillions of rials in fresh losses, sharply reducing pharmacies’ ability to restock.
Kalantari said shelves and warehouses had grown “thinner” in recent months, with strategic reserves steadily eroding – a development he described as an early alarm for broader shortages.
Abdollah Abdollahi Asl, director general for medicines and controlled substances at the Food and Drug Administration, said inventories had fallen below critical thresholds: less than one month at factories, under two months at distribution companies and under three months at pharmacies, compared with a recommended minimum of three to four months.
He said around 800 of the roughly 3,000 medicines on Iran’s official list are in a shortage warning status, awaiting foreign exchange and liquidity. He added that 21 essential hospital medicines and 56 essential non-hospital drugs are already in short supply.
The warnings echo recent statements by industry figures who say Iran could face a sharp deterioration in drug supplies within months if current conditions persist.
Alireza Chizari, head of Tehran province’s association of medical and pharmaceutical equipment producers, said earlier this month that the crisis had not yet fully hit society because regulators were managing depleted warehouses, but warned the situation could become “disastrous within one or two months.”
Iran’s pharmaceutical sector has been squeezed by foreign exchange shortages, sanctions-related payment hurdles and rising costs. Drug prices, medical equipment and healthcare expenses have jumped by about 70% since the government removed a subsidized exchange rate for medicine imports earlier this year, while insurance coverage has lagged behind.
Medical specialists have cautioned that sudden switches from imported medicines to domestic alternatives can pose risks for some high-risk patients, even though local drugs are effective in most cases.