Physicians Serious Opportunity for the West
The victory of a relatively unknown candidate in the Iranian presidential election was surprising to many. Masoud Pezeshkian, a member of parliament and former health minister, who was almost unknown outside the country and not a prominent figure even within the country, won against the hardline candidate Saeed Jalili in the second round of the election on July 5.
The unexpected victory of a reformist figure in the limited political spectrum of the Islamic Republic raises many questions, especially for the first time since 2001. It raises questions about the extent of his authority, his approach to the country’s nuclear deal with the West, and his ability to navigate an unstable regional atmosphere.
Given his explicit criticisms of the current path of the country, the election of Pezeshkian has shocked many observers. Some in the West may expect a reformist figure like his predecessors. They might see him as a wolf in sheep’s clothing, more moderate than a regime whose nuclear ambitions and regional logic have not changed.
Others may see him as a savior whose mission is to pull Iran out of social and economic crises and be ready to give concessions in exchange for reducing Western sanctions.
Several elements can help predict the future path. The first one relates to the nature of Iran’s politics.
The president is far from absolute power and must confront various overt and covert centers of power and influence. The fundamental principles have not changed; Ayatollah Khamenei still has the final say. Also, the control of conservatives over all other governmental institutions will limit the moderates.
However, presidents in Iran are not just symbolic figures. The differences in style and content between Hassan Rouhani, who negotiated and signed the nuclear deal with global powers and recognized the need to reduce some social restrictions, and Ebrahim Raisi, who failed to restore the nuclear deal and doubled down on enforcing Islamic dress code for women, leading to widespread unrest in 2022, show this reality.
The new vice president-elect has both a unique advantage and a weakness. He refrained from specific commitments during his campaign and instead focused on his governing approach, acknowledging the limitations he may face as a vice president.
By not appearing as a figure that disrupts the political structure excessively and by managing societal expectations, he has created space for maneuvering.
However, the election has given him weak support, considering one of the lowest levels of participation in the history of the Islamic Republic at 49.8% according to official reports, with him receiving only a quarter of the eligible voters’ support.
What physicians can achieve in foreign policy is determined more by factors beyond his control than by his own ability and willingness to engage with Iran’s enemies, especially the United States.
The most important factor will be the outcome of the U.S. presidential election.
Most of the diplomatic progress between Iran and the United States since the 1979 revolution, from initial efforts to de-escalate tensions in the late 1990s to the nuclear agreements in 2015, occurred during the second term of a Democratic presidency.
Unlike the late President Rouhani, whose government largely ignored relations with the West, the physicians and his team have promised to rebalance a renewed opening towards the West with growing relations with non-Western powers, especially Russia and China.
However, experienced diplomats who are likely to return to power in the physicians’ government have expressed disappointment at what they saw as the slowness of the Biden administration’s overlap with the Rouhani government in 2021, which took away opportunities to restore nuclear agreements.
The second Trump administration poses an even greater challenge, with Trump’s advisors criticizing Biden for weakening Washington’s hand by weakly enforcing sanctions and likely reverting to his old belief in negotiation from a position of strength, possibly returning to his maximum pressure policy instead of bringing Iran back to the negotiating table under more favorable conditions for the United States, pushing for a more aggressive nuclear program and displaying more power in the region, bringing Iran and the United States alarmingly close to a serious confrontation several times between 2019 and 2020.
There is also intense animosity between Iranian leaders and Trump, who ordered the assassination of General Qasem Soleimani, the commander of the Quds Force of the Islamic Revolutionary Guard Corps, in 2020.
Meanwhile, the United States suspects that Iran is plotting to assassinate senior American officials in retaliation for Soleimani’s killing.
The escalation of war in Gaza to other parts of the Middle East could also limit the ability of medical professionals to engage constructively with the West.
If hostilities escalate into a full-fledged conflict between Israel and Hezbollah in Lebanon, it could turn the jewel in the crown of Iran’s non-state partners in the region, making Iran’s image in the West even more toxic at a time when internal clashes, arms transfers to Russia, ongoing nuclear activities, and the imprisonment of dual nationals and foreign citizens have brought relations to their lowest level.
This scenario could unfold if Iran-backed Houthi rebels in Yemen resume border attacks against Saudi Arabia or the United Arab Emirates, reversing the trend of tension reduction that Iran and its Arab Gulf neighbors have pursued in recent years.
However, the presence of more moderate voices calling for moderation in Iran’s decision-making process, especially compared to the possibility of Jalili’s presidency, is a positive point.
Strategic decisions in Iran are made by a small group of senior officials who are relatively shielded from changes in formal structures, including the outcome of elections, yet they reflect those changes.
Political uncertainty in Washington and turmoil in the region leave little room for the US and Iran to reach a new agreement in the short term, but they should at least try to revive some informal understandings they reached in 2023. These understandings aimed at limiting Iran’s nuclear advancements, preventing attacks on US forces in Iraq and Syria, and restricting Iran’s assistance to Russia in the war against Ukraine in exchange for access to some of Iran’s blocked assets abroad.
This will help Biden keep tensions with Iran at a lower level and provide a short-term economic relief.
This will be a temporary solution. Today, the idea of achieving a nuclear deal is more difficult than the 2015 threshold.
Positions on both sides have become tougher, the little trust that existed at that time has dangerously weakened, with the least cause being Trump’s withdrawal from the previous agreement. Iran’s nuclear program has significantly advanced, and sanctions have increased.
Western doubts about the ability of physicians to present an agreement, along with Tehran’s doubts about whether America, in particular, can accept coexistence with the Islamic Republic or provide effective and sustainable sanction relief, align.
Also, the deadline is quickly approaching as the UN Security Council resolution that endorsed the 2015 agreement expires in October 2025, depriving the West of a major pressure point. The ability to keep Iran under pressure by threatening to reimpose international sanctions that were lifted in 2015.
Given Iran’s significant concerns that another Trump-like government may abandon any agreement currently being negotiated and the toxic image of Iran in US domestic politics, the Biden administration is not in a position before November to engage with the physicians’ government in a forward-looking process to find a more stable diplomatic solution for the nuclear crisis and other points of contention.
Once again, the task of leading nuclear negotiations with Tehran will fall on Europeans, who have been leading the talks since 2003.
The first opportunity for serious negotiations will be on the sidelines of the United Nations General Assembly in New York in September.
Providing infrastructure can help a future Democratic government in the US make rapid progress after the November elections.
In the event of a second Trump presidency, such infrastructure may at least offer him an option to find a mutually beneficial arrangement with Tehran or face another dangerous confrontation that will only further entangle Washington in the Middle East.
The outlook presented by the election of physicians may or may not materialize.
In the face of the many internal and external challenges he will confront as he begins his work, it is better for the United States and Europe to have constructive interaction with the president-elect, offer him limited economic facilities, and at least explore the option of whether his administration can pivot Iran’s policy domestically and internationally.
