While most Americans and the US foreign policy elite were focused on last week’s final presidential debate, a small office within the US Treasury Department, without fanfare, rewrote regulations governing key aspects of the Iranian sanctions.

New rules issued Oct. 22 by the Office of Foreign Assets Control (OFAC) — named the Iranian Transactions and Sanctions Regulations — implement sanctions contained in last year’s National Defense Authorization Act and Executive Order 13599, which required American institutions to freeze the assets of the Government of Iran, the Central Bank of Iran and all other Iranian financial institutions. However, in an unexpected move, the regulations now permit US companies to sell certain medicines and basic medical supplies to Iran without first seeking a license from OFAC.

It is clear that the Treasury Department did not want much publicity surrounding the release of the new regulations. Such a major change to US sanctions would normally warrant at least a press release; even mid-level narcotics traffickers usually merit a cursory statement by OFAC Director Adam Szubin when they are designated by the office and their assets in the US are frozen.

What is most curious about the radio silence that has greeted this abrupt change is that the humanitarian costs of sanctions, particularly reported medicine shortages in Iranian hospitals, have long been an area of concern for international organizations and media.