BEIRUT (AP) — The family of a Lebanese man with U.S. permanent residency who has been held in Iran for nearly two years says his condition is deteriorating three weeks after starting a hunger strike.

The brother of Nizar Zakka, who went missing on Sept. 18, 2015, during his fifth trip to Iran, says the 50-year-old was rushed to hospital on Sunday, where he refused an IV. Ziad Zakka said Tuesday his imprisoned brother is prepared to die if he is not released.

Nizar, who used to live in Washington, leads the Arab ICT Organization, or IJMA3, an industry consortium from 13 countries that advocates for information technology in the region.

Last September he was sentenced to 10 years in prison and given a $4.2 million fine in connection with spying allegations.