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Health in the Islamic Republic of Iran, challenges and progresses.

2013; National Institutes of Health; Linguagem: Inglês

Kamran Bagheri Lankarani, Seyed M Alavian, Payam Peymani,

Global Health and Epidemiology

The Islamic republic of Iran (Iran) is a great country with a wide area and dispersed population. You may find only few countries in the world that neighbor 17 countries in which two of them involved in a concurring war. The weather, culture, the environmental hazards and the infrastructures and ultimately heath indicators have a great diversity in Iran. The specific geographic situation of Iran and mass immigration from Afghanistan and Iraq, the wars and insecurity after it in the region, and illegal drug traffic from eastern borders with Pakistan and Afghanistan have all affected the health system in Iran (1). There are noticeable health inequalities within the country; for instance, the difference between life expectancy between different provinces reaches 24 years. The same is through for almost all indicators excluding the vaccine coverage and access to primary health care which are above 90% nationwide. While the major burden of disease in the country as a whole and specially in the large metropolitans is non communicable diseases (NCDs) including cardiovascular disease (CVD), cancer and injuries, the country is still faced with the problem of infectious diseases which in many instances are somehow related to its neighbor countries (2, 3). In the both recent epidemics of the Cholera which occurred in Iran in 2005 and 2007 through fingerprinting of the bacteria it was clearly shown that organisms was imported from Pakistan and Iraq respectively (4). Cremean Congo fever previously not known in Iran is now a real health hazard with up to 250 cases each year affected with a fatality rate of 25%. All these reported cases were related to smuggled poultry from neighbor countries. Two out of four countries which could not still eradicate poliomyelitis are neighbors of Iran. Despite of these challenges, it is now 12 years that Iran has obtained the certificate of polio eradication and sustained this success. Malaria although previously endemic in Iran is now confined to three south eastern provinces which its majority of falciparum cases being foreigners who entered the country illegally. These threats could not stop the success of the Ministry of Health and Medical Education (MHOME) in control of all of epidemics and even in helping the neighbor countries through the so called group 5 initiative which was launched on 2005 during Eastern Mediterranean regional meeting of the world health organization(WHO) between Iran, Iraq, Pakistan, Afghanistan and WHO with central role of Iran as the secretary. This could have been done only through strengthening of the primary health care (PHC), active surveillance and frequent monitoring, vaccination at borders and even sending free vaccines to the neighbor countries. Working for the future is based on our current capacities. This is through analyzing the previous achievements and realizing today's needs and predicting fluctuating situations in tomorrow. In this study, we reviewed some of the achievements of Iranian health system in the recent decades.