Health care in Iran

Health care in Iran and medical sector's market value was almost US $240 billion in 2002 and is forecast to rise to US $310 billion by 2007. [ [http://www.austrade.gov.au/Health-services-and-pharmaceuticals-to-Iran/default.aspx Health services and pharmaceuticals to Iran - For Australian exporters - Austrade ] ] With a population of almost 70 million, Iran is one of the most populous countries in the Middle East. The country faces the common problem of other young demographic nations in the region, which is keeping pace with growth of an already huge demand for various public services. Fifty per cent of Iran’s population are currently under 20 years old. Soon they will be old enough to start new families, which will boost the population growth rate and subsequently the need for public health infrastructures and services.

The World Health Organization in the last report on health systems ranks Iran's performance on health level 58th, and its overall health system performance 93rd among the world's nations. [cite web| url=http://www.who.int/whr/2000/en/annex10_en.pdf| title=The World Health Report 2000| first=World Health Organisation| last=WHO| accessdate=2006-10-12] The health status of Iranians has improved over the last two decades. Iran has been able to extend public health preventive services through the establishment of an extensive Primary Health Care Network. As a result child and maternal mortality rates have fallen significantly, and life expectancy at birth has risen remarkably. Infant (IMR) and under-five (U5MR) mortality have decreased to 28.6 and 35.6 per 1,000 live births respectively in 2000, compared to an IMR of 122 per 1,000 and a U5MR of 191 per 1,000 in 1970. [ [http://www.unicef.org/infobycountry/iran.html UNICEF - At a glance: Iran (Islamic Republic of) - The big picture ] ] Immunization of children is accessible to most of the urban and rural population.

Health services

The constitution entitles Iranians to basic health care, and most receive subsidized prescription drugs and vaccination programs. An extensive network of public clinics offers basic care at low cost, and general and specialty hospitals operated by the Ministry of Health and Medical Education (MOHME) provide higher levels of care. In most large cities, well-to-do persons use private clinics and hospitals that charge high fees. About 73% of all Iranian workers have social security coverage. Iran has been very successful in training/educating the necessary human resources for its health system. The system of almost 30 years ago where the country was facing a shortage of all kinds of skilled personnel in the health and medical sector has been completely changed into one in which the necessary professionals now completely suffice the country’s needs. There were 0.5-1.1 physicians per 1000 population in 2004 according to various estimates (about 46 percent of physicians were women). [http://www3.who.int/whosis/core/core_select_process.cfm?country=irn&indicators=healthpersonnel&intYear_select=all&language=en]

Although overall improvements have been achieved in all health areas since the 1979 revolution, the present challenging economic conditions of the country, combined with rapid advances in medical technology and information technology, individuals’ expectations, and the young demographic of the population will undoubtedly challenge the sustainability of past improving trends. Moreover there is a considerable variation in the human development index and the human poverty index across different provinces in the country.

Health network

Today the largest healthcare delivery network is owned and run by the Ministry of Health and Medical Education (MOHME) through its network of health establishments and medical schools in the country. MOHME is in charge of provision of healthcare services through its network, medical insurance, medical education, supervision and regulation of the healthcare system in the country, policymaking, production and distribution of pharmaceuticals, and research and development. Additionally, there are other parallel organisations such as Medical Services Insurance Organizations (MSIO) that have been established to act as a relief foundation as well as an insurance firm. Some hospitals, such as Mahak for childrens cancer, are run by charitable foundations.

According to the last census that Statistical Centre of Iran undertook in 2003, Iran possesses 730 medical establishments (eg. hospitals, clinics) with a total of 110,797 beds, of which 488 (77,300 beds) are directly affiliated and run by the MOHME and 120 (11,301 beds) owned by the private sector and the rest belong to other organisations, such as the Social Security Organization of Iran (SSO). There were about seven nurses and 17 hospital beds per 10,000 population.

An elaborate system of health network has been established which has ensured provision of Primary Health Care (PHC) to the vast majority of public. However, access and availability of health care continues to be somewhat limited in lesser developed provinces where the health indices are also lower as compared to national averages. The country is in an epidemiologic transition and faces double burden of the diseases. New emerging threats should also be considered. The demographic and epidemiological transition underway will have a significant effect on the pattern of morbidity and mortality in the near and distance future, especially as it affects the emergence of chronic non-communicable diseases and the health problems of an aging population. In the early 2000s the main natural causes of death have been cardiovascular disease and cancer.

Water and sanitation

Iran has one of the highest percentages of population in the Middle East with access to safe drinking water, with an esimated 92% of its people enjoying such access (nearly 100% in urban areas and about 80% in rural areas as of 2007) [http://www.unicef.org/specialsession/about/sgreport-pdf/03_SafeDrinkingWater_D7341Insert_English.pdf] [ [http://www.wssinfo.org/pdf/country/IRN_wat.pdf Iran_islamic_rep_of_04.xls ] ] .

There is a considerable shortfall in wastewater treatment; for example, in Tehran the majority of the population has no wastewater treatment, with raw sewage being injected directly into the groundwater [ [http://darwin.nap.edu/books/0309092930/html/217.html] ] . As the water crisis deepens with an expanding population, this pollution of groundwater causes increasing health risks.

Nutrition

Despite the fact that Iran consists of an agrarian economy, there is a high degree of malnutrition within the country. Approximately one fourth of all young children have stunted or wasted growth characteristics due to undernourishment [ [http://www.fao.org/ag/agn/nutrition/ira-e.stm Nutrition country profiles: Iran summary ] ] ; moreover, as an indicator of the poor food distribution capability, the percentage of undernourished children in villages is much higher. As an additional measure of public health and inefficient food distribution, about thirteen percent of the young people are classified as obese, according to the same United Nations FAO sources.

Communicable diseases & drugs

Cholera has been a persistent problem in Iran. In the 2005 epidemic which involved loss of lives, state television warned people not to eat vegetables or buy ice blocks on the streets [ [http://www.iranian.ws/cgi-bin/iran_news/exec/view.cgi/3/8985 Iran cholera outbreak takes more life, mullahs' regime clueless - Persian Journal Iran news, Latest iran news Iranian newspaper women zan ] ] . Salads were also banned in some restaurants. The 1998 epidemic involved considerably more cases and loss of life. According to the United Nations, AIDS has been increasing in Iran at a rapid rate [ [http://www.unaids.org/en/Regions_Countries/Countries/Iran_Islamic_Republic_of.asp Countries ] ] . The major factor fuelling the epidemic until now has been injecting drug use, while there is an increase in sexual transmission of the disease." The rate of the epidemic in Iran is however still very low compared to international standards.

Opium, which is being smuggled through the border with Afghanistan and other drug addictions constitute a major and growing health problem; in 2005, estimates of the number of drug addicts ranged from 2 to 4 million (1.2 million according to the Government) [http://www.unodc.org/pdf/afg/afg_drug-situation_2002-10-01_1.pdf] . Reasons for addiction include lack of economic prospects among the youth and lack of freedom. Increased drug use has driven up the incidence of human immunodeficiency virus (HIV). In 2005 two-thirds of the official total of 9,800 HIV cases were attributed to drug use. Iran has established a national HIV treatment system, including 150 testing sites and a free needle exchange program [ [http://lcweb2.loc.gov/frd/cs/profiles/Iran.pdf Country profile - US library of Congress] ] .

Pharmaceuticals

Iran has a rather developed pharmaceutical production capability, however, the country still relies on imports for raw materials and many specialised drugs.

Iran’s Ministry of Health and Medical Education (MOHME) has a mission to provide access to sufficient quantities of safe, effective and high quality medicines that are affordable for the entire population. Since the 1979 revolution, Iran has adopted a full generic-based National Drug Policy (NDP), with local production of essential drugs and vaccines as one of the main goals. [ [http://www.iran-daily.com/1385/2773/html/economy.htm Iran-Daily: Biggest Pharmaceutical Plant to Open Soon] ] .

Currently 55 pharmaceutical companies in Iran produce more than 96 per cent (quantitatively) of medicines on the market, worth $1.2 billion annually [ [http://iran-daily.com/1386/2880/html/national.htm Iran Daily - National - 07/01/07 ] ] . Although over 85 per cent of the population use an insurance system to reimburse their drug expenses, the government heavily subsidises pharmaceutical production/importation in order to increase affordability of medicines. The regulatory environment of the country is rather strict on the import of drugs and pharmaceuticals towards companies that intend to enter into the market for the first time.

Major Iranian Pharmaceutical Companies:

*Darupakhsh
*Pars Darou
*Iran Pharmaceutical Development & Investment Co. (IPDIC)
*Pharmieco
*CinnaGen

Medical equipment

The Department of Medical Equipments in the Ministry of Health and Medical Education (MOHME) is responsible for supervising imports in this segment, but the import and distribution of such equipment is mostly handled by the private sector. Iran has undergone the primary stages of development in terms of industrialisation and a rather strong indigenous manufacturing capability exists in the country. Therefore one can expect to find a handful of local producers for basic medical equipment, making it very hard to penetrate into the Iranian market for similar imported ones.

There are over 100 Iranian companies representing the international suppliers in this market, handling both promotion and the after-sales service of the products. Iran is a mature market when it comes to medical equipment. Most of the major international players in this sector are present in the Iran market (American sanctions against Iran do not apply to medical equipment or pharmaceuticals):

*3M
*Aesculap
*Boston Medical Group
*Cordis
*Guidant
*Hiticha
*Johnson & Johnson
*Medtronic
*Ohmeda
*Philips
*Siemens
*Smith & Nephew
*Stryker
*Toshiba Medical Systems
*Varian Medical Systems
*Zimmer

References

ee also

*Medicine in Iran
*List of hospitals in Iran
*Family planning in Iran
*Economy of Iran
*List of Iranian companies
*Environmental issues in Iran
*Sports in Iran

External links

* [http://www.mohme.gov.ir Ministry of Health and Medical Education - Iran]
* [http://www.who.int/countries/irn/en/ World Health Organization - Iran]
* [http://www.austrade.gov.au/Health-services-and-pharmaceuticals-to-Iran/default.aspx Health services and pharmaceuticals to Iran - Australian Trade]
* [http://www.sci.org.ir/portal/faces/public/sci_en/ Statistical center of Iran]
* [http://iran-pharma.blogspot.com/]