Medical Science and Health Care in Contemporary Iran
With some 77 million people, Iran is today one of the most populous countries in the Middle East. The country faces a variety of problems, one of which, most often affecting the demographically young nations of the region, is the ever-increasing demand for public services
With some 77 million people, Iran is today one of the most populous countries in the Middle East. The country faces a variety of problems, one of which, most often affecting the demographically young nations of the region, is the ever-increasing demand for public services. The youngest segment of the population will soon be old enough to start a family, which will lead to an increase in the rate of growth and therefore an increased need for public care infrastructure and new services. According to statistics from the WHO (World Health Organization) in 2000, Iran ranks 58th in the list of countries offering the best medical services in the world.
Over the last two decades, Iran's status in the field of medical care has evolved considerably. The country has succeeded in developing its preventive health and care services through the establishment of a particularly elaborate primary health care network. As a result, the death rate among children and women has decreased significantly and life expectancy, as well as the birth rate, has increased dramatically. In addition, we can talk about a notable phenomenon that has shaken up the medical condition in Iran in recent years: the immunization of children that the authorities have managed to generalize in both urban and rural areas.
In addition, thanks to medical advances, life expectancy has increased from 70 years in 2005 to 71.5 in 2010. The insurance coverage of the Social Security Organization of Iran ensures that all Iranians can benefit from basic medical care, have access to medication and benefit from alternative immunization campaigns. An extensive network of clinics and clinics provides affordable medical care, and general and specialized hospitals operating under the auspices of the Ministry of Health and Medical Studies provide more sophisticated medical care. It is also important to underline that in metropolitan cities that have witnessed a notable demographic increase, and as a result of a remarkable development in urban planning and infrastructure, a good number of citizens can afford the luxury of resorting to clinics and private hospitals usually reserved for a minority of wealthy people. In addition, about 73% of Iranian workers today benefit from medical care and social security. According to WHO statistics, in 2000, 94% of the population already had access to health care services. This figure tended to vary from 86% in rural areas to 100% in urban areas. In addition, access to essential and affordable drugs varied between 80% and 94% in 1999 compared to the area concerned. Since 2009, the government has taken the necessary steps to implement a new insurance plan, after which all Iranians have been granted the right to health coverage throughout the country.
With regard to the labor force, Iran has performed very well in the areas of learning and education of the medical workforce. Thirty years ago, the country was facing a shortage of staff and specialized care in the medical sectors. Today, the many medical sectors in Iran are able to meet the basic health needs of the population. In 2004, there were 488 active government hospitals in Iran, ie a doctor (per 1,000 people) working in a government center with 46% of female medical staff. In 2011, Iran had 51 medical schools, one million medical students, 20,000 medical professors, 20,000 village clinics, 100,000 doctors and 170,000 active nurses.
Today, the largest health care network in Iran belongs to the Ministry of Health and Medical Studies, which ensures the smooth running of its facilities and schools throughout the country through a particularly well-developed network. . The Ministry of Health and Medical Studies is responsible for the provision of health care, medical insurance, medical studies, supervision and regulation of the health system, production and pharmaceutical distribution, research and development throughout the country. There are also parallel health structures on the territory, including the Insurance Organization of Medical Services, established as a foundation which second the insurance companies. Some hospitals complete this network, including the famous Mahak, specializing in the field of childhood cancer, and working with the support of charitable foundations of the country. According to the latest census carried out by the Statistical Center of Iran in 2003, the country had 730 health facilities and 110,797 beds, that is, 17 hospitals per 10,000 individuals in the country.
Despite the quality of the health network that ensures, as we have said, the provision of first aid throughout the country, the presence of these same care continues to be lacking in the less developed provinces where the health indices s also lower by national standards. Moreover, the country is currently in an epidemiological transition phase, not to mention the emergence of emerging threats. The demographic and epidemiological transition will undoubtedly have a significant effect on the mortality rate in the years to come, but especially in the distant future. It can also influence the emergence of chronic diseases and health problems that aging populations typically face.
Although considerable medical advances have been made in the various medical fields since the 1979 Revolution, the current economic conditions of the country, the rapid development of medical and computer technology, and the individual expectations and ultimately the youth of the Iranian people, jointly challenge and represent a challenge for the permanence of medical progress in Iran. In this regard, the country is implementing reforms that promote preventive medicine, value the role of the family doctor and better take into account the electronic medical history of the patient. There is also a considerable change in the human development index and a reduction in the poverty index in the various provinces of the country. Currently, Iran ranks 19th in the world in medical research and plans to reach 10th place in the next 10 years starting in 2012.
Iran is also one of the twelve countries that practice biological medicine technology and have, effectively or potentially, the necessary infrastructure for the development of medical tourism. It is also important to note that Iran welcomes about 30,000 foreign visitors each year who come to the city to receive medical treatment.
The good condition of the sanitary facilities in Iran is also worth noting. The country has one of the highest percentages in the Middle East of population with access to drinking water, namely 80% in rural areas and 100% in urban areas. Nevertheless, we note the qualitative inadequacy of wastewater treatment in Iran, especially in large cities, including Tehran, which do not benefit from a sewage system, and whose wastewater penetrates the soil directly and then reaches the water table. In addition, the water crisis due to the population's expansion is causing the aquatic pollution of wastewater to accelerate the growth of health risks. Serious attention has also been paid to feeding Iranians since the establishment of the Institute of Nutrition and Food of Iran by Dr. Habibollah Hedayat in 1961. Despite the fact that Iran has a centrally-located economy on agriculture, there is a significant degree of malnutrition, particularly due to the rapid development of the fast-food culture. Nearly a quarter of Iran's youth are showing signs of nutritional deficiency due to malnutrition. In addition, the food distribution indicator shows that the number of undernourished children in Iranian villages is much higher than in the cities. In parallel, according to the UN Food and Agriculture Organization (UNAA or FAO), given the inefficiency in some places of the distribution of food products necessary for a healthy diet, about 13 % of Iranian youth suffers from obesity. According to the Iranian government, 60% of Iranians are overweight and 35% of women and 15% of men are considered obese. Today, Iran produces about three billion liters of different types of soft drinks in the country to meet the consumption of 46 liters per capita annually. On the other hand, raising people's awareness of the damage caused by the consumption of soft drinks and sugar, as well as the high rate of diabetes, are factors that are starting to create healthy health reflexes in the population.
Aside from the problem of obesity, Iran faces other more immediate threats to human health. Cholera was one of the most rooted diseases in the Iranian population. In 2005, a dangerous epidemic caused the death of twenty people. The event took on such proportions that the government solemnly proposed to the population to no longer consume raw vegetables and to avoid buying ice cubes on the street. This sad health episode recalled another even more bitter that occurred in 1998 and resulted in an even larger number of deaths. The use of drugs has also led to an increase in the number of human immunodeficiency virus carriers and AIDS patients. By the way, in 2005, three-quarters of the official AIDS cases reported were attributed to drug use. Iran has recently established a national AIDS treatment system, including 150 testing sites and free specialty programs. According to the United Nations, the AIDS epidemic is experiencing relatively rapid growth in Iran. In 2009, among people affected by this disease, 93% were men and only 7% were women. Nevertheless, the percentage of people infected in Iran remains relatively low compared to international standards: 0.16% of the adult population of the country is affected by the syndrome, which, according to the UN, nevertheless represents (end of 2009) 100,000 victims.
Until the beginning of 2000, the most common natural causes of death in Iran were cardiovascular diseases and cancer. According to the Ministry of Health and Medical Education, in 2003, 41% of deaths were due to problems with the blood circulation system. Then came myocardial infarction, with 25% of deaths. Addiction to various drugs was considered the fourth leading cause of death in Iran, followed by road accidents, heart disease in general, and nervous breakdowns (the latter sometimes being linked). Between 2001 and 2010, more than 438,000 people were killed by electrocution, city gas poisoning or chemical intoxication.
The pharmaceutical industry in Iran was born in its modern form in 1920 with the inauguration of the Pasteur Institute. Today, Iran devotes significant resources to the manufacture of pharmaceuticals, yet this does not prevent the country from remaining dependent on imports of raw materials and specific drugs. Standards related to pharmaceuticals in Iran meet the criteria set by the Pharmacopeia Council. The Ministry of Health and Medical Education is responsible for supplying the market with medicines and ensuring their quality. To these responsibilities must also be added that of price control. Since 1979, Iran has adopted a new national generic drug production policy with the main objective of producing essential drugs and vaccines. In 2006, 55 pharmaceutical companies produced more than 96% of the drugs in the Iranian market, equivalent to $ 1.2 million per year, in line with the generalization policy for generic products. That amounted to $ 3.65 million in 2013. Most of these products are drugs for cancer, diabetes, various infections and depression. It should also be noted that Iran is the first country in the Middle East with the technical and scientific capacity to export vaccines abroad. It is estimated that the country will achieve self-sufficiency in vaccine production by the year 2014. To take concrete examples, new drugs launched in Iran on the market include Interferon beta-1b and Pegaferon. Iran also produces Ziferon (multiple sclerosis drug) in large quantities, as well as a generic version of fingolimod (by Novartis), as well as a similar version of Serono's EMD, Rebif. Iranian researchers have also developed 41 types of anti-cancer drugs, which has significantly reduced the need for this drug. Iran is also on the list of twelve countries producing biotech drugs. The authorities concerned hope soon to achieve autonomy in the field of biotech production. Iran is also very much in the spotlight on the innovation of generic medicinal herbal medicines that number as high as 7500 species in Iran, of which 300 are used exclusively in the pharmaceutical industry. The country owns 80% of the world's medicinal herbs, but the lack of adequate treatment technology obliges the medical authorities to export its various varieties as raw materials. There are 92 pharmaceutical companies in Iran, the largest of which, the SSIC, is a social security investment company affiliated with the Ministry of Social Welfare. We can then mention the company Dârou Pakhsh which belongs mainly to the Social Security Iran. Other companies are currently taking over in this area, including Farabi, Jabber Ebn-e Hayyan, Exir, Kosar, Tehran Chemie, Loghman, Dana, Alborz Darou and Chemi Daurou.
With regard to medical equipment, Iran has begun to focus and expand its domestic manufacturing capacity in the country and will soon be able to count on their availability in the Iranian market. Two major exhibitions are also held annually in Iran, Iran MED and Iran LAB, entirely devoted to the medical equipment industry and medical analysis. There are also more than a hundred foreign companies, international suppliers of medical equipment in Iran. At the same time, they ensure the sale, promotion and provision of after-sales services for their products in Iran.
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