A multi-sectoral approach to combatting non-communicable diseases: Iran’s experience
- 110 Downloads
Combat Non-communicable diseases (NCDs) as a leading cause of death across the world need to high level political commitment and multi-sectoral approach in all countries. So, Iran established the national multi-sectoral arrangement as Iranian Non Communicable Diseases Committee (INCDC) and developed NCDs’ national action plan through inter and intra-sectoral collaboration. This multi-sectoral plan was approved by the Supreme Council for Health and Food Security (SCHFS), and Iran motivate NCDs’ prevention and control in national and sub-national levels through oriented priority-based interventions mobilize equitable health system.
KeywordsMulti-sectoral Non-communicable diseases Iran
The burden of non-communicable diseases (NCDs) poses a major health challenges in the world and fuels inequalities amongst countries and communities. In the past three decades, tens of millions of people died from NCDs in the world , many of them occurring in low and middle-income countries affecting people with lower socioeconomic status [2, 3]. Nevertheless, NCDs were not included in the Millennium Development Goals , and, only in 2014, the World Health Organization (WHO) took action and demanded a 25% reduction in premature mortality from NCDs by 2025 . In addition, Sustainable Development Goals (SDGs) emphasized on reducing one third of NCDs’ death by 2030 (target 3.4) and a new Political Declaration on NCDs was endorsed by Member States in 2018 at the Third High-level Meeting of the United Nations General Assembly . In Iran, similar to other countries of the world, dealing with NCDs and the inequalities they cause consist a formidable task for health policy-makers [7, 8].
High burden of NCDs and annual loss of thousands people due to non-communicable diseases as high political commitment to tackle NCDs in Iran . Accordingly, Iran has established National Non-Communicable Diseases Committee (INCDC) through multi-sectoral mechanism and partnership of all sectors in the Ministry of Health and Medical Education and other related sectors and ministries, organizations, NGOs, and communities . INCDC was developed as a national action plan for prevention and control of NCDs in a duration of 2015 to 2025 by means of thirteen targets which includes nine WHO targets and four targets specifically designed for Iran. These country-specific targets include: (i) reducing trans fatty acid in food products, (ii) decreasing traffic injures, (iii) decrease in drug abuse related mortality, and (iv) promotion of mental health . This multi-sectoral plan was approved by the Supreme Council for Health and Food Security (SCHFS) and obtained support of the President (who chairs the supreme council), the Speaker of the Parliament, the Vice President and nine minister from other ministries . Today, this highly-endorsed NCDs national action plan consists the foundation of Iranian health policy against non-communicable diseases in Iran. It is noteworthy that all corresponding multilateral agreements are signed amongst ministry of health and other ministries established health secretariat in their organizations.
Besides national commitments, in sub-national levels, INCDC requires governors and universities chancellors to form their own provincial NCDs prevention and control committees through inter- and intra-sectoral collaborations to ensure full implementation of the nationally-endorsed strategies by means of community-based approaches [12, 13]. Information about national and sub-national strategies against NCDs  and their risk factors are uploaded on the VIZIT, as an online visualization tool that facilitate evidence-based priority setting and strategic planning in different levels of the country. Through this platform, provincial policy makers are assisted to develop their sub-national strategies through partnership of all related sectors and mobilization of all resources.
In the Provisional document on NCDs related to Regional Committee for the Eastern Mediterranean Sixty-sixth session (RC66) hosted by Iran in October 2019, the following goals were set for the committee: (i) promotion of mental health (ii) reduction in indoor and outdoor air pollution, (iii) efficient utilization of monetary resources (iv) adaptation of innovative financing models, and (v) highlighting the importance of NCDs management in emergencies as new political commitments. In addition, financial investment, capacity building, multi-sectoral collaboration, and accountability emphasized in RC66 document to scale up actions on NCDs . Remarkably, it was considered in multi-sectoral NCDs’ national action plan in Iran. In the way forward, Iran scale up NCDs prevention and control programs in the context of “health-in-all-policies, whole-of-government and whole-of-society approaches” through national and sub-national political commitments by equitable health system.
Conflict of interest
The authors declare that they have no conflict of interest.
- 1.Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2018;392(10159):1736–88.Google Scholar
- 3.NCD Countdown 2030: worldwide trends in non-communicable disease mortality and progress towards Sustainable Development Goal target 3.4. Lancet. 2018;392(10152):1072–88.Google Scholar
- 5.Global action plan for the prevention and control of noncommunicable diseases 2013–2020. Geneva, World Health Organization. 2013. who.int/nmh/events/ncd_action_plan/en/. Accessed 28 Sep 2019.Google Scholar
- 11.Hashemi H, Larijani B, Sayari AK, Malekzadeh R, Dinarvand R, Aghajani M, et al. National Action Plan for prevention and control of NCDs and the related risk factors in the Islamic Republic of Iran, 2015 to 2025. 1th ed. Ministry of Heath and Medical Education Tehran, Iran: Iranian Non Communicable Diseases Committee (INCDC); 2015. http://incdc.behdasht.gov.ir/uploads/sanadmelli_en.pdf. Google Scholar
- 13.Rising rural body-mass index is the main driver of the global obesity epidemic in adults. Nature. 2019;569(7755):260–4.Google Scholar
- 14.Peykari N, Sepanlou SG, Djalalinia S, Kasaeian A, Parsaeian M, Ahmadvand A, et al. National and sub-national prevalence, trend, and burden of metabolic risk factors (MRFs) in Iran: 1990–2013, study protocol. Arch Iran Med 2014;17(1):54–61.Google Scholar
- 15.Accelerating regional implementation of the Political Declaration of the Third High-level Meeting of the General Assembly on the Prevention and Control of Noncommunicable Diseases. World Health Organization, Regional Committee for the Eastern Mediterranean Sixty-sixth session .2019. http://applications.emro.who.int/docs/RC_Technical_Papers_2019_7_en.pdf?ua=1. Accessed 15 Oct 2019.