Financing of NCD Prevention in LMICs: Iran Case Study

Objective: This case study is part of a series of 10 case studies from low-and-middle-income countries that werecarried out to describe the enablers, dynamics, and challenges of financing prevention programmes to counter noncommunicablediseases, and to identify promising practices and common threads and trends in these countries.Prevention programmes are increasingly seen as critical for tackling the rising burden of non-communicablediseases (NCDs), but tend to be under-prioritised and under-funded, particularly in low and middle-incomecountries. The objective of this study is to critically assess the NCD prevention efforts made by the Iraniangovernment over the years with a particular focus on cardiovascular diseases, cancers, chronic pulmonary diseases,diabetes, and psychiatric disorders.Methods: The available literature on NCD prevention, funding, policy formulation, and recommendations wasreviewed and selected publications were thematically organized into categories of analysis that were refined basedon the emerging evidence. Later, a specific search was undertaken for broader literature, including policyframeworks on NCDs in Iran. An in-depth interview was carried out with an official from the health ministry to gaininsights into the government’s perspective and approach.Results: Iran’s NCD prevention efforts are guided by a National Action Plan developed by the Iranian Non-Communicable Diseases Committee, which was set up by the high-powered Supreme Council for Health and FoodSecurity (SCHFS). Under the 6th National Development Plan (2016-2021), Iran announced a US$ 480 million increasein its NCDs budget for the next five years. The health ministry determines the financing requirement for everyprogramme and campaign that is to run on the ground and the government issues the required funds. The cost ofNCD prevention programmes is minimal in most cases since they are integrated into an already existing publichealthcare system. Iran’s NCD efforts operate without any external development assistance for health, and thegovernment’s plans are further restricted due to international trade sanctions.Conclusion: In spite of trade sanctions, COVID-19 triggered economic meltdown, and zero international assistancefor health, Iran has made considerable progress in preventing and containing the spread of NCDs. Internationalsupport, easing of trade sanctions, and improvements in the current PHC can reduce the economic burden of theNCDs, as well as support the government’s ability to improve the condition of the existing health care systems andnetworks.Keywords: Diseases, Stress, COVID-19, Diabetes, Management, Policy