SPHs of 2030 to achieve sustainable development Dr Ali Akbari Sari, Dean, School of Public Health 1 st International Conference on Health Sustainable Development And 50 th Anniversary of School of Public Health 24, 25 April 2016 Tehran University of Medical Sciences
دانشکده بهداشت دانشگاه علوم پزشکی تهران معاونت بهداشت وزارت بهداشت درمان و آموزش پزشکی فلوشیپ شبکه بهداشتی درمانی تابستان- پاییز 1393
Talk structure Major characteristics of the region Iran population 1950-2045 Iran Health issues: past, present and future Characteristics of future public health programs SPHs expected routine activities/programs in the future SPHs expected roles in unstable uncertain situations Conclusion
Major characteristics of the region Variations/diversities Unrests/wars Uncertainty/instability Migrations Natural disasters Limited resources/expertise Oil dependent economy
Iran in 1950s Population: 16 millions (1950) Life expectancy: 39y (1955) Malaria rate: 40% Ascaris rate: 50% Other infectious disease: very common 1952: Birth of Malariology Institute at Tehran University 1956: Malariology and Parasitology Institute By 2015: 800 MSc, 280 MPH and 200 PhD thesis, 420 books, 4500 articles were published in the field of parasitology by Iranian academics
100 90 80 70 60 50 40 30 20 10 0 Iran Population 1955 to 2045 1955 2015 2030 2045 1955 1960 1965 1970 1975 1980 1985 1990 1995 2000 2005 2010 2015 2020 2025 2030 2035 2040 2045 Population (million) Median Age Fertility Rate Density (P/Km²) Urban % http://www.worldometers.info/world-population/iran-population/
Age Pyramid: 2010 and 2030 Euromonitor International, 2011
Population age shift Euromonitor International, 2011
Population density Euromonitor International, 2011
NCDs will still be the main causes of deaths in Iran in 2030 W HO, 2007
Diabetes in developing countries: will affect people aged 45 65 years Developed Countries Developing Countries Estimated number of people with diabetes (millions) 60 50 40 30 20 10 0 2000 2030 20 44 45 64 65+ 160 140 120 100 80 60 40 20 0 2000 2030 20 44 45 64 65+ Wild S et al. Diabetes Care 2004;27(5):1047 1053
12 Global projections for selected causes, 2004 to 2030 Cancers 10 Ischemic HD Deaths (m illions) 8 6 4 2 TB 0 Malaria 2000 2005 2010 2015 2020 2025 2030 Updated from Mathers and Loncar, PLoS Medicine, 2006 Stroke Acute respiratory infections Road traffic accidents Perinatal HIV/A IDS
Other major public health issues in 2030 Mental disorders is expected to be among the first contributors to the total disease burden in 2030 Currently road traffic crashes is among the first contributors to the total DALY in Iran, but the situation is expected to be improved by 2030 http://w w w.ncbi.nlm.nih.gov/pm c/articles/pmc3965873/
Characteristics of many future public health programs Substantial total contribution Small but significant marginal contribution Margin different for different groups and different interventions Larger contribution in quality of life Role of economic evaluation to identify and select less costly and more cost-effectiveness interventions Health status Healthcare inputs Folland et al
SPHs should be flexible and consider future changes in their future activities and programs Training, research, policy analysis, collaborations, Expansion of the school departments, units, courses, faculties Resource allocations Routine monitoring and surveillance of health systems and health conditions Policy and cost analysis of current and future programs Ready to produce guidelines, policy reports, HTAs, etc according to the needs and request of policy makers
SPHs should also be prepared to play their roles in the following situations Dealing with uncertain/unstable situations e.g. A new government has come to power with urgent need for a program to run the Ministry of Health An earthquake of around 7 Richter has happened in a large city Epidemics of emerging and re-emerging infections diseases e.g. Influenza, SARS, Dengue, Zika, food infection, Huge migration from a neighboring country due to an unexpected war/unrest
Conclusion SDGs, UHC and NCDs will be the most important and most topical public health issues in the future. SPHs should be flexible and proactive to adopt the new changes and to play a major role regarding them. Although NCDs are the main public health issues now and in the future, the improvement programs to fight them are not always the same. This depends on the marginal benefits of different programs in different groups and times that need carful study. SPHs can always play a major role in policy/cost analysis of the public health programs and identification of cost effective interventions SPHs can also play a major role in the current and future unstable uncertain situations in the region
دانشکده بهداشت دانشگاه علوم پزشکی تهران معاونت بهداشت وزارت بهداشت درمان و آموزش پزشکی فلوشیپ شبکه بهداشتی درمانی تابستان- پاییز 1393
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