1. Health Legislation and Legal Structure in Iran Nouradin Pirmoazen,MD,FACS, Clinical Research Fellow, Harvard Medical School

2. Turning Point : Motivation History of Ronak! History of Ronak! 12 Y/F 12 Y/F Fever, Anorexia, Abdominal Pain Fever, Anorexia, Abdominal Pain Perforated Appendecitis Perforated Appendecitis Complications! Complications! Life-long infertility Life-long infertility

3. ``Declare the Past, Diagnose the Present, Foretell the Future.`` Hippocrates (c.470-277 BC)

4. Declarations History: Revolution in Thinking and Practice 1978 : Declaration of Alma-Ata: Health for All 1978 : Declaration of Alma-Ata: Health for All -Health For All (HFA) by 2000 -Health For All (HFA) by 2000 -Primary Health Care (PHC) -Primary Health Care (PHC) -Protect and Promote the Health -Protect and Promote the Health -Health is Fundamental Human Rights -Health is Fundamental Human Rights -National Health System (NHS) -National Health System (NHS) 2000: Millennium Declaration: All for Health 2000: Millennium Declaration: All for Health -Comprehensive Development Framework -Comprehensive Development Framework -MDG s Place a Central Focus on Public Health -MDG s Place a Central Focus on Public Health -Public Health Improvement Break `Poverty Vicious Cycle` -Public Health Improvement Break `Poverty Vicious Cycle` -MDG s Depend Critically on Scaling up Public Health -MDG s Depend Critically on Scaling up Public Health Investments in Developing Country (Sachs, Bulletin WHO Investments in Developing Country (Sachs, Bulletin WHO

5. Global Partnership Forum! Poverty & Hunger Primary Education Maternal Health HIV/AIDS Malaria…. Environmental Sustainability Child Mortality Gender Equality

6. MDG s : Focused on Health 1.Eradicate Extreme Poverty and Hunger 2.Achieve Universal Primary Education 3.Promote Gender Equality and Empower W 4.Reduce Child Mortality 5.Improve Maternal Health 6.Combat HIV/AIDS, Malaria… 7.Ensure Environmental Sustainability 8.Develop Global Partnership for Development

7. Bridging the `Know-Do Gap` Policies: MDG s Achievement Premises: Better World Promises: Better Health

8. Translating Knowledge into Action Policy Plan Politics

9. WHO PRSP: Poverty- Health Links Health Inequality Poverty/Wealth

10. Soviet Medicine Before the Fall The Financing of the Health Services came last, after all expenditures had been met, and it had to take whatever was left, which was very little! The Financing of the Health Services came last, after all expenditures had been met, and it had to take whatever was left, which was very little! `Residual Service` `Residual Service` Chazov, Chazov, Health Minister Health Minister Harvard Medical Alumni Bulletin Harvard Medical Alumni Bulletin

11. Principles of Health Reform  Fair Access: to Essential Health Care Services, Equity, Universal Coverage  Efficiency: to Deliver with Maximum Outcome  Responsiveness to Society: Accountability, Quality,Performance, Expectations, Protections  Innovations: on a Day to Day Basis, Products, Diagnostic, Therapeutic….

12. Legislative Pyramid Parliament Guardian Council Assembly of Expert Cabinet

13. Parliament,Majlis, Parliament,Majlis, National Assembly, 290 MPs, 10% MD

14. Council of Guardians  Six Faqih,Cleric Islamic Canonists  Six Jurists Legislations Comply with Islamic Laws and Constitution

15. Laws Pathway  Government Bills: Presented to Parliament after approval in the Cabinet  Representatives Plans: Proposed by MPs if Sponsored by 15 MPs

16. Public Health Law in the Constitution Article 3/12: Creating Welfare, Removing Poverty Eliminating any form of Deprivation in the field of Nutrition, Housing, Employment, Health Care Generalized Social Insurance

17. Public Health Law in the Constitution Article 29: Universal Right of All in -Social Security covering Retirement, Unemployment, Old age, Disability, Destitution, Accidents, Calamities, - National Medical Insurance, Health Care Services and Treatments

18. Public Health Law in the Constitution Article 43/1: -Satisfaction of Basic Needs : Housing, Nutrition, Clothing, Preventative Health, Medical Treatments, Services Education Family for All Setting

19. Health For All: Health Care Network System Health Houses (HH) Health Centers (HC) `Behvarz` Training Geographic Locations Whole Country Distribution Care Delivery Levels Specialized Clinics, Hospital Teaching Modern Hospitals PHC System! Access! PHC System! Access!

20. National Health Policy: Principles  Accessibility  Equity  Quality  Insurance Coverage

21. Investing in Health means Investing in People and Development  Health Allocation from GDP: 2001-2004 5.7% 2001-2004 5.7% 2005-2010 7.2% 2005-2010 7.2%  Out-Of-Pocket 2001-2004 50-60% 2005-2010 30% 2005-2010 30%

22. Public Health Improvement Assessment Figuring Out what health problems are Policy Development Deciding What to do Assurance Doing it well

23. To Strive, To Seek, To Find, And not to Yield!

24. Thank You All!