You can review the full text and after that responds to my question.
Article Ministry of Health in Iran Is Serious about Controlling Hepatitis B
I think HBV ,HIV or other disease can not be controlled without cooperation of at least 5 organization in Iran .
1- health ministry
2- IRIB
3- Education ministry
4- parliament
5- judiciary system
my recommendation clearly is :
foundation of supreme council of health under supervision of president with regular monthly meetings like shoraie alie enghelab farhangi .
This question is about health policy rather than a pure scientific question. Dr Alavian, who is an expert in the field, surely has his comments. When we talk about such a strategy, seeing all actors in the field is crucial. Looking for the same experiences in other countries is also helpful.
We should consider the role of private medical centers and facilities too. Re-education of general practitioners and internists who are in the first line of contact with the patients seems valuable.
I do not recommend action by the ministry of health as it should be the site of planning and supervision. The plans of the ministry should be carried out by universities & health systems from the official side and GPs and internists/ gastro-enterologists from the private section side.
As long as we do not have private investors like NGOs in controlling of HIV in Africa, the support of Ministry of Health of Iran is necessary to control HBV in such a vast country. But first of all, fully understanding of epidemiology of HBV,particularly identification of introduction routes of infection to our country by other countries and a correct dispersal model (intra-country is necessary) of HBV are the most important prerequisites. In my opinion, this way is better than sitting and just treat patients ( actually, unlimited patients are out puts of uncontrolled dispersal of HBV in our population) with antivirals which have their own subsequent complications. Blocking the ways of infection, concurrently vaccination , identification and well treatment of carriers insured the elimination of HBV. let's have a look at last review by Professor Blumberg before passing away in 2011(PMID: 20036981).
I think the role of ministry of health is important, but we must involve other organizations. We need to educate general population about hepatitis, it's better to produce some TV programs about controlling hepatitis,also we should start from schools(more than 13 years old)!
It's better to work on prevention more and more. Prevention needs Education!
I think it is an excellent idea, but the key issue is whether HBV vaccine is or will be made available to the general population in Iran. The Italian policy of vaccinating newborns as well as pre-puberal boys and girls was highly successful and allowed to protect newborns and teens in 12-year time.
I agree with Mario and I would like to introduce a published article about good achievements in Italy in this issue:
Coppola RC, Meloni A, Campagna M. Impact of universal vaccination against hepatitis B: the italian model. Hepat Mon. 2012 Jul;12(7):417-9.
As its known for medical carrier, prevention is better than treatment
so a good well established programmes of health education, global vaccination and a high standared level of managing infected cases well ease the task .
Hi Seyed. Also please see Alex Zanetti's many papers on the subject such as Lancet. 2005 Oct 15-21;366(9494):1379-84 and J Med Virol. 2002 Jul;67(3):440-3.
Good luck!
Mario
This question requires a knowledge of several aspects that only who lives in Iran knows. In addition, it is more a matter of policy rather than science.
You can follow the universal immunization programme of Bangladesh. All the children of Bangladesh are under this coverage.The results are very successful.
I think that the Iranian Ministry of Health MUST be involved in this initiative. I also suggest that world expert should be involved as advisors to streamline the process.
Why not starting from the vaccination in all newborns. as in European Countries?
The newbornS vaccination has long time ago been started in Iran, even before European countries! AND as a great achievement the rate of HBV related HCC has dramatically been decreased. Also, due to this program the rate of HBV chronicity has considerably been decreased.
I am sorry for my poor knowledge of your National Heath habits, but I did not find this news in the forum. I am very happy for excellent results and hope you will excuse my ignorance.
No problem, There are several articles which report this success but we have to control it as much as possible. I think Professor Alavian wants to know ideas beyond governmental management.
For more information I address one of those reports considering HBV vaccination in Iran.
http://www.ncbi.nlm.nih.gov/pubmed/18638096
warm regards
It is very critical to ask the scientists, is increase the coverage of HBV vaccination to the general population can stop the viscus circle in transmission of HBV or not? is it cost benefit or not?
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