Over the last decade obesity in Iran has risen from 14.2 per cent in 2005 to nearly 65 per cent in 2018. At the same time more than 55 per cent of the population were physically inactive, doing less than 150 minutes of physical activity through the week. This meant that 45 per cent of men and 65 per cent of women in Iran did less than two and a half hours of exercise per week.

Worldwide, the statistics are equally frightening: 1.4 billion of us are not doing enough physical activity and this number has not improved since 2001, with around 1 in 3 women and 1 in 4 men not doing enough to stay healthy. In 2016 the highest rates of insufficient activity were in countries like Kuwait, Saudi Arabia, and Iraq.

The habit of doing physical activity starts in childhood. Studies have shown that children and adolescents who live near parks or open outdoor space has been associated with higher levels of physical activity. Living in walkable neighbourhoods is good for everyone: adults are more likely to walk or cycle for transportation if they can, and school aged children are likely to do the same to school.

In Iran, 20 per cent of children have inadequate physical activity because there isn’t proper education and cities in the country are not built for outdoor activity, said Afshin Ostovar, the Health Ministry’s director for non-communicable diseases in the Tehran Times. Earlier in the year, Maryam Hazrati, the deputy health minister for nursing, mentioned that 82 per cent of premature deaths in Iran can be linked to non-communicable diseases (NCDs). This is in line with the worldwide average according to the World Health Organization (WHO).

Though the facts are bleak, coordination, policymaking, planning, national programmes and commitment to reduce the effect of NCDs can be turned around.

In February 2018 Seyyed Hassan Ghazizadeh Hashemi, the Minister of Health and Medical Education in Iran, was appointed as a Commissioner of the WHO Independent High-level Commission on NCDs. By July the government put prevention and control of NCDs high on the agenda.

As detection, screening and treatment of NCDs, along with palliative care are becoming the focus for those looking and working with patients, the healthcare system continues to use the WHO’s PEN (Package of Essential Noncommunicable Disease Interventions for Primary Health Care in Low-Resource Settings) so that health workers can show Iranians how to deal with their NCD, provide access to affordable medicines, and give guidance on practicing healthy habits, like regular exercise and proper diets to control blood sugar.

At the end of 2018 the IraPEN programme, piloted in July, was ready to screen approximately 4 million people throughout Iran. The first phase of the programme about 50,000 people were screened and in November 2018 the programme was ready to start covering the whole population. The money for this programme came from a €450 million (US$ 480 million) increase in government spending on NCDs per year. The programme is planned to increase accessibility of drugs for NCDs (cancer treatments, diabetes care, etc.) in the public health system.

“The Islamic Republic of Iran is showing it is feasible for countries, and the world, to respond to the NCDs epidemic,” said Dr Oleg Chestnov, Assistant Director-General – Noncommunicable Diseases and Mental Health of the WHO. “Through political commitment and all-of-government action, progress is being made to improve the health of Iranians, by protecting them from NCDs and providing needed care.”

And this progress is being shown in the numbers: according to The Lancet’s report NCD Countdown 2030 Iran has shown improvement in NCD incidence and mortality.