Introduction: The system of issuing governmental licenses for health activities serves as one of the key instruments of health stewardship, playing a fundamental role in safeguarding public health. However, the legal framework governing these licenses in the Iranian legal system faces structural challenges that can undermine the efficiency of the health system, legal security for stakeholders, and access to services.
Methods: This study is a legal-analytical research with a descriptive-analytical approach. Data were collected through documentary analysis of valid and enforceable laws (from the National Laws and Regulations Portal). Relevant laws were first identified and refined, followed by structural analysis of relationships among rules, institutions, and licenses. In certain cases, a comparative study with the French Health Code was employed to identify legal gaps.
Results: The research findings indicate the presence of structural challenges in the legal system of health and medical licenses. Related legal provisions are scattered across multiple laws, various institutions are involved in issuance and oversight, proliferation and inflation of licenses are observed, normative ambiguity and conflicts exist in the relationship between general and specific licenses, and legal gaps are evident in areas such as licensing for online drug distribution platforms. These challenges can interact with one another and reduce the effectiveness of health stewardship.
Conclusion: The identified challenges are structural in nature and require fundamental reconsideration. It is recommended that legislative coherence be enhanced through the development and enactment of Iranian Health Code, institutional competencies be clarified, and licenses be reviewed to improve the efficiency of the licensing system.