The Dichotomy of Development and Deprivation: An Analysis of Health Mega-Challenges and Mega-Opportunities in Southeast Iran in the Coming Decade

Background and Aim: Southeastern Iran, comprising Sistan and Baluchestan and parts of Kerman and Hormozgan Provinces, is entering a decisive decade. Despite its remarkable natural resources, cultural diversity, and unique geopolitical position, the region faces a combination of distinctive megachallenges and unprecedented opportunities. This study aims to simultaneously analyze these threats and opportunities and identify strategic megachallenges and mega opportunities for overcoming the duality of development and deprivation.
Methods: This research employed a mixed-method approach. First, a systematic review of scientific literature, national policy documents, and official reports related to southeastern Iran was conducted. Subsequently, 43 semi structured interviews were carried out with national, provincial, and local experts using purposive sampling. The qualitative data were coded and analyzed through content analysis. Finally, a qualitative synthesis was performed to integrate the documentary and field based findings.
Results: The results revealed several major megachallenges in the region, including chronic water scarcity, infrastructural and economic inequalities, vulnerability of health and education systems, weak integrated regional governance, out migration of skilled professionals, and expansion of social harms. Conversely, strategic positioning along international trade corridors, the development of the Makran Coast and the marine based economy, renewable energy potential, mineral capacities, and a young human capital were identified as key mega opportunities.
Conclusion: This study demonstrates—through an analytical and forward looking perspective—that linking large scale economic projects with social and health impact frameworks, strengthening regional governance, and enhancing the retention of skilled human resources are essential for navigating the development–deprivation divide. These measures can guide southeastern Iran toward a sustainable and balanced development trajectory.