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Despite significant progress in Iran's immunization programs, vaccine policymaking in the country still faces various challenges and shortcomings. To address these issues and ensure sustained progress toward achieving comprehensive vaccination policies, it is essential to identify the critical factors influencing vaccine policies in Iran. Our study aims to provide evidence-based insights that can inform the development of effective and equitable vaccine strategies, leading to a more sustainable and efficient approach to vaccination in the country.

This mixed-method study aimed to analyze the factors influencing the future of human vaccine policy using Cross Impact Analysis. Firstly, a scoping review was conducted to identify the factors affecting the future of human vaccine development. Secondly, a semi-structured interview was conducted with experts in this field to add more factors and confirm the identified factors within the Iranian context. Finally, a Cross-Impact Analysis (CIA) approach was applied to comprehend the complex relationships between the identified factors. Thematic analysis was used for the qualitative data, and MICMAC analysis was applied to characterize the relationships between the factors.

Seventeen key driving force factors were identified through comprehensive review and interviews. These factors were assigned weighted values ranging from zero to three and subsequently analyzed using MICMAC software. Employing the Cross-Impact Analysis (CIA) technique, the study characterized the impact of each factor on vaccine policy and elucidated the intricate interactions between them. The findings underscored that robust leadership and governance, an innovative ecosystem, and well-established immunization information systems emerged as pivotal driving forces shaping vaccine policy in Iran.

While this study contributes valuable insights into the driving factors influencing vaccine policy in Iran, it is important to acknowledge several limitations. The results rely on the subjective perceptions of a diverse group of specialists, and future research could delve into additional factors in other countries to identify common themes and differences.

This study provides evidence to assist policymakers in making informed decisions regarding vaccines in Iran. The findings suggest that enhancing access to vaccines, fostering trust in the healthcare system, and prioritizing equity in distribution can contribute to increased vaccination rates and a reduction in vaccine-preventable diseases.

This study provides a unique contribution to the field of vaccine policy by utilizing the cross-impact analysis to examine the complex interactions among various factors. The results of this analysis demonstrate that these interactions can significantly impact the overall system, highlighting the need for policymakers to consider multiple factors when formulating effective strategies. By revealing the significance of these interactions, this research offers valuable insights into the development of successful policies that can shape a desirable future for vaccine policy in Iran. Future studies could ratify the findings from this research by applying other methodological approaches.

Implementing the 17 Sustainable Development Goals (SDGs) unarguably demands huge financial investments. However, the United Nations has acknowledged the huge financial gap militating against the implementation of the SDGs worldwide, leading experts to question the possibility of complete implementation of the goals by their terminal dateline of 2030. While the bulk of the finance currently outlaid on the SDGs comes from traditional sources including foreign direct investments (FDIs), there is the need to focus more attention on developing and exploiting impact investments that are more suitable for financing development programmes and projects. In this chapter, the SDG implementation profiles of the 12 Arab West Asia countries concerning the five most targeted SDGs were evaluated and sustainable finance issues were discussed. Secondary data were retrieved from World Bank's DataBank. The data were descriptively analyzed. Based on the profiles generated, debt relief is put forward as a possible impact investment mechanism suitable for funding the SDGs. Specifically, this chapter recommends that outright cancellation of debts based on the debt-for-SGD swap could serve as some of the impact investments needed to boost the global drive for a developed, peaceful, and just world.