Determining the foundations and scope of state civil liability for bodily, financial, and other losses attributable to state actions or omissions in managing communicable diseases raises significant theoretical and practical challenges due to the overlap between civil liability, public obligations arising from the right to health, and social compensation mechanisms. This study aims to elucidate the theoretical foundations of state civil liability for such losses through a comparative analysis of the laws of Iran, England, and the United States. Employing a descriptive-analytical methodology and a comparative approach, the study examines the foundations of state liability in the three legal systems based on criteria including the duty of care, breach of duty, causation, sovereign immunity, and compensation mechanisms, drawing on legislation, judicial decisions, and authoritative doctrinal sources. The findings demonstrate that, in Iranian law, state liability is primarily grounded in the fault-based theory, the Islamic jurisprudential rules of Itlaf (destruction) and Tasbib (causation), and constitutional principles. By contrast, English and United States law rely on criteria including the duty of care, breach of duty, causation, the distinction between policy and operational decisions, and limitations arising from sovereign immunity. The study further demonstrates that state liability in this field requires distinguishing judicially enforceable civil liability from protective obligations arising from the right to health and social compensation mechanisms. The novelty lies in proposing a three-level framework for distinguishing these domains and clarifying their interrelationship, thereby providing a more coherent basis for analyzing the scope of state liability in public health emergencies.