WHY SANCTIONS CAN BE

AS DEADLY AS WAR

30 MILLION DEATHS SINCE 1971

For decades, the United States has relied on economic sanctions as a central tool of foreign policy, often describing them as a non-violent way to pressure governments accused of wrongdoing. This framing has made sanctions politically attractive across administrations and parties. Yet growing evidence suggests that this view is incomplete. While sanctions may avoid direct military confrontation, they frequently impose severe and lasting harm on civilian populations, raising serious questions about whether they are genuinely a humane alternative to war.

A major study published in The Lancet Global Health highlights these concerns. Analyzing data from 1971 to 2021 across 152 countries, the researchers found that unilateral economic sanctions are associated with significant increases in mortality, particularly among children and older adults. The study estimates that unilateral U.S.-related sanctions were associated with nearly 600,000 excess deaths per year, a toll comparable to the global mortality burden of armed conflict. Over the full 50-year period examined, this amounts to an estimated 30 million deaths in sanctioned countries. These deaths occur not through direct violence, but through economic disruption, collapsing public services, and declining access to basic necessities.

Sanctions typically operate by restricting access to international trade, financial systems, and foreign currency. Although they are often described as targeted measures aimed at political leaders or specific industries, their effects quickly spread throughout the economy. Government revenues fall, imports become scarce, and inflation rises. Hospitals struggle to obtain medicines and equipment, food prices climb, and infrastructure deteriorates. Even when humanitarian exemptions exist, banks and suppliers often refuse to process transactions for fear of violating U.S. regulations, thereby delaying or blocking aid.

These consequences have appeared across a wide range of countries and political systems. In Iran, sanctions have restricted access to medical supplies despite formal exemptions. In Iraq during the 1990s, sanctions coincided with widespread malnutrition and excess child mortality. In Afghanistan, the freezing of financial assets after the Taliban takeover deepened an already severe humanitarian crisis. Across these cases, sanctions have tended to harm ordinary people far more than political elites, who often retain alternative access to resources.

Venezuela offers a more recent illustration, though it is not unique. U.S. sanctions expanded sharply after 2017, including financial restrictions and, later, an oil embargo that cut off the country’s primary source of revenue. Venezuela’s economy was already weakened by mismanagement and corruption, but sanctions intensified the collapse by limiting imports, shrinking public spending, and isolating the economy. Multiple studies estimate tens of thousands of excess deaths during the most severe years of sanctions, linked to shortages of food, medicine, and basic services. The Venezuelan case shows how sanctions can magnify existing crises and turn economic distress into prolonged humanitarian emergencies.

Supporters of sanctions often argue that such outcomes reflect failures of the targeted governments rather than the sanctions themselves. Domestic policies do matter, but this argument sidesteps a central issue. If sanctions predictably worsen living conditions, raise mortality, and block access to essential goods, their humanitarian impact cannot be dismissed as incidental. Even when sanctions do not cause crises outright, they frequently deepen suffering and limit societies' ability to recover.

There is also growing evidence that sanctions often fail to achieve their stated political goals. Studies show they rarely produce democratic reforms or significant policy changes, particularly when imposed unilaterally. Instead, they can entrench hardline leadership, weaken civil society, and shift blame outward, while the human costs accumulate quietly in hospitals, households, and refugee flows.

Taken together, the evidence challenges the assumption that sanctions are a clean or moral alternative to war. While they may avoid immediate violence, sanctions can function as a form of economic warfare that exacts a heavy toll on civilian life. Any foreign policy that claims to prioritize human rights must confront the reality that economic coercion, as currently practiced, can be as destructive as the conflicts it is meant to prevent.

Effects of international sanctions on age-specific mortality: a cross-national panel data analysis. (The Lancet, August 2025)

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