38 MILLION KILLED: HOW ECONOMIC SANCTIONS

ARE KILLING MORE THAN WAR

Jason Hickel, an economic anthropologist and author who writes widely on global inequality and development, has argued that Western sanctions represent one of the deadliest and least acknowledged forms of structural violence in the modern world. Drawing on newly published research in The Lancet Global Health, he estimates that unilateral sanctions may have caused as many as 38 million premature deaths since 1970. For Hickel, these deaths are not accidents of policy but the foreseeable outcome of deliberate political choices, with sanctions functioning as a form of war by other means—disrupting access to medicine, food, and public health infrastructure, while systematically targeting the most vulnerable.

The study Hickel draws upon, published in August 2025, was conducted by researchers Francisco R. Rodríguez, Silvio Rendón, and Mark Weisbrot. Analyzing mortality data across 152 countries from 1971 to 2021, they used a range of statistical methods to ensure reliability and found a direct link between sanctions and increased death rates. Their results show that unilateral economic sanctions are responsible for approximately 564,258 excess deaths per year, with a 95% confidence interval of 367,838 to 760,677. While the best estimate is around half a million lives lost annually, the actual toll could reasonably be somewhat lower or considerably higher, but almost certainly falls within that range. This means sanctions are killing on a scale comparable to global civilian deaths in wars. The Center for Economic and Policy Research (CEPR) emphasized that most of these deaths are among young children, especially those under five, making the impact of sanctions particularly devastating.

The study also found that unilateral sanctions, especially those imposed by the United States, have the most damaging effects. By contrast, United Nations sanctions showed no clear statistical link to higher mortality, suggesting that multilateral sanctions may be structured in ways that provide better humanitarian safeguards. This raises difficult questions about the morality of unilateral measures, which are often described as “targeted” but in practice hurt civilian populations on a massive scale. CEPR highlighted this point by noting that the global death toll from unilateral sanctions is “roughly equivalent to total deaths from wars, including civilian casualties.” Jason Hickel underscores this finding, pointing out that sanctions are not the clean alternatives they are claimed to be but tools of coercion that generate human suffering on a scale rivaling global conflict.

The human cost is most clearly seen in personal tragedies. In August 2025, the Financial Times reported the death of Amir Hossein Naroi, a 10-year-old Iranian boy who relied on medication for thalassemia, a rare blood disorder. When U.S. sanctions blocked critical drug deliveries, his treatment was interrupted, and he died. In Venezuela and Syria, sanctions have similarly obstructed or delayed humanitarian aid, worsening already severe crises. While policymakers frame sanctions as tools aimed at governments, in reality, it is ordinary civilians who suffer the most. For Jason Hickel, stories like these illustrate why sanctions must be understood as structural violence: the harm is systematic, predictable, and borne overwhelmingly by those least responsible.

The findings also echo historical lessons. Sanctions on Iraq in the 1990s were infamously linked to significant increases in child mortality, with estimates ranging from 100,000 to 250,000 excess child deaths, and in some reports, even higher. Later studies questioned the exact numbers, but there was little doubt that the sanctions inflicted widespread humanitarian suffering. That experience eventually prompted the UN to design more targeted sanctions. Yet the new research suggests that unilateral measures imposed by powerful countries continue to cause staggering levels of civilian harm, even today.

The policy implications are profound. Sanctions are not the “clean” or bloodless tool they are often made out to be; they cause human suffering on a scale equivalent to war, and children pay the highest price. The evidence that UN sanctions appear less deadly suggests that international coordination and oversight can help reduce harm, while unilateral actions lack those safeguards. Meanwhile, the sheer scale of sanctions has expanded dramatically: only about 8% of countries were sanctioned in the 1960s, compared with 25% between 2010 and 2022, mainly as a result of U.S. and European measures. With sanctions now touching a quarter of the world’s nations, the humanitarian stakes are enormous.

In light of these findings, sanctions can no longer be seen as a soft alternative to war. They are a silent siege, responsible for hundreds of thousands of preventable deaths each year, and tens of millions over the past half-century. As Jason Hickel argues, if the international community is serious about upholding humanitarian principles, sanctions must be fundamentally rethought—made more transparent, better monitored, and in many cases replaced with diplomatic strategies that do not turn civilians into collateral damage.

Effects of international sanctions on age-specific mortality: a cross-national panel data analysis (The Lancet, 8-25)

The staggering death toll of Western sanctions (Jason Hickel, 9-9-25)

Sanctions can kill as many people as wars (Financial Times, 8-7-25)

New Study Estimates Over Half a Million People Die Each Year Due to Unilateral Economic Sanctions (CEPR, 7-23-25)

'Immoral and Indefensible': Study Reveals Deadly Consequences of US Sanctions (Common Dreams, 7-23-25)

Effects of International Sanctions on Age-Specific Mortality: A Cross-National Panel Data Analysis (CEPR, 7-22-25)

International sanctions against Iraq (Wikipedia)