Economic sanctions: An invisible weapon of war

In July 2025, The Lancet Global Health published a study that can be described as historic. The authors – economists Francisco Rodríguez (University of Denver), Silvio Rendón (Inter-American Development Bank), and Mark Weisbrot (Centre for Economic and Policy Research, CEPR) – have undertaken a first systematic and causal assessment of the impact of economic sanctions on global mortality. By analysing a dataset spanning 152 countries and five decades (1971–2021), they arrived at a conclusion that is as precise as it is disturbing: Unilateral sanctions imposed by the United States and the European Union caused approximately 564,258 deaths annually during this period (with a 95 per cent confidence interval between 367,838 and 760,677). Over 50 years, these deaths add up to roughly 38 million human lives lost.¹
    This figure is neither a rough estimate nor a speculative extrapolation. The researchers used four different econometric methods designed to infer causal relationships from observational data – entropy balancing, Granger causality, event studies, and instrumental variables. The robustness of the results, which are consistent across all four approaches, significantly reinforces the validity of the conclusions. The sanction-related mortality rate corresponds to a 3.6 per cent increase in overall mortality in the sanctioned countries.

War by other means

The title of the article in The Lancet sounds like a scientific provocation: The authors quote Woodrow Wilson, who as early as 1919 described economic sanctions as “something more tremendous than war,” and conclude: “Our study suggests that he was right.” Wilson’s statement, made at the founding of the League of Nations, shows that the idea of resorting to economic suffocation rather than weapons is not new. What is new, however, is that science is now confirming the American president’s intuition with unprecedented accuracy.²
    The mechanism by which sanctions kill is indirect but relentless. By blocking access to financial markets, international trade, foreign exchange, and technology, sanctions undermine a state’s ability to fund its healthcare system, import medicines, maintain drinking water and sanitation infrastructure, and ensure the food security of its population.
    These effects are not immediately apparent: They are cumulative and intensify over time. The study in The Lancet is particularly clear on this point: Sanctions lasting less than three years increase child mortality by 6 per cent; those lasting four to six years increase this number to 8.6 per cent, and those lasting more than seven years raise it to 10.5 per cent. The duration of sanctions is a creeping death sentence.³
    The comparison with armed conflicts is striking. The average of 564,000 deaths per year due to unilateral sanctions “is within the range that researchers have calculated for annual deaths related to armed conflicts.” In 2021, more than 800,000 people died as a direct result of the sanctions imposed by Washington and Brussels – roughly eight times the number of deaths from combat in all armed conflicts worldwide that same year. The Progressive International Organisation put it more precisely: This tally corresponds to a rate of 1,500 deaths per day, comparable with the siege of Leningrad by Nazi Germany.⁴ According to some estimates, Western sanctions have claimed at least as many lives in the 20-year period covered by the study as all armed conflicts and genocides worldwide combined.

First and foremost: Innocent and young victims

One of the most disturbing findings of the Lancet study concerns the identity of the victims. The official narrative portrays sanctions as targeted instruments aimed at ruling elites, authoritarian regimes, and criminal networks. The statistical reality paints a very different picture. Children under five account for 51 per cent of sanctions-related deaths. By extension, if one counts victims aged 15 and younger together with those aged 60 to 80, the figure rises to 77 per cent of sanctions-related deaths. It is the most vulnerable – those who have no influence over their governments’ political decisions – who pay the highest price.
    The impact on child mortality is precisely quantified: US sanctions are associated with a 9.3 per cent increase in neonatal mortality, a 9.1 per cent increase in under-1 mortality, and an 8.5 per cent increase in under-5 mortality. Behind these abstract percentages lie concrete and tragic realities: infants who do not receive the necessary vaccinations, children who die from infectious diseases because antibiotics are no longer available, mothers who give birth without adequate medical care. Another study, published by Stanford University in The Lancet Global Health in March 2025 and specifically addressing sanctions against development aid, estimates that if these measures last more than five years, they can wipe out up to 64 per cent of the progress made in reducing maternal mortality and up to 29 per cent of the progress made in reducing child mortality in low-income countries.⁵
    The most famous response to this fact remains that of Madeleine Albright, then US ambassador to the UN, when interviewed on CBS News’s “60 Minutes” in 1996. Interviewer Lesley Stahl pointed out that sanctions against Iraq had resulted in the deaths of half a million children under the age of five – more than those who perished in Hiroshima – and asked if this toll was worth the price. Albright’s reply: “I think it’s a very difficult decision, but yes, it’s worth the price.” Decades later, in 2020, she admitted to having made a “stupid remark,” adding that she had learned that “global sanctions often harm the population of the country without really achieving what is intended to be done to change the behaviour of the sanctioned country.”⁶

Africa, a favourite target

The Lancet study does not break down the findings by continent, but the available geographical data paints a clear picture. Relative to its population and level of development, Africa is the most heavily sanctioned continent in the world. Ten African countries are the subject of active sanctions programmes involving the United States, the European Union, and, in some cases, the United Nations. It is no coincidence that this list almost entirely coincides with the World Food Programme’s “hunger hotspots.”⁷
    The case of Zimbabwe is telling. Since 2001, US and EU sanctions have cost the country, by its own estimates, more than US$150 billion in frozen assets, cuts in aid, and blocked trade opportunities. The arms embargo imposed on the Central African Republic in 2013 deprived a state embroiled in civil war of the means to defend itself against external terrorist groups – an example of how perverse measures presented as protecting human rights can be.⁸
    Several African analysts and legal scholars have termed this phenomenon economic neo-colonialism: Unilateral sanctions are a tool used almost exclusively by the world’s richest countries against the poorest, exacerbating power imbalances inherited from the colonial era. A legal opinion issued by the African Bar Association puts it bluntly: “By violating the right of African states to equality and sovereignty, unilateral coercive measures exacerbate the power imbalance between the countries of the Global South and the Western powers, thus becoming an instrument of neocolonialism.”⁹

“Humanitarian exemptions” that do not work

In response to recurring criticism, the governments of the US and Europe invariably maintain that their sanctions include “humanitarian exemptions” for food, medicine, and emergency aid. In November 2022, a group of independent United Nations experts issued a strongly worded statement on the matter, describing these exceptions as “ineffective and inefficient.” The problems are systemic: The exemptions do not cover all sanctioning systems; humanitarian organisations and banks lack the expertise and resources to navigate labyrinthine legal systems; the fear of inadvertently violating sanctions drives financial institutions to paralysing overcompliance, and the deadlines for obtaining special licenses often exceed the timeframes for humanitarian emergencies.¹⁰
    The COVID-19 pandemic dramatically highlighted these shortcomings. In 2020, the Norwegian Refugee Council warned: “The current sanctions regimes restrict our ability to help people in need in many places.” When the Afghan economy collapsed following the Taliban’s return to power in 2021, humanitarian organisations found themselves unable to transfer funds into the country for fear of violating sanctions: Exemptions were granted late and only partially, with educational activities initially excluded. Exemptions exist on paper; in practice, however, they represent a bureaucratic labyrinth that only large organisations can navigate, and that sometimes, but not always.¹¹

A 69 per cent ineffective weapon

The main justification for sanctions is their supposed diplomatic effectiveness: They are meant to change the behaviour of targeted governments at a lower cost than war. This premise is seriously challenged by the data. The seminal study by Gary Hufbauer and his co-authors for the Peterson Institute for International Economics remains the academic reference in this area, and this concludes that sanctions are “successful” in about 34 per cent of cases – meaning they fail in the remaining two-thirds. The CEPR arrives at a comparable rate of 31 per cent. However, it must be noted that this definition of “success” is very vague: It includes any outcome where the sanctions “contributed substantially to the achievement, in whole or in part, of the foreign policy objective.”¹²
    In the cases receiving the most media coverage, the ratio of human cost to political outcome is particularly unfavourable. North Korea, for example, remains a nuclear-armed nation despite decades of sanctions. Cuba remains under communist rule despite a 60-year US embargo. Russia continues its war in Ukraine despite an unprecedented sanctions regime imposed since 2022. There are even cases wherein sanctions strengthen the target governments: Faced with an external threat, populations often rally behind their leaders, who can instrumentalise the sanctions to legitimise their cause and attribute their economic difficulties to an external enemy. This “rally-round-the-flag” dynamic has been documented in Russia, Iran, Cuba, and many African countries.¹³

A policy without a democratic mandate

At some point, the question of trust inevitably arises: Have the citizens of the US and Europe ever been consulted on sanctions policy? This governance issue is as crucial as the humanitarian record itself. However, the answer is unequivocal: They have not.
    In the United States, almost all sanctions are imposed by presidential executive order, without a vote in Congress and without any consultation with the public. The legal basis is usually the International Emergency Economic Powers Act of 1977, the IEEPA, which authorises the president to declare an “extraordinary national emergency” as soon as he determines an “unusual and extraordinary” threat that originates wholly or partly abroad. This definition is so vague that it can be applied to almost any crisis situation. In fact, “the power to impose sanctions has increasingly shifted to the executive branch over the past hundred years, so that the Office of Foreign Assets Control, the OFAC), [see box] can sanction thousands of entities annually, with remarkably limited legislative oversight.”¹⁴
    The increase in sanctions programmes illustrates this problematic development. The Biden administration imposed more sanctions than any previous president, doubling the number imposed by Trump (during his first term). In 2022, no fewer than 11,097 new entries were added to US lists in a single year, a historic record. In 2024, the OFAC Specially Designated Nationals list¹⁵ was expanded by an additional 3,135 entries, a 25 per cent increase over 2023. Globally, there are now more than 70,000 sanctioned individuals and organisations, a 370 per cent increase since 2017.¹⁶
    In this context, the question of the democratic legitimacy of these decisions is by no means theoretical. It points to a fundamental tension between two understandings of democracy. On the one hand, elected representatives grant the government a general mandate to conduct foreign policy. On the other hand, a policy that causes the deaths of more than half a million people in third countries every year – including hundreds of thousands of children – has a severity comparable with a declaration of war. Yet no electoral mandate, neither in the United States nor in Europe, has ever explicitly referred to the need to sanction this or that country. No presidential platform has offered voters a choice between sanctions and dialogue regarding Iran, Cuba, or Zimbabwe. No popular referendum has endorsed a policy the humanitarian consequences of which are, as we now know, comparable with those of war.
    The Brennan Center for Justice, a respected American legal institution, has pointed out that when Congress passed the IEEPA in 1977, it anticipated that these emergency powers would be used “rarely and briefly” – “not as a substitute for normal and ongoing problems.” Today, “national emergencies” that justify sanctions programmes are declared and extended indefinitely, often for decades, and the populations of either the sanctioned or the sanctioning countries are never consulted.
    On the European side, the mechanism is somewhat different but leads to the same result. EU sanctions are decided unanimously by the Council of Ministers, an unelected body composed of representatives of the member governments. The European Parliament, the only directly elected institution, has no formal right to co-decision on matters of the Common Foreign and Security Policy. Thus, European citizens have no more say than their American counterparts.

A weapon that must be reviewed or abolished

The Lancet study does not advocate the abolition of all forms of international pressure. However, it pointedly notes that United Nations sanctions, i.e., those decided by the UN Security Council, – the only ones subject to a multilateral consultation process involving the affected countries – have no statistically measurable effect on mortality. This observation suggests a line of reasoning: The legitimacy of the process by which sanctions are decided is not without influence on their humanitarian impact. Furthermore, unilateral sanctions imposed without discussion or agreement with the affected countries create resentment that leads populations to resist foreign interventions in the form of sanctions rather than turn against their leaders. These sanctions miss their mark, and they hurt those that are the most vulnerable.
    The authors of the study reach a clear conclusion: “It is difficult to imagine other government measures that have such devastating effects on human life and yet continue to be so widespread.” Mark Weisbrot, one of the co-authors, goes even further: “It is immoral and indefensible that such a deadly form of collective punishment continues to be used and has even been regularly expanded over the years.”¹⁷
    In this context, the concept of “collective punishment” is particularly noteworthy. International humanitarian law – in particular Article 33 of the Fourth Geneva Convention – explicitly prohibits collective punishment against “protected populations” for acts they did not commit. However, this prohibition formally applies to situations of military occupation and not to international economic policy, creating a significant legal loophole. The difference between bombing a hospital and disrupting the supply of medicines to an entire country is small from a moral point of view, even if it is clear from a legal one.¹⁸
    One might rightly ask whether, in 50 years, historians of international law will not treat massive economic sanctions in the same way we treat torture or the death penalty today – a practice long accepted by the official justice system, gradually exposed as ineffective and morally unacceptable through empirical research, and ultimately outlawed. The difference is that 50 more years of sanctions at the current rate would mean 28 million additional deaths. •

Main sources:
Rodriguez, Francisco; Rendon, Silvio; Weissbrot, Mark. “Effects of International Sanctions on Age-Specific Mortality: A Cross-National Panel Data Analysis,” in: The Lancet Global Health, Volume 13, July 2025, pp. 1358–1366; Hufbauer et al. “Economic Sanctions Reconsidered,” Peterson Institute for International Economics; Brennan Centre for Justice. “Reining in the President’s Sanctions Powers”, 2021; Gibson et al. “Foreign Aid Sanctions and Maternal and Child Mortality,” in: The Lancet Global Health, March 2025

1 Rodriguez, Francisco; Rendon, Silvio; Weissbrot, Mark. “Effects of International Sanctions on Age-Specific Mortality: A Cross-National Panel Data Analysis,” in: The Lancet Global Health, Volume 13, July 2025, pp. 1358–1366.
2 “Sanctions, on rise, are as deadly as armed conflict: Study,” In: Straits Times of 23 July 2025.
3 “Punishment of ‘innocent civilians’ through government sanctions must end: UN experts,” in UN News, 11 August 2021.
4 Progressive International is a global “movement of movements.” It unites political parties, trade unions, farmers’ movements, NGOs, and activist collectives – more than 70 member organisations – under an explicitly anti-capitalist, anti-imperialist, and ecological programme. Founded in 2020, primarily at the initiative of the Sanders Institute (US) and the European movement DiEM25 (Yanis Varoufakis’s organisation), it coordinates campaigns and produces analyses (the PI Briefings series). Source: Leier, Elizabeth. “Introducing Progressive International – a global left-wing solidarity movement,” in: Canadian Dimension of 24 September 2020.
5 Fonseca, Nathallia. “U.S. sanctions raise mortality to war-like levels, says study,” in Brasil de Fato, 25 July 2025. Duff-Brown, Beth; Hansen, Jamie. “Study finds foreign aid sanctions set back decades of progress on maternal and child mortality,” Stanford University of 19 March 2025.
6 “Madeleine Albright dies at 84; once defended U.S. sanctions despite deaths of 500K+ Iraqi children,” in: Democracy Now! of 24 March 2022; Rodriguez, Francisco; Rendon, Silvio; Weissbrot, Mark. “Effects of International Sanctions on Age-Specific Mortality: A Cross-National Panel Data Analysis,” in The Lancet Global Health, Vol. 13, July 2025, pp. 1358–1366.
7 Kwaku Afesorgbor, Sylvanus. “Economic sanctions need a rethink: evidence shows they raise food prices and hurt the poor most,” in Democracy in Africa, 26 September 2025; Ekanem, Solomon. “10 African countries with the most international sanctions,” in: Africa Business Insider of 26 June 2025.
8 “The impact of international sanctions in Africa: a look at the impact of restrictive measures,” in: Fatshimetrie of 30 November 2024.
9 Gordon, Joy. “The Brutal Impact of Sanctions on the Global South,” in Yale Journal of International Law, 28 June 2023; Douhan, Alena. “Mesures coercitives unilatérales: notion, types et qualification,” in: Nations Unies of 8 July 2021.
10 “Humanitarian exemptions in unilateral sanctions regimes ineffective and inefficient: UN experts,” Office of the High Commissioner for Human Rights, 23 November 2022; “Review sanction regimes to facilitate Covid-19 response,” Norwegian Refugee Council of 22 April 2020.
11 Arcuri, Hope. “IRC calls for global humanitarian sanctions exemption,” International Rescue Committee of 8 December 2022.
12 Hufbauer, Gary Clyde; Schott, Jeffrey J.; Elliott, Kimberly Ann; Oegg, Barbara. “Economic Sanctions: New Directions for the 21^st Century”, Peterson Institute for International Economics of 15 July 2008; Hufbauer, Gary Clyde; Schott, Jeffrey J.; Elliott, Kimberly Ann. “Economic Sanctions Reconsidered,” Peterson Institute for International Economics of June 2009; conclusions at: https://www.piie.com/publications/chapters_preview/4075/06iie4075.pdf
13 Grauvogel, Julia; von Soest, Christian. “Claims to legitimacy count: Why sanctions fail to instigate democratisation in authoritarian regimes,” in: European Journal of Political Research of November 2014.
14 Khadduri, Max. “Broad and Expansive Sanction Power: A Case for Curtailing Executive Authority,” in Brooklyn Law Review, 91, Issue 1, 2025; Boyle, Andrew. “Reining in the President’s Sanctions Powers”, Brennan Center for Justice at New York University School of Law of 4 August 2021.
15 Office Foreign Assets Control website. “About OFAC”: https://ofac.treasury.gov/about-ofac
16 Hume, Eleanor; Rutter, Kyle. “Sanctions by the Numbers: 2024 Year in Review,” Center for a New American Security, 11 March 2025; “Global sanctions trends: the GSI report,” London Stock Exchange Group of 16 May 2024; Vuksic, Spencer. “Year in Review: How Sanctions Changed in 2023 with 17 charts,” in: Castellum.AI of 1 January 2024.
17 Beeton, Dan. “New study estimates over half a million people die each year due to unilateral economic sanctions,” Centre for Economic and Policy Research of 23 July 2025.18
18 “Article 33 – Responsabilité individuelle. Peines collectives. Pillage. Représailles,” in: Bases de données de Droit international humanitaire of 12 August 1949; “Punishment of ‘innocent civilians’ through government sanctions must end: UN experts,” ibid.

(Translation Current Concerns)

* Jean-Guy Rens is an IT consultant (marketing, market research, industry profiles, etc.) in Canada and North Africa. He is the author of a history of telecommunications in Canada, published under the title “L’empire invisible” (The Invisible Empire). He is an expert in cybersecurity and fintech studies. Rens has just completed a book on digital sovereignty in Africa.