The invisible war: U.S. sanctions cause more deaths than armed conflict

The main finding of the new research published by The Lancet is brief but significant: sanctions are often lethal.

The review found that unilateral sanctions, particularly those imposed by the United States, can be as deadly as war. Since the 1970s, over 500,000 people have died annually due to sanctions, with children and the elderly being the primary victims.

Rising use of economic sanctions

International sanctions are restrictions on international trade used by some countries to achieve foreign policy objectives.

The growing use of sanctions over time is notable. The share of the global economy affected by unilateral sanctions has increased from 5.4% in the 1960s to 24.7% during 2010–2022.

The impact of sanctions on public health and mortality in target countries is one of the most controversial topics in contemporary economic policy discussions.

In the 1990s, political debates highlighted that sanctions can reduce both the quantity and quality of public health services, limit access to essential imports (like medical equipment and food) due to restricted foreign currency revenue, and constrain humanitarian organizations through actual or perceived obstacles to effective operations.

This concern led to initiatives addressing the humanitarian impact of sanctions, yet the use of economic sanctions has significantly increased in recent decades.

According to the Global Sanctions Database (GSDB), 25% of all countries from 2010 to 2022 were under some form of U.S., EU, or UN sanction, compared to an average of 8% in the 1960s. This rise reflects sanctions claimed to end wars or promote human rights.

Impact of sanctions on mortality in target countries

The study analyzed the effects of sanctions on age-specific mortality in target countries. Using age-related mortality data and sanction periods for 152 countries from 1971 to 2021, the researchers concluded that from 2010 to 2021, unilateral sanctions were associated with 564,258 deaths annually.

This estimate represents 3.6% of all observed deaths in sanctioned countries—higher than the average annual war-related deaths during the same period (106,000 per year) and comparable to some estimates of total war casualties, including civilian deaths (~500,000 per year).

The research examined “sanctions-related mortality across all age groups over time.” Unilateral economic sanctions were significantly linked to increased mortality in at least six of seven age groups, with children under five accounting for 51% of total sanctions-related deaths from 1970–2021. Overall, 77% of deaths occurred in the 0–15 and 60–80 age groups.

The report highlights the U.S. government as the primary offender. Unilateral sanctions, especially those imposed by the U.S., caused disproportionate increases in mortality, particularly affecting children under five.

The findings demonstrate a causal link between sanctions and increased deaths, with the strongest effects from U.S. unilateral economic sanctions.

The authors concluded that sanctions have serious negative effects on public health, comparable to war.

Former U.S. President Woodrow Wilson called sanctions “bigger than war,” and evidence now confirms that statement. Over the past decade, unilateral sanctions are estimated to have caused roughly 560,000 deaths per year worldwide.

Few policy interventions with such widespread harmful effects on human life continue to be widely used.

The U.S.: Main actor in sanctions

Economic sanctions are more dangerous and deadly than cyberattacks, misinformation campaigns, or mild economic pressures. As part of America’s hybrid warfare strategy, they serve as a form of aggression, intended to destabilize or weaken independent countries.

Sanctions emerged alongside decolonization and the determination of the U.S. and other industrialized nations to maintain control over newly independent and poorer countries. They facilitate imperialist objectives.

According to Peoplesworld, legal researcher Joy Gordon notes that sanctions are tools of wealthy and powerful countries, used almost exclusively against target nations. After World War II, the U.S. held near-exclusive power to use sanctions aggressively to achieve its goals.

Mark Weisbrot, co-author of the Lancet report, stated in a separate article that sanctions are becoming the U.S.’s weapon of choice, not because they are less destructive than military action, but because their human cost is less visible. He even suggests sanctions and war may be morally equivalent.

U.S. officials, media, and activists often ignore or remain blind to excessive deaths caused by sanctions.

Weisbrot writes that when the full scale of economic violence from widespread sanctions becomes apparent, they will be politically indefensible. Yet he frustratingly remains silent on the deadly 63-year U.S. economic blockade of Cuba.

For American power brokers, there is always a justification for unilateral sanctions. Madeleine Albright, U.S. Secretary of State in 1996, defended sanctions against Iraq, saying: “It’s worth it.”

The reality: U.S. sanctions in Iraq killed 500,000 children.