Economic sanctions have become the defining coercive instrument of American foreign policy. Currently, roughly 27% of the world’s countries are under sanctions imposed by the United States, the European Union, or the United Nations—up from just 4% in the early 1960s. A landmark 2025 study published in The Lancet Global Health by economists Francisco Rodríguez, Silvio Rendón, and Mark Weisbrot has put a number on the cumulative death toll of these measures.
Unilateral sanctions kill approximately 564,000 people per year, a figure comparable to the total annual mortality burden of armed conflict. Over the 1971 to 2021 period, the aggregate implied toll approaches thirty-eight million deaths. Children under five constitute 51% of sanctions-related deaths.
These findings do not emerge in isolation. Decades of country-level studies on Iraq, Cuba, Iran, Venezuela, Syria, North Korea, and Afghanistan converge on the same conclusion. Broad economic sanctions that sever national economies from global trade and financial systems are instruments of mass civilian harm. They restrict food imports, destroy pharmaceutical supply chains, collapse public health infrastructure, and trap entire populations inside economic catastrophe engineered from abroad.
The modern sanctions system was born at the Paris Peace Conference of 1919 from the experience of the Allied naval blockade of the Central Powers during World War I. That blockade contributed to an estimated 478,500 to 800,000 deaths from malnutrition and disease among German civilians—though historians note that domestic policy failures and other factors also contributed to the toll.
President Woodrow Wilson articulated the logic of translating wartime blockade into a peacetime instrument. His description remains the most honest characterization of what economic sanctions actually are.
Speaking in 1919 to audiences during his League of Nations tour, Wilson described sanctions as “something more tremendous than war”:
“…[an] absolute isolation…that brings a nation to its senses just as suffocation removes from the individual all inclinations to fight…Apply this economic, peaceful, silent, deadly remedy and there will be no need for force. It is a terrible remedy. It does not cost a life outside of the nation boycotted, but it brings a pressure upon that nation which, in my judgment, no modern nation could resist.”
As historian Nicholas Mulder documents in his 2022 book The Economic Weapon, in the League of Nations’ early years the mechanism was called literally “the economic weapon.” Wilson’s characterization of “peaceful, silent, deadly” acknowledged the instrument’s lethal nature while claiming it spared lives. History has repeatedly demonstrated the first claim was true and the second false.
The most comprehensive quantitative reckoning with sanctions mortality to date was published in August 2025 in The Lancet Global Health. The study analyzed age-specific mortality rates and sanctions episodes for 152 countries between 1971 and 2021.
The core findings are devastating. Unilateral sanctions are associated with an annual toll of 564,258 excess deaths, per the study’s own figures as summarized by CEPR. Children under five constitute 51% of total sanctions-related deaths. 71% of deaths fall in the 0 to 15 and 60 to 80 age groups, confirming that sanctions primarily harm those outside the labor force rather than government elites. The study finds “no statistical evidence of an effect for UN sanctions.”
Mark Weisbrot, CEPR co-director and co-author, stated plainly what the findings mean:
“It is immoral and indefensible that such a lethal form of collective punishment continues to be used, let alone that it has been steadily expanded over the years. Sanctions are widely misunderstood as being a less lethal, almost nonviolent policy alternative to military force.”
The Lancet study’s own cumulative mortality estimates imply that unilateral sanctions imposed by the United States and European Union caused approximately 38 million deaths between 1971 and 2021.
No episode of sanctions-induced humanitarian catastrophe has been more extensively studied than the comprehensive United Nations-imposed sanctions on Iraq from 1990 to 2003. Columbia University public health researcher Richard Garfield estimated a minimum of 100,000 excess deaths among children under five from August 1991 through March 1998, with a more likely estimate of 227,000.
Other assessments have placed the toll considerably higher. The Geneva International Centre for Justice documented estimates that “the number of people who lost their lives because of the sanctions range up to 1.5 million people, including more than 500,000 children. The World Health Organisation concluded that the health system had been set back by some 50 years.”
The 2019 CEPR paper Economic Sanctions as Collective Punishment by Mark Weisbrot and Jeffrey Sachs found a 31% increase in general mortality from 2017 to 2018, implying more than 40,000 excess deaths. Jeffrey Sachs stated the case bluntly:
“American sanctions are deliberately aiming to wreck Venezuela’s economy and thereby lead to regime change. It’s a fruitless, heartless, illegal, and failed policy, causing grave harm to the Venezuelan people.”
Tricontinental Institute calculated that U.S.-led sanctions caused Venezuela to lose oil revenue equivalent to 213% of its GDP between January 2017 and December 2024, totaling an estimated $226 billion in losses.
Venezuelan economist Francisco Rodríguez’s 2024 working paper found that Venezuela’s per capita income declined by 71% between 2012 and 2020, the largest peacetime economic contraction in modern history. He attributed approximately 52% of the GDP decline to sanctions and other politically induced causes. Rodríguez has explicitly described comprehensive sanctions as “siege warfare.” In a University of Denver profile, he noted that the average GDP decline from comprehensive multilateral sanctions is equivalent to the United States’ Great Depression decline. According to Rodríguez’s CEPR survey, 54 countries representing 27% of all nations were under some form of sanctions at the time of writing. In 2024, the Treasury Department added 3,135 persons to the Specially Designated Nationals List, a 25% increase from 2023, according to the Center for a New American Security.
Alfred de Zayas, who served as UN Independent Expert on the Promotion of a Democratic and Equitable International Order, conducted the first UN rapporteur visit to Venezuela in twenty-one years. His August 2018 report to the Human Rights Council stated that “sanctions can amount to crimes against humanity under Article 7 of the Rome Statute.” He concluded simply that “Economic sanctions kill.” Trita Parsi, co-founder and Executive Vice President of the Quincy Institute for Responsible Statecraft, noted that one-third of Iran’s middle class fell into poverty between 2018 and 2019 as a result of Trump’s maximum pressure sanctions and Iranian government mismanagement.
Senator Rand Paul (R-KY) argues that U.S. actions against Venezuela—including the military operation to capture Nicolás Maduro, the naval blockade, and seizure of oil tankers—constitute an “ongoing war.” As he stated on Meet the Press in January 2026: “That is an act of war, it’s an ongoing war, to continue to take their oil, ongoing war, to distribute it.” Joy Gordon, who holds the Ignacio Ellacuría Chair in Social Ethics at Loyola University-Chicago, produced the most comprehensive analysis of the Iraq sanctions in her book Invisible War (Harvard University Press, 2010). In her 2020 essay for Responsible Statecraft, Gordon argued that the Iraq sanctions “are the template for the systemic, devastating sanctions we see in place today.”
All in all, economic sanctions, particularly comprehensive unilateral sanctions imposed by the United States, are instruments of mass civilian harm that function through the logic of siege warfare. They fail in many documented cases to achieve regime change or major behavioral changes, while succeeding fully at the harm.
