It is widely recognised that wars and conflicts are major drivers of civilian deaths. It is estimated that during 2012–21, armed conflict caused roughly half a million deaths annually, most of them civilians. Yet an equally serious reality has received far less attention: economic sanctions may be claiming a similar number of lives each year, despite being imposed ostensibly in the name of peace, security or moral pressure.
A recent study published in The Lancet Global Health—“Effects of international sanctions on age-specific mortality: a cross-national panel data analysis”—authored by Prof. Francisco Rodrigues, Dr. Silvio Rendon and Dr. Mark Weisbrot, concludes that unilateral sanctions imposed during this decade caused an estimated 564,000 excess deaths annually. That figure could be higher if all forms of sanctions are included.
The most vulnerable carry the greatest burden. According to the study, nearly half these deaths are likely to be children below the age of five, followed closely by the elderly. When the researchers extended their analysis into earlier decades, the pattern intensified: sanctions repeatedly generated lethal deprivation, especially in younger age groups.
While the United Nations has also imposed sanctions, its measures have generally been designed to minimise civilian harm, though not always successfully. The highest mortality is associated with sanctions imposed unilaterally, primarily by the United States and, to a lesser degree, European governments. The study notes that these sanctions “aim to create conditions conducive to regime change or shifts in political behavior,” and that policymakers are often aware that deterioration in living conditions may be part of this strategy.
The reach of sanctions has widened dramatically. In the 1960s, only about 8% of countries were subject to sanctions. By 2012–21, that proportion had tripled to 25%. With this expansion has come escalating humanitarian damage, amplified by the dominance of the dollar and euro in global banking systems and the extraterritorial reach of U.S. sanctions.
Woodrow Wilson once argued that sanctions were “more tremendous than war.” The Lancet study makes a persuasive case that economic coercion, when used broadly and without guardrails, has become a policy instrument with wartime consequences.
The toll of sanctions is visible today in widespread shortages—food, electricity, medicine, fuel—alongside collapsing public services, inflation, unemployment and social breakdown. Depending on local vulnerabilities, sanctions can paralyse supply chains, empty hospitals and schools, gut livelihoods and destabilise entire societies.
If several hundred thousand deaths a year are caused by sanctions—many of them children—the ethical implications are stark. How can governments justify the pursuit of geopolitical objectives through instruments that predictably cost so many civilian lives?
Nor have sanctions replaced war. The post-9/11 “War on Terror” shows what happens when both tools are deployed simultaneously. The Costs of War Project at Brown University estimates about 920,000 direct conflict deaths in Afghanistan, Pakistan, Iraq, Syria and Yemen due to U.S.-led military actions. But its researchers have long warned that indirect deaths—from hunger, disrupted healthcare, water contamination and infrastructure collapse—would be many times higher.
Their later study, “How Death Outlives War: The Reverberating Impact of the Post-9/11 Wars on Human Health,” estimates indirect deaths at 3.6–3.7 million. Combined with direct deaths, total mortality could reach 4.5–4.6 million—five times the immediate battlefield toll. And counting continues, particularly among children facing malnutrition, disease and displacement.
The study highlights how crises do not end when the bombing stops. In Iraq, high rates of child disabilities and chronic disease linked to war-era contamination remain disputed but deeply feared. In Somalia, counter-terror laws reportedly delayed aid during famine conditions, worsening hunger and mortality. Libya and Yemen show similarly prolonged harm.
In many cases—including Iraq—the same populations that endured war also suffered under sweeping sanctions. Entirely avoidable deaths of civilians, including infants, are difficult to see as anything other than violations of basic justice. The argument for reparations—from states that imposed wars and sanctions—to people who lost lives, health and livelihoods is morally compelling.
There is also an urgent need to study combined impacts: deaths caused through overlapping pathways of invasion, bombing, proxy warfare, blockades, economic strangulation and financial isolation. The number of people affected is enormous. Today, nearly 239 million people face severe humanitarian crises, overwhelmingly in nations scarred by sanctions and armed conflict.
The world’s richest states continue to impose sanctions more frequently, more broadly and with fewer constraints, even as wars and proxy conflicts grind on. The result is a global system where policy decisions taken in distant capitals can trigger hunger, illness and death on a mass scale.
A world truly committed to peace must scrutinise—not normalise—the silent mass casualties caused by economic coercion. If sanctions are killing as many people as war, then the international system requires urgent reform: to restrain their use, protect civilians and hold powerful actors accountable.
Above all, it demands a shift in moral calculus—from strategic advantage to human survival. The priority should be reducing suffering, not adding to it.
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The writer is Honorary Convener, Campaign to Save Earth Now. His recent books include Planet in Peril, Protecting Earth for Children, Earth Without Borders, Man Over Machine and A Day in 2071
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