US Economic Sanctions and Their Human Cost

Methodology

Lancet Global Health (2025)

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Data Sources

Sanctions regimes compiled from the Global Sanctions Database (GSDB, Drexel University), Congressional Research Service reports, and academic literature.

The landmark study by Rodriguez, Rendon & Weisbrot in Lancet Global Health (2025) provides the first cross-national causal estimates of sanctions mortality. Their replication data is available at Harvard Dataverse.

Death Toll Estimates

The Lancet study estimates 564,258 deaths per year (95% CI: 367,838-760,677) from unilateral sanctions globally. This is similar in magnitude to the annual death toll of all armed conflicts worldwide. Children under 5 account for 51% of deaths.

This is a global aggregate estimate, not broken down by country. Country-level mortality estimates exist only for a handful of regimes:

• Iraq (1990-2003): Garfield (1999): 227K-350K excess child deaths; UNICEF: 500K (contested by later surveys)
• Venezuela (2017-2018): Weisbrot & Sachs, CEPR (2019): 40K+ excess deaths
• Haiti (1991-1994): Gibbons & Garfield (1999): ~20K excess child deaths
• North Korea (1990s): 500K-2.5M famine deaths (sanctions a contributing but not primary cause)
• Afghanistan (2021+): 13K+ newborn deaths; WHO warned 1M children at risk

For most sanctioned countries, the humanitarian impact is documented qualitatively but not quantified as excess deaths. The gap between the Lancet aggregate (~28M cumulative, 1971-2021) and the sum of country-level estimates (~750K-3M) reflects this measurement deficit, not an absence of harm.

Presidential Attribution

Sanctions count is attributed to the president who imposed them. Death toll is distributed evenly across the years of each sanctions regime and attributed to the sitting president. This is the least subjective approach given the absence of year-by-year mortality data for most sanctioned countries.

A president who maintains sanctions initiated by a predecessor is attributed deaths that occur during their term.

Key Finding

The Lancet study found that US unilateral sanctions drive the mortality effect. EU unilateral sanctions showed no significant effect. UN multilateral sanctions showed no significant effect. The strongest effects were on children under 5 and adults aged 60-80.

Limitations

• Attributing deaths specifically to sanctions (vs. other factors like conflict, misgovernment, or pre-existing poverty) is methodologically challenging.
• The Lancet global estimate is contested; one author has affiliations with Venezuelan advocacy organizations.
• Country-level estimates for Iraq (UNICEF 500K figure) have been challenged by later surveys.
• North Korea's famine was primarily caused by economic mismanagement, not sanctions alone.