Hardly any figure shapes the sanctions debate as strongly as this one: more than half a million people die every year from their consequences. It comes from a peer-reviewed study. Another study reaches the opposite result on one important question, and the case of Iraq shows how easily death tolls can be bent. This review puts both camps side by side.
What is being measured
No one can attribute a death directly to a sanction. Research therefore compares many countries over many years: how do mortality or life expectancy develop in countries under sanctions, compared with similar countries without sanctions and with the years before? The result is an estimate, not a count. It depends on which countries and years are included, how a sanction is counted and which other influences, such as war, oil prices or governance, are controlled for. All the authors discussed here state this caveat themselves.
The 2025 study: over half a million a year
In August 2025 Francisco Rodríguez, Silvio Rendón and Mark Weisbrot analysed data from 152 countries from 1971 to 2021 in The Lancet Global Health (volume 13, issue 8, pages e1358 to e1366). For unilateral sanctions they estimate an average of 564,258 additional deaths a year for 2012 to 2021; the 95 percent confidence interval runs from 367,838 to 760,677. Children under five are hit hardest according to their results: they account for 51 percent of the attributed deaths (we took this breakdown, the period 2012 to 2021 and the 0 of 14 estimates from the full text; they are not in the abstract); people aged 60 to 80 are also affected. They find the strongest associations for unilateral, economic and US sanctions.
For UN sanctions none of the 14 estimates is statistically significant, and six even have a negative sign. The authors stress that their data cannot rule out meaningful harm from UN sanctions. They name the limitations themselves: the data are observational; unobserved factors may bias the estimate; the methods rest on assumptions that cannot be proven; countries may react before sanctions take effect; and earlier sanctions do not necessarily resemble today’s.
Funding and declarations belong to the picture. The study was funded by the Center for Economic and Policy Research in Washington, which according to the authors had no direct role in writing or submission. One author declares work as an expert witness in Venezuela litigation. That does not make the study wrong, but readers should know it.
Objection came in the same journal. Reza Majdzadeh of the University of Essex wrote in a 2026 letter that life expectancy in Iran shows no clear break in step with sanctions despite long exposure. He considers life expectancy a late signal and advises watching earlier indicators, such as whether medicines are available and treatment can continue. His objection targets large, immediate national effects, not the assumption that sanctions harm health.
The 2019 study: UN sanctions hit hardest
Jerg Gutmann, Matthias Neuenkirch and Florian Neumeier studied 98 developing and emerging countries from 1977 to 2012, published in December 2019 as CESifo Working Paper 8033 and in 2021 in the Journal of Development Studies (volume 57, pages 139 to 162). Their result: an average episode of UN sanctions is associated with 1.2 to 1.4 years less life expectancy, an episode of US sanctions with 0.4 to 0.5 years. Women are more affected than men; sanctions are not “gender-blind”.
Gutmann, Neuenkirch, Neumeier: 98 countries, 1977 to 2012. Bars: range of estimates in years.
| Sender | Loss of life expectancy |
|---|---|
| UN sanctions | 1.2 to 1.4 years |
| US sanctions | 0.4 to 0.5 years |
Source: CESifo Working Paper 8033, December 2019, abstract; accessed 3 Nov 2026.
The contradiction, stated openly
The two large studies contradict each other on a point central to the political debate. The Lancet study finds no significant effect of UN sanctions on mortality, the CESifo study finds the largest loss of life expectancy for UN sanctions. Possible reasons are obvious: different outcomes, periods, countries and methods. Which reason is decisive cannot be settled from the publications. Anyone arguing with one study should mention the other. That applies to critics who present UN sanctions as less harmful as much as to supporters who consider unilateral sanctions better targeted.
| Study | Data | Finding | Limitations as stated | Funding, declarations |
|---|---|---|---|---|
| Rodríguez, Rendón, Weisbrot, Lancet Global Health 2025 | 152 countries, 1971 to 2021, age-specific mortality | unilateral sanctions: about 564,000 additional deaths a year (2012 to 2021); UN sanctions: no significant effect | observational data, possible unobserved confounders, assumptions of the estimators, anticipation before entry into force | funded by the Center for Economic and Policy Research; one author declares expert-witness work in Venezuela litigation |
| Gutmann, Neuenkirch, Neumeier, CESifo 2019, J. Dev. Studies 2021 | 98 countries, 1977 to 2012, life expectancy | UN sanctions: 1.2 to 1.4 years less; US sanctions: 0.4 to 0.5 years; women more affected | earlier period, different outcome | Universities of Hamburg and Trier, ifo Institute |
| Dyson, Cetorelli, BMJ Global Health 2017 | all surveys of child mortality in Iraq from 2003 | the 1999 survey showed a rise that largely did not happen; data rigged in the authors’ assessment | retrospective on surveys, no model of sanctions effects | London School of Economics |
Compiled by Helfen statt Blockieren from the studies and publisher records, accessed 3 Nov 2026.
The lesson from Iraq
For Iraq in the 1990s one figure was long considered established. A 1999 survey reported that mortality among children under five had risen from 56 per 1,000 births (1984 to 1989) to 131 per 1,000 (1994 to 1999). The head of UNICEF concluded that without the rise there would have been about 500,000 fewer child deaths from 1991 to 1998. The figure was quoted worldwide.
In 2017 Tim Dyson and Valeria Cetorelli of the London School of Economics analysed all later surveys. They show child mortality of about 40 per 1,000 for 1995 to 2000 and no exceptional rise after 1990, at most a slight one around 1991. Dyson called the 1999 results for central and southern Iraq “a deception”; the authors consider the data rigged, possibly under pressure from a government that wanted sanctions to end. In 2025 political scientist Maria J. Debre described the case as an example of how governments steer the narrative on sanctions.
It does not follow that the sanctions on Iraq were harmless. It follows that a figure is only as good as the data beneath it, and that governments under sanctions can have an interest in high figures, just as sanctioning states can have an interest in low ones.
And Cuba?
No figure for Cuba can be read from these studies; they average over many countries. It is documented that medicines are scarce in Cuba: according to Human Rights Watch, the health minister said in 2025 that only 30 percent of essential medicines were available. There are two documented explanations for the shortage: the US embargo, which makes purchasing, payment and transport harder, and decisions of the Cuban leadership, under which Prisoners Defenders counted 1,351 political prisoners in September 2026. Both halves are covered in “Cuba: human rights and political prisoners” and in the topic sheet Medicine.
The economic costs of sanctions for countries of the Global South are covered in “Costs in the Global South”; whether sanctions achieve their political aims is discussed in “Do sanctions work?”.
This article is information, not legal advice. It relies on the sources listed; where experts disagree, it names the positions and who holds them. “Helfen statt Blockieren” is non-partisan.
Sources
- Rodríguez F, Rendón S, Weisbrot M: Effects of international sanctions on age-specific mortality: a cross-national panel data analysis. Lancet Glob Health 2025; 13(8): e1358-e1366, doi 10.1016/S2214-109X(25)00189-5 (Crossref), https://doi.org/10.1016/S2214-109X(25)00189-5
- Center for Economic and Policy Research: Effects of International Sanctions on Age-Specific Mortality (text, funding and declarations), https://cepr.net/publications/effects-of-international-sanctions-on-age-specific-mortality/
- Majdzadeh R: Life expectancy is a late signal of sanctions-related harm. Lancet Glob Health 2026, correspondence, doi 10.1016/j.langlo.2026.104046 (manuscript, University of Essex repository), https://repository.essex.ac.uk/43738/1/Sanctions%20and%20Life%20expectancy.pdf
- Gutmann J, Neuenkirch M, Neumeier F: Sanctioned to Death? The Impact of Economic Sanctions on Life Expectancy and its Gender Gap. CESifo Working Paper 8033, December 2019, https://www.cesifo.org/DocDL/cesifo1_wp8033.pdf
- Gutmann, Neuenkirch, Neumeier: same title, Journal of Development Studies 57 (2021) 139-162, doi 10.1080/00220388.2020.1746277, https://doi.org/10.1080/00220388.2020.1746277
- Dyson T, Cetorelli V: Changing views on child mortality and economic sanctions in Iraq: a history of lies, damned lies and statistics. BMJ Global Health 2017; 2(2): e000311, https://doi.org/10.1136/bmjgh-2017-000311
- London School of Economics: Iraqi government misreported child mortality, LSE research finds, 25.7.2017, https://www.lse.ac.uk/news/latest-news-from-lse/iraqi-government-misreported-child-mortality-lse-research-finds
- Maria J. Debre: Alternative zum Krieg, Aus Politik und Zeitgeschichte „Sanktionen“, bpb, 14.2.2025, https://www.bpb.de/shop/zeitschriften/apuz/sanktionen-2025/559418/alternative-zum-krieg/
- Human Rights Watch: World Report 2026, Cuba, 12.1.2026, https://www.hrw.org/world-report/2026/country-chapters/cuba
- Prisoners Defenders: Presos políticos en Cuba, septiembre 2026, 15.10.2026, https://www.prisonersdefenders.org/2026/10/15/presos-politicos-cuba-septiembre-2026/
All online sources accessed on 3 November 2026.