Sanctions are sold as a peaceful alternative to war, but their effects often fall hardest on civilians – through poverty, shortages, damaged health systems and preventable deaths.
Sanctions largely attack a civilian population in the knowledge that it will kill and maim many of them in the hope that they will change their government. The young, sick and aged are particularly vulnerable.
Madeleine Albright, the US ambassador to the UN, when asked in 1996 about the then widely reported claim that 500,000 Iraqi children had died under sanctions, replied, “we think the price is worth it”. She later qualified that comment. But it was hardly a slip of the tongue!
Research published in Lancet Global Health (LGH), August 2025, has given us a disturbing outline of the damaging consequences of sanctions, particularly unilateral, economic and US sanctions.
Woodrow Wilson referred to sanctions as “something more tremendous than war”. According to the researchers, “our evidence suggests that he was right. Over the past decade we estimate that unilateral sanctions were associated with 564,000 additional deaths a year. It is hard to think of other policy interventions with such adverse effects on human life that continue to be pervasively used.”
Recently, US Treasury Secretary Scott Bessent announced a sustained economic campaign to cripple Iran. “Let there be no ambiguity as to the position of the United States. An economic engagement of any kind with this murderous regime will expose those responsible to the full reach of American power … our objective is to sever every economic lifeline that sustains this tyrannical regime until Tehran stands alone. It is now a time for world leaders to decide between prosperity and isolation, peace and terror, America and Iran.” There was going to be an economic D-Day for Iran.
There is plenty of evidence in the way that the US uses sanctions. A State Department memo written in April 1960 noted that Fidel Castro and the revolution, more broadly, enjoyed widespread popularity in Cuba. It argued that “every possible means should be undertaken promptly to weaken the economic life of Cuba by denying money and supplies to Cuba to decrease monetary and real wages, to bring about hunger, desperation and overthrow of government”.
Jeffrey Sachs, who co-authored a prominent Centre for Economic and Policy Research report in 2019 with Mark Weisbrot, highlighted that the multi-decade embargo against Cuba has had a deeply pernicious and cumulative effect on the island’s economic development. He described the attitude of the United States to Cuba as “pure imperialism”. Cuba’s health system, one of the most respected in the developing world, has been severely constrained by the inability to import medicines, medical equipment, spare parts for hospital machinery and raw materials for pharmaceutical production. When I was the CEO at Qantas, we arranged for medical supplies to be sent to Cuba through an indirect route.
Jeffrey Sachs also estimated that US sanctions contributed to more than 40,000 deaths in Venezuela between 2017 and 2018 by depriving the population of food, medicine and medical equipment.
At a September 1970 meeting at the White House, US President Richard Nixon explained the US response to Salvador Allende winning power in 1970 in Chile. Nixon explained the objective was “to make Chile’s economy scream”. This paved the way for the US-backed coup that installed the right-wing dictatorship of Augusto Pinochet.
Australia supported a range of sanctions against Iraq beginning in 1990. Estimates of deaths from sanctions ran into the hundreds of thousands, although the scale remains contested. Whatever the final figure, Madeleine Albright nevertheless replied that the price was worth it.
Dennis Halliday, the UN humanitarian coordinator for Iraq who resigned in 1998 in protest over the sanctions, described them as “a deliberate policy to destroy the people of Iraq”.
The United States has maintained some form of sanctions against Iran since the 1979 hostage crisis, although the scope and intensity of the sanctions have changed over time. Iran refused to do what the US told it! Decades of US sanctions have helped devastate the Iranian currency, throwing many Iranians into poverty and severely impairing access to food, housing and water. The sanctions on banking, the financial system and shipments of supplies have led to scarcity of life-saving medicines. The impact of the sanctions has been immense on the lives of the poor, patients, women and children. Jeffrey Sachs is in no doubt that the sanctions were designed for regime change and the installation of a pliant government. Trump called for the Iranian people to revolt against their regime. Reza Pahlavi, the exiled son of the last shah of Iran who was overthrown in the 1979 revolution, paraded himself as the new leader of Iran. But even Trump had his doubts about Reza Pahlavi!
One feature of sanctions is the inconsistent way in which sanctions have been applied.
Australia’s most active current sanctions are directed at Russia following the invasion of Ukraine. We have imposed travel bans, an asset freeze on hundreds of Russian individuals and entities, restricted trade in goods and participated in the international oil price cap mechanism, although under Australian sanctions law Russian crude substantially transformed in a refinery in Brunei is no longer treated as Russian-origin oil.
But contrast the selectivity with which we address the Israeli genocide in Gaza. Despite the widespread deaths, Australia has not imposed trade or arms sanctions on Israel, nor sanctions on Israeli leaders such as Benjamin Netanyahu or Yoav Gallant, who are under ICC arrest warrants. Pressured by the Zionist lobby, ministers will never use the word “genocide”.
China also makes extensive use of sanctions and economic coercion. In recent years it has built a formal counter-sanctions framework in response to Western measures targeting Xinjiang-related entities, technology companies and military contractors. But Chinese economic pressure has also been used in wider political disputes with countries including Australia, Lithuania, Norway and South Korea. Its legal architecture differs from Western-style sanctions regimes in being framed primarily around countering foreign sanctions, interference and threats to Chinese sovereignty and security, rather than the human rights and democracy promotion principles formally invoked by Western governments.
The US intent is that sanctions will change the behaviour of governments that are not doing what they are told. It cannot be stated like this because if it were stated plainly, the humanitarian and political justification for sanctions would collapse. Sanctions are designed to attack a civilian population in the knowledge that it will kill or maim many in the hope that they will change their government.
John Menadue is the Founder of Pearls and Irritations and a board member. He was formerly the Editor-in-Chief. John was the Secretary of the Department of Prime Minister and Cabinet under Gough Whitlam and Malcolm Fraser, Ambassador to Japan, Secretary of the Department of Immigration and CEO of Qantas.