The British journal Lancet, one of the world’s most respected scientific publications, published a study in its 13th volume, in the August 2025 issue, that analyzed the impact of sanctions imposed by the United States, the European Union, and the United Nations (UN) on mortality rates in sanctioned countries. The study was conducted by Francisco Rodríguez, PhD in Economics from Harvard and a senior researcher at the Center for Economic and Policy Research (CEPR); Silvio Rendon, an economist, academic, and Deputy Executive Director of the Inter-American Development Bank; and Mark Wesibrot, Director of CEPR.
The researchers analyzed how different sanctions impacted mortality rates among children, adults, and the elderly in 152 countries between 1972 and 2021. The study used four parameters to isolate the impact of sanctions and identify whether the mortality rise was a reflection of the measures or the result of another phenomenon. It concluded that unilateral sanctions imposed by the United States are the most harmful, especially increasing the mortality of children aged five and under.
Seven age groups were analyzed: newborns, children under one year of age, children under five years of age, children under ten years of age, adolescents, adults, and the elderly. Except for adolescents, U.S. sanctions increased mortality in all other groups. Children under five were the most affected, with an estimated mortality rise of 9.3% for newborns, 9.1% for infants up to one year old, and 8.5% for children up to five years old.
The negative effects on the mortality rate are exacerbated by the duration of sanctions, leading to a progressive increase. Sanctions lasting up to three years increased child mortality by 6%, according to the study. For sanctions lasting four to six years, the increase was 8.6%. Sanctions lasting seven years or more increased mortality by 10.5%.
Researchers stress that “results showed a significant causal association between sanctions and increased mortality” and that “the strongest effects were for unilateral, economic, and U.S. sanctions.” No statistical evidence was found of worsening mortality rates due to UN sanctions.
For them, a “possible interpretation of this finding is that this difference results from the greater public scrutiny to which UN decisions, a deliberative body with the participation of the target countries [of the sanctions], are naturally subject.” Unilateral sanctions by the European Union were also not statistically significant in any age group analyzed.
“US sanctions, in contrast, often aim to create conditions conducive to regime change or changes in political behavior, with the deterioration of living conditions in target countries, which, in some cases, are recognized by policymakers as part of the intentional mechanism through which objectives are to be achieved,” the study points out.
U.S.-led unilateral sanctions result in 564,000 deaths annually, researchers estimate, equivalent to 3.6% of total deaths in sanctioned countries. The number is higher than that observed annually in armed conflicts and wars, estimated by the study at half a million deaths annually.
“Sanctions can lead to reductions in the quantity and quality of public health care, driven by declines in public revenues, and decreased availability of essential imports, resulting from sanctions-induced reductions in foreign currency revenues, which limit access to medical supplies, food, and other crucial goods, and restrict humanitarian organizations,” the researchers point out.
Sanctions use, however, is on the rise. Between 2010 and 2022, 25% of countries worldwide were targeted by some form of sanction imposed by the United States, the European Union, or the UN. In the 1960s, the rate was 8%.
Not everyone is at risk, however. As part of its methodology, the study analyzed which countries were sanctioned. Although they did not separate mortality data by nation, the researchers found that countries that vote against the United States and the European Union in the UN General Assembly are at greater risk of being punished – and, as a result, suffering more deaths.
Causality, not correlation
The study does not simply correlate U.S. sanctions on countries with an increase in mortality among the affected population. It establishes causality, that is, an analysis that, after ruling out other factors, helps to corroborate the increase in the number of deaths. Four elements are used for this purpose.
Entropy balancing – The researchers created groups of countries suffering or not suffering under sanctions with similar observable characteristics, such as the level of economic development. This is necessary because the mortality rate of a developed country cannot be directly compared with that of a developing or underdeveloped country. Comparing similar countries allows for an analysis of the impact of sanctions on the rise in deaths.
Event study representation – The study analyzed how mortality rates behaved before and after sanctions were imposed and whether there were other indicators, such as a rise in mortality rate before sanctions or other social conditions that influenced the issue. The gradual increase in mortality rates with the maintenance of sanctions supports this metric used in the study.
Granger Causality Test – It analyzes whether the cause came before the effect, and defines what each of these things is in the object studied. If mortality rates rise after sanctions are imposed (rather than sanctions being imposed after mortality rate growth), this points to a causal relationship in which the cause is the sanction and the effect is the increase in the number of deaths, and not the other way around.
Instrumental variables – This tool seeks to analyze something that influences the probability of a country being sanctioned, but which, by itself, does not affect the mortality rate in any way. The researchers analyzed that countries that vote less in line with the United States and the European Union in the UN General Assembly are more likely to receive sanctions. A country’s political position in the UN General Assembly does not affect its mortality rate, but receiving sanctions does. If sanctions were not the cause, all countries that vote against the United States and the European Union would experience increases in their mortality rates – which only happens to those that also receive sanctions.
