Tehran – In early 2023, nurses in the pediatric ward in Caracas explained how a 9-year-old leukemia patient wasted. His chemotherapy drugs had disappeared from hospital shelves, but his family had no money or visa to seek treatment abroad. Black market alternatives were unsafe or affordable.
No missiles were fired. The soldiers did not invade. However, in the quiet devastation of everyday life under economic siege, the child was lost.
From Havana to Hartzm, from Tehran to Damascus, these stories are not outliers. They are symptoms of global practices that hide behind technocratic language, but harm brutal efficiency, or sanctions. When sold as a humanitarian alternative to war, sanctions became a weapon of mass confusion. They collapse currency, block medicines, thwart infrastructure, and deepen poverty. Although perhaps “smart” and “targeted”, they often made the sick, young and poor the most difficult.
In Iran, US financial sanctions have made it virtually impossible to import life-saving drugs, even when humanitarian exemptions are present on paper. The fear of bank restrictions and violating OFAC guidelines has led to widespread overconsolidation by businesses around the world. Pharmacies are running out of insulin and chemotherapy drugs. The dialysis machine disassembles without spare parts. A 2019 report by Human Rights Watch found that Iranian cancer and rare disease patients suffered from worsening consequences due to limited access to essential medicine. Meanwhile, the Iranian Rial has lost more than 80% of its value since 2018, exacerbating poverty and inflation.
In Venezuela, a 2021 report by the UN Special Rapporteur on One-Side Enforcement Measures points out that sanctions have exacerbated food insecurity, disrupt the health system and contributed to massive migration. The country’s public revenue losses are estimated to be over $17 billion a year since 2017. In Zimbabwe, 20 years of sanctions have exacerbated the decline of the economy and capital flight without any meaningful political reforms. The 2022 African Union Report called for the lifting of sanctions and labeled them as obstacles to sustainable development.
Despite the claims of “humanitarian sculpture,” in practice, sanctions regimes often suffocate the supply chain. Humanitarian actors, banks and insurance companies fearing penalties have even allowed the transaction. The United Nations Special Rapporteur warned in 2020 that this calm effect would turn legal exemptions into “empty procedures.” The results: Hospitals without antibiotics, universities without research software, and students were locked out of global educational platforms. Academic collaboration has become nearly impossible in Iran and Syria. US export restrictions block access to online tools, cloud computing, and even platforms like Zoom.
Sanctions quietly kill. There are no images of bombed buildings, burnt villages, or television frontlines. But there are families walking miles for infant mortality spikes, empty operating rooms and fuel. This is war with spreadsheets managed through Excel sheets and compliance reports. Politicians don’t pay the price to impose it. But the receivers pay with a shortened life and a broken future.
But the landscape is changing. The southern countries of the world are becoming more resistant. From BRICS to Shanghai cooperative organizations, new platforms are emerging that seek autonomy from Western-controlled systems. Currency exchanges, local payment systems and decoupling efforts are gaining momentum. These are not just technical changes, which are political declarations. As one African diplomat said at the 2024 BRICS+ forum, “If we can sanction children’s insulin, we cannot lead to moral order.”
To be clear, none of this exonerates false errors or suppression within the approved state. However, sanctions rarely affect the ruling elite. Instead, they hurt civilians who didn’t vote for the government’s decision. The IMF, FATF, and even some UN agencies are often intertwined with enforcing these punitive regimes under the guise of neutrality. This structural accomplice undermines the credibility of global governance itself.
In a world that advocates human rights valuation, we must face the human costs of economic coercion. Military intervention is being properly scrutinized. Sanctions deserve the same moral and legal rigor. The outcome is the same whether the child died from a missile or from a lack of medicine. Responsibility must be owned.