Economic Sanctions and Global Health
How economic sanctions reshape health systems, increase mortality, and why humanitarian safeguards must be grounded in evidence.
Stanford Research · Lancet Published · Policy ImpactWhat Are Economic Sanctions and Why Do They Matter for Global Health?
Economic sanctions, including trade embargoes, financial restrictions, asset freezes, and aid suspensions, are among the most widely used tools of foreign policy. Over 30 countries currently face some form of international sanctions. While designed to pressure governments into changing behaviour, these measures carry serious consequences for civilian populations.
Research shows that sanctions disrupt pharmaceutical supply chains, weaken health infrastructure financing, restrict access to medical devices, and erode public health systems. The people most affected are children, pregnant women, the elderly, and those with chronic illnesses.
Dr. Ruth Gibson's research at Stanford University draws on four decades of data across more than 140 countries, providing some of the strongest empirical evidence on these health impacts to date.
The Evidence: Key Research Findings
Drawing from landmark publications in The Lancet and The Lancet Global Health, Dr. Gibson's research programme has produced several critical findings:
Aid sanctions are linked to a significant increase in maternal mortality, with effects that persist for years after sanctions are lifted.
Comprehensive economic sanctions correlate with measurable rises in under five mortality across affected nations.
Women and children bear the greatest burden, facing disrupted health services and nutrition programmes.
Humanitarian exemptions in current sanctions frameworks fall short. Bureaucratic barriers, bank overcompliance, and supply chain disruptions undermine their effectiveness.
The 1990 to 2019 panel analysis covering 140+ countries is the largest longitudinal study of sanctions and health impacts ever conducted.
Source: Gibson RM, Darmstadt GL. "The impact of aid sanctions on maternal and child mortality, 1990-2019." The Lancet Global Health, 2025.
Real-World Case Studies
The human cost of economic sanctions is real and measurable. Dr. Gibson's research and fieldwork document specific cases where sanctions have directly worsened health outcomes.
Iran: Health Under Sanctions
U.S. sanctions reimposed in 2018 severely disrupted Iran's pharmaceutical supply chain, restricting access to cancer medications, transplant drugs, and rare disease treatments. Dr. Gibson's research documents how banking restrictions created barriers to importing essential medicines, even those technically exempt. The 2025 UN snapback of multilateral sanctions raised further concerns about compounding health impacts on 88 million Iranians.
Russia/Ukraine: Children in Conflict
Dr. Gibson's ongoing project examines the forcible transfer of Ukrainian children by Russian authorities and the role of targeted sanctions in addressing war crimes. This work explores how sanctions can be designed not only to punish but to protect, proposing frameworks for using economic statecraft to deter crimes against children in armed conflict.
Cuba: A Health System Under Pressure
Decades of U.S. sanctions on Cuba have created chronic shortages of medical supplies, diagnostic equipment, and pharmaceuticals, even with humanitarian exemptions in place. Dr. Gibson's systematic review documents how overcompliance by international banks and shipping companies extends the reach of sanctions well beyond their legal text.
Broader Global Patterns
Analysis across 140+ countries reveals that aid sanctions, the suspension of development assistance as a policy tool, are linked to significant increases in maternal and child mortality. The effects are concentrated in sub Saharan Africa and South Asia. These findings challenge the assumption that targeted measures spare civilian populations.
Policy Recommendations and Humanitarian Safeguards
Dr. Gibson's research informs practical policy recommendations for governments, international organisations, and those who design sanctions:
Mandatory Health Impact Assessments
Require prospective health impact assessments before imposing or extending sanctions, modelled on environmental impact reviews.
Strengthened Humanitarian Exemptions
Redesign exemption mechanisms to reduce bureaucratic barriers and bank overcompliance that effectively block legitimate medical trade.
Real Time Health Monitoring
Establish independent health monitoring frameworks in sanctioned countries to track mortality, disease prevalence, and supply chain disruptions as they happen.
Targeted Over Comprehensive
Prioritise targeted sanctions such as asset freezes and travel bans over comprehensive trade embargoes that disproportionately harm civilian health.
Protection of Health Infrastructure
Explicitly protect health financing, pharmaceutical supply chains, and medical device imports from sanctions restrictions.
Accountability Mechanisms
Create transparent review processes for evaluating whether sanctions achieve their political objectives relative to their humanitarian costs.
Current Stanford Research & The Lancet Series
Dr. Gibson's research programme at Stanford's Center for International Security and Cooperation (CISAC) within the Freeman Spogli Institute for International Studies continues to advance the evidence on sanctions and health. Her current work includes:
Lancet Series on Foreign Engagement and Global Health
Sanctions to Punish Russia’s Forcible Transfer of Ukrainian Children
Key Publications in This Area
Dr. Ruth Gibson's Expertise
Dr. Ruth Gibson is a scholar at the Center for International Security and Cooperation (CISAC) at Stanford University's Freeman Spogli Institute for International Studies, based in Palo Alto, California. Her research spans international relations, security studies, and global health, with a particular focus on the health consequences of economic statecraft.
Her research, published in The Lancet and The Lancet Global Health, provides strong empirical evidence on how sanctions, aid restrictions, and trade barriers affect population health. She holds an MD from Harvard Medical School and a PhD in International Relations from the University of Cambridge.
Dr. Gibson has conducted fieldwork in conflict zones and sanctioned regions including Iran, Venezuela, Syria, and Ukraine. She advises international health organisations and has informed policy discussions at the United Nations, the G7, and the European Commission on humanitarian exemptions in sanctions regimes.
Resources & Further Reading
Research Projects
Explore Dr. Gibson's current and completed research projects on sanctions, conflict, and global health.
Publications
Access peer-reviewed research published in The Lancet, The Lancet Global Health, and other leading journals.
Talks & Media
Watch conference presentations, interviews, and media appearances on sanctions and global health.
Press Kit
Bios, headshots, stats, and contact information for journalists and media producers.
Research on how economic sanctions reshape health systems, increase mortality, and why humanitarian safeguards must be grounded in evidence. By Dr. Ruth Gibson, Stanford University.
Work With Dr. Gibson
Dr. Gibson is available for speaking engagements, research collaborations, expert commentary, and media interviews on the health impacts of economic sanctions.