Without robust, built-in health protections, sanctions kill civilians as surely as bombs and bullets, as Iran’s broken health system makes clear.

By Mohammad Reza Farzanegan, Ruth Gibson and Maziar Moradi-Lakeh

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In international diplomacy, economic sanctions are often portrayed as a clean and humane alternative to war, a supposedly civilised way to pressure governments into compliance with international law without shedding blood. Yet this reassuring narrative hides a devastating truth: sanctions can destroy the health and wellbeing of ordinary people. While they are intended to weaken regimes, they often end up crippling the targeted state’s ability to provide basic healthcare to the very citizens those measures claim to protect. The mechanisms meant to safeguard civilians and allow humanitarian aid frequently collapse, leaving the most vulnerable to pay the highest price for political decisions made far from their reach.