New Report Associating Sanctions with Deaths Has Implications for Cuba

The new report from the UK’s Lancet medical journal does not mention Cuba, but its main finding – that sanctions are often lethal – clarifies to what extent and how it is that the U.S. economic blockade of Cuba is war against Cuba. The report informs activists and others of defining features of a state of war that many perhaps were already aware of.

The report shows that the economic sanctions making up the blockade are more dangerous and lethal than are U.S. actions often characterized as hybrid war. That kind of aggression, aimed at destabilizing or undermining governments not to U.S. liking, may involve the use of armed thugs, cyber warfare, disinformation campaigns, and/or  “economic pressure” of a softer variety. 

The Lancet serves the worldwide community of practitioners and scientists as an indispensable source of bio-medical research findings. The journal also regularly explores societal causes of ill health such as inequalities, environmental crises, and war. 

Lethal sanctions

The authors analyzed “the effect on health of sanctions using a panel dataset of age-specific mortality rates and sanctions episodes for 152 countries between 1971 and 2021.” They reported that, during the period between 2010 and 2021, “unilateral sanctions were associated with an annual toll of 564,258 deaths.” The report is remarkable for its sophisticated methods of statistical analysis.

They add that, “This estimate corresponds to … 3·6% … of total deaths observed in sanctioned countries [and is] higher than the average annual number of battle-related casualties during this period (106 000 deaths per year) and similar to some estimates of the total death toll of wars including civilian casualties (around half a million deaths per year).”

Their inquiry looks at “deaths caused by global sanctions for each age segment over time.” According to the report, “[U]nilateral economic sanctions were significantly associated with increased mortality for at least six of the seven age groups.” More specifically, “[D]eaths of children younger than 5 years represented 51% of total deaths caused by sanctions over the 1970–2021 period … [and] most deaths (77% over the same period) were in the 0–15 years and 60–80 years age groups.”

The U.S. government is the lead offender: “US unilateral sanctions were significant for six age groups, whereas EU unilateral sanctions were not significant in any of the age groups … [and we] found no statistical evidence of an effect for UN sanctions.”  Ultimately, “unilateral and economic sanctions, particularly those imposed by the USA, lead to substantial increases in mortality, disproportionately affecting children younger than 5 years.”

Epidemiologic data show that, indeed, those Cubans vulnerable on account of age and dependency are more likely than others to die. Cuba’s infant mortality rate (IMR), the number of babies dying in their first year of life per 1000 births, is 8.2 so far in 2025; that’s up from 7.1 in 2024.  Cubans and their government had taken pride in having reduced Cuba’s IMR to 4.2 in 2014. Cuba’s 1960 IMR was somewhere between 65 and 39 (estimates vary). The U.S. IMR in 2014 was 5.9, down from 25.9 in 1060. 

By 2023, Cuba’s death rate for children under five per 1000 births, 6.0 in 2014, had increased to 8.3.  Life expectancy at birth in Cuba dropped in 2021 due to the Covid pandemic but afterwards returned to pre-pandemic norms.

The survival of infants anywhere rests on access to competent healthcare and on favorable social circumstances. These include mothers with education and families with adequate income, food, and housing. These conditions hardly exist in Cuba today, thanks to the blockade.  

Mechanisms 

Cubans have been confronting a process that starts with U.S. regulations, continues with shortages, and finishes with suffering and even death. We review elements of this process, probably familiar to many readers, in order to clarify the nature of U.S. war on Cuba. 

The U.S. government restricts Cuba’s worldwide imports and exports, the arrivals of ships and planes, and Cuba’s sources of foreign income. These include the tourist industry, remittances, Cubans working abroad such as doctors, international loans, and payments from abroad. Regulations requiring international financial institutions to not handle dollars in Cuba’s transactions cause special grief; most countries must use dollars in similar circumstances, but Cuba may not.

Food supply is unreliable due to Cubans’ lack of purchasing power and farmers’ lack of resources like spare parts, new equipment, credit, fertilizers, seeds, and adequate transportation. The need to import food is a great financial drain.

Healthcare is problematic due to shortages of medical supplies and drugs and of healthcare workers, their numbers diminished on account of emigration, amplified by the blockade. The repair and building of houses suffer from lack of funds, supplies, equipment, and tools. Schools confront shortages of imported supplies, emigration of teachers, and infrastructure deficiencies.

Imperialism 

According to the report, sanctions mushroomed following World War II: “The fraction of the world’s economy subject to unilateral sanctions … has grown from 5·4% in the 1960s to 24·7% in the 2010–22 period.”  

The sanctions regimen coincided with decolonization and determination by the United States and other industrialized states to maintain their control over newly independent states and other poorer nations. Sanctions facilitate imperialist purposes.  

Writing on the “The Brutal Impact of Sanctions on the Global South,” legal scholar Joy Gordon agrees: “[S]anctions are overwhelmingly a tool of wealthy and powerful nations, used almost exclusively against countries that are vastly smaller and economically precarious.” Following World War II, the U.S. “had a near monopoly on the aggressive use of [sanctions] to achieve its objectives.”

Mark Weisbrot, coauthor of the report discussed here, notes in a separate article where he discusses his report that, “Sanctions are becoming the preferred weapon of the United States and some allies — not because they are less destructive than military action, but more likely because the toll is less visible.” He is evidently close to accepting the idea that sanctions and war may be the same. 

However, establishing the equivalence as regards the Cuba blockade requires adherence to a crucial criterion, namely the fact of deaths caused by the blockade, the killing. The U.S. blockade does pass that test.   

U.S. public officials, the media, and many activists may be blind to the excess deaths, or choose to ignore them. Weisbrot, in his article, laudably cites sanctions-related deaths in Venezuela, and did so earlier. He writes that, “When the economic violence of broad sanctions becomes widely known, they will be indefensible and no longer politically sustainable.”  

He seems to be imagining a campaign. Annoyingly, however, he is silent on the deadly U.S. economic blockade of Cuba, existing for 63 years. For U.S. powerbrokers, Cuba may be a special case, and the blockade is “worth it.”  After all, a Communist party holds political power there. Secretary of State Madeleine Albright spoke those words in 1996 as she justified U.S. sanctions against Iraq. They killed 500,000 children.

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