The Impact of Economic Sanctions on Health in Africa: A Literature Review, 2010–2024
DOI:
https://doi.org/10.51137/wrp.ijarbm.432Keywords:
Boycott, Libya, Sudan, Health, Economic SanctionsAbstract
Anecdotal evidence suggests that health and well-being are often threatened in nations subjected to sanctions; however, the causal link remains complex and indirect. This paper examines the impacts of economic sanctions on the overall health and well-being of African countries, specifically Sudan and Libya. Using a literature review design, the study draws from peer-reviewed publications, grey literature, and institutional reports to assess how sanctions interact with pre-existing structural and political challenges. The analysis reveals that while sanctions have contributed to worsening humanitarian conditions, their effects are largely exacerbating rather than causal. In both Sudan and Libya, decades of conflict, governance fragility, and underinvestment in health infrastructure remain the principal determinants of deteriorating health outcomes. Sanctions amplify these pre-existing challenges by impeding trade, restricting financial transactions, and complicating access to essential medicines and medical equipment. Consequently, it becomes difficult to attribute the decline in health systems solely to sanctions. The study concludes by underscoring the need to review sanction regimes to ensure that humanitarian exemptions and international collaboration mechanisms are effectively implemented to protect civilian health and uphold human rights in sanctioned states.
References
Afesorgbor, S.K and Mahadevan, R. (2016). The impact of economic sanctions on income inequality of target states. World Development 83 1-11. https://doi.org/10.1016/j.worlddev.2016.03.015
Allen, L. N., Aghilla, M., Kak, M., Loffreda, G., Wild, C. E. K., Hatefi, A., et al. (2022). Conflict as a macro-determinant of non-communicable diseases: The experience of Libya. BMJ Global Health, 7, e007549. https://doi.org/10.1136/bmjgh-2021-007549
Aloosh, M. (2018). How economic sanctions compromise cancer care in Iran. Lancet Oncol ;19:e334.
Al Faisal, W., Al Saleh, Y., and Sen, K.(2012). Syria: public health achievements and sanctions. The lancet, 379 (9833), 2241
Ameri A, Barzegartahamtan M., Ghavamnasiri M, Mohammadpour R, Dehghan H, Sebzari A. (2018). Current and future challenges of radiation oncology in Iran: a report from the Iranian society of clinical oncology. Clinical oncology (Royal College of Radiologists (Great Britain).
Ascherio, A., Chase, R., Coté, T, et al.(1992) Effect of the Gulf war on infant and child mortality in Iraq. N Engl J Med 1992;327:931–6.
Barry, M. (2000). Effect of the US embargo and economic decline on health in Cuba. Annals of internal medicine, 132(2), 151-154.
Berger, S. (2017). Infectious diseases of Sudan and South Sudan. Gideon Informatics.
Borger, J. and Dehghan, S.K. (2013). Iran unable to get life-saving drugs due to International Sanctions.(https://www.theguardian.com/world/2013/jan/13/iran-lifesaving-drugs-international-sanctions (Retrieved 16 December, 2025)
Bürgmann, H., Frigon, D., Gaze, W., Manaia, C., Pruden, A., Singer, A. C., Smets, B. F., & Zhang, T. (2018). Water and sanitation: An essential battlefront in the war on antimicrobial resistance. FEMS Microbiology Ecology, 94(11), fiy166. https://doi.org/10.1093/femsec/fiy166
Bundervoet T. and Verwimp P. (2005) Civil war and economic sanctions: an analysis of anthropometric outcomes in Burundi. Brighton: University of Sussex, 2005.
Columbia Research. (2024). Economic Sanctions and Restricted Parties. https://research.columbia.edu. (Retrieved November 27, 2024).
Coutts, A., McKee, M., and Stuckler D. (2013). The emerging Syrian health crisis. The Lancet, http://dx.doi.org/10.1016/50140-6736(13)60053-7
Charani, E., Cunnington, A. J., Yousif, A. H. A., Ahmed, M. S., Ahmed, A. E. M., Babiker, S., Badri, S., Buytaert, W., Crawford, M. A., Elbashir, M. I., Elhag, K., Elsiddig, K. E., Hakim, N., Johnson, M. R., Miras, A. D., Swar, M. O., Templeton, M. R., & Taylor-Robinson, S. D. (2019). In transition: Current health challenges and priorities in Sudan. BMJ Global Health, 4, e001723. https://doi.org/10.1136/bmjgh-2019-001723
Clarinval, C., & Biller-Andorno, N. (2014). Challenging Operations: An Ethical Framework to Assist Humanitarian Aid Workers in their Decision-making Processes. PLoS currents, 6, ecurrents.dis.96bec99f13800a8059bb5b5a82028bbf. https://doi.org/10.1371/currents.dis.96bec99f13800a8059bb5b5a82028bbf
Clinton, J.W. (1997). Executive Order 13067—Blocking Sudanese Government Property and Prohibiting Transactions with Sudan,” November 3, www.presidency.ucsb.edu/ws/index.php?pid=53505. (Retrieved March 23, 2025)
Daponte, B.O. and Garfield, R. (2000). The effect of economic sanctions on the mortality of Iraqi children prior to the 1991 Persian Gulf War. Am J Public Health ,90:546–52.
Doctors Without Borders. (2024). Shocking number of maternal and child deaths in South Darfur, Sudan. https://www.doctorswithoutborders.org/latest/shocking-number-maternal-and-child-deaths-south-darfur-sudan (Retrieved 10 February, 2024).
Dafallah, A., Elmahi, O. K. O., Ibrahim, M. E., & others. (2023). Destruction, disruption and disaster: Sudan’s health system amidst armed conflict. Conflict and Health, 17, 43. https://doi.org/10.1186/s13031-023-00542-9
Donoghoe, M. C., Lazarus, J. V., & Matic, S. (2005). HIV/AIDS in the transitional countries of Eastern Europe and Central Asia. Clinical medicine 5(5), 487–490. https://doi.org/10.7861/clinmedicine.5-5-487
Dye, C. (2001). The resurgence of tuberculosis in Russia. Philos Trans R Soc Lond B Biol Sci 356: 1069–1075.
Ebrahim, E. M. A. (2017). “Health Care System in Sudan: Review and Analysis of Strength, Weakness, Opportunity, and Threats (SWOT Analysis)”, Sudan Journal of Medical Sciences, 12(3), pp. 133–150. doi: 10.18502/sjms.v12i3.924.
El-Mogassabi, A., & Kaziri, I. G. (2025). The impact of conflict on cancer care in Libya. Journal of cancer policy, 43, 100528. https://doi.org/10.1016/j.jcpo.2024.100528
Farmer, P. (2001). Infections and inequalities: the modern plagues. University of California Press.
Financial Times. (2012). Iran’s seriously ill suffer as US sanctions hit medical supplies. Financial Times, 5 Sept., p. 7.
Garfield, R., Devin, J., & Fausey, J. (1995). The health impact of economic sanctions. Bulletin of the New York Academy of Medicine, 72(2), 454–469.
Gibbons, E., & Garfield, R. (1999). The impact of economic sanctions on health and human rights in Haiti, 1991-1994. American journal of public health, 89(10), 1499–1504. https://doi.org/10.2105/ajph.89.10.1499
Gutmann J, Neuenkirch M, and Neumeier F. (2021). Sanctioned to death? The impact of economic sanctions on life expectancy and its gender gap. J Dev Stud 57:139–62.
Hassani, M. (2018). Impact of sanctions on cancer care in Iran. Archives Bone Joint Surg.;6(4):248.
Hassanain, S. A., Eltahir, A., & Elbadawi, L. I. (2022). Freedom, Peace, and Justice: A new paradigm for the Sudanese health system after Sudan's 2019 Uprising. Economic Research Forum (ERF).
Hemmeda, L., Tiwari, A., Kolawole, B. O., Ayoobkhan, F. S., Fatima, K., Shabani, M. M., Kundu, M., Anugu, N. R., Richard, R. M., Ibrahim, D., & Ahmed, K. A. H. M. (2024). The critical pharmaceutical situation in Sudan 2023: A humanitarian catastrophe of civil war. International journal for equity in health, 23(1), 54. https://doi.org/10.1186/s12939-024-02103-9
Macrotrends (2025). Libya Life Expectancy (1950-2025). https://www.macrotrends.net/global-metrics/countries/lby/libya/life-expectancy (Retrieved September 23, 2025)
Majid, S. H. (2024). Implications of Sanctions on Local Populations in Africa: a Case Study of United States of America’s Sanctions Against Sudan (Doctoral dissertation, University of Nairobi).
Malik M, and Malik M. (2015). The Efficacy of United States Sanctions on the Republic of Sudan, Journal of Georgetown University-Qatar Middle Eastern Studies Student Association 2015:7 http://dx.doi.org/10.5339/messa.2015.7
Masters, J. (2024). What are Economic Sanctions? Council on Foreign Relations. https://www.cfr.org/backgrounder/what-are-economic-sanctions (Retrived September 1, 2024).
Mejia-Prieto, M.J. (2019). The Impact and Effectiveness of Economic Sanctions: Libya as a Case Study. Canadian Forces College. https://share.google/DnBEANAED3tT2pzfV (Retrieved October 11, 2025)
Moret, E. S. (2014). Humanitarian impacts of economic sanctions on Iran and Syria. European Security, 24(1), 120–140. https://doi.org/10.1080/09662839.2014.893427
Musa, M. K., Eshun, G., Modber, M. A. A., Haruna, U. A., Abdulsalam, A., Zailani, A. S., Zakariya, F., Adamu, N. A., Musa, M. B., & Biney, G. K. (2024). Public health consequences of armed conflict in Sudan in the face of global donor fatigue. Public health challenges, 3(1), e156. https://doi.org/10.1002/puh2.156
Neuenkirch, M., and Neumeier, F. (2016). The impact of US sanctions on poverty. Journal of Development Economics, 121, 110–119.
Olaleye, S. O. (2023). Sudan’s maternal health needs urgent attention amid armed conflict. The Lancet, 402(10405), 848–849. https://doi.org/10.1016/S0140-6736(23)01788-1
Ogbonna, C. C. (2016). Targeted or restrictive: Impact of US and EU sanctions on education and healthcare of Zimbabweans. African Research Review, 11(3), 31-41.
Parker D.P, Foltz J.D and Elsea D. (2016). Unintended consequences of sanctions for human rights: conflict minerals and infant mortality. The Journal of Law and Economics, 59:731–74.
Peksen, D. (2019). When do imposed economic sanctions work? A critical review of the sanctions effectiveness literature. Defence and Peace Economics, 30(6), 635–647.
Peksen D. (2011) Economic sanctions and human security: the public health effect of economic sanctions. Foreign Policy Analysis,7:237–51.
Pinna-Pintor, M., Suhrcke, M., & Hamelmann, C. (2023). The impact of economic sanctions on health and health systems in low-income and middle-income countries: a systematic review and narrative synthesis. BMJ global health, 8(2), e010968. https://doi.org/10.1136/bmjgh-2022-010968
Ravinetto, R., & Singh, J. A. (2023). Responsible dissemination of health and medical research: some guidance points. BMJ evidence-based medicine, 28(3), 144–147. https://doi.org/10.1136/bmjebm-2022-111967
Reid, B.C, Psoter W.J, Gebrian B., Wang M.Q (2007). The Effect of an International Embargo on Malnutrition and Childhood Mortality in Rural Haiti. International Journal of Health Services. 2007;37(3):501-513. doi:10.2190/MR65-2605-1285-0406
ReliefWeb. (2021). Libya: Health sector bulletin. https://reliefweb.int/report/libya/libya-health-sector-bulletin-august-2021 (Retrieved September 15, 2025)
Reuters. (2024). Conflict drives surge in maternal deaths in Sudan's South Darfur https://www.reuters.com/world/africa/conflict-drives-surge-maternal-deaths-sudans-south-darfur-msf-says-2024-09-25/. Retrieved 10 February, 2024
Rodríguez, F. (2024). The human consequences of economic sanctions. Journal of Economic Studies, 51(4), 942-963.
SARA Libya Report. (2017). Service Availability and Readiness Assessment of the Public Health Facilitation in Lybia. https://share.google/0myXL3omjuUb7yYwg (Retrieved October 05, 2025)
Siddig, K. (2010). Economic sanctions and trade diversions in Sudan. China-USA Business Review, 9(12), 13.
Suhrcke M, Stuckler D, Suk JE, Desai M, Senek M, McKee M, (2011). The impact of economic crises on communicable disease transmission and control: a systematic review of the evidence. PLOS ONE 2011;6(6):e20724.
Smeets, M. (2018). Can Economic Sanctions be effective? Staff Working Paper ERSD-2018-03. Economic Research and Statistics Division. World Trade Organisation.
Taha, A.E. (2023). The state of health and health services in Sudan as a result of the war. Afr J Prm Health Care Fam Med. 2023;15(1), a4260. https:// doi.org/10.4102/phcfm. v15i1.4260
UNICEF. (2022). "Sudan Demographic, Health and Infant Mortality" 14 June 2021, https://data.unicef.org/country/sdn/ (Retrieved, September 23, 2015)
United Nations. (2024). Goal 3. Department of Economic and Social Affairs. https://sdgs.un.org/goals/goal3 (Retrieved 21 March 2025)
United Nations. (2018). “Libya: Healthcare under Attack,” (2018). Available: https://www.ohchr.org/sites/ default/files/Documents/Countries/LY/21052018_Attacks_on_Health_Care_EN.pdf (Retrieved February 26, 2025)
United Nations. (1996). Impact of the UN sanctions against Libya. Excerpts from the report transmitted to the Secretary-General by the Libyan Mission to the UN, 1996.
USDT. (2009). Effectiveness of U.S. economic sanctions with respect to Sudan. Retrieved June 24, 2009, from http://www.treas.gov/offices/enforcement/ofac/programs/sudan/sudan_report_030509’ (Retrieved 28 October,2024).
Verjee, A. (2018). Sudan After Sanctions: Sudanese views of Relations with United states. Institute of Peace. Speacial Report. www.usip.org (Retrieved 11 October 2025).
Wang, Y., Alfakiali, A. Y., & Niu, Y. (2025). Why Sanctions Termination Doesn’t Put an End to Humanitarian Crises: The Case of Sudan. Journal of Asian and African Studies, 60(3), 1471-1483.
World Population Review. (2025). Maternal Mortality Rate by Country. https://worldpopulationreview.com/country-rankings/maternal-mortality-rate-by-country (Retrieved March 27, 2025)
World Health Organization (2022) Libya: Health at a glance. World Health Organization. Available at: https://share.google/N55fhogTdH1myG4v0 (Retrieved September 30, 2025)
World Health Organization, (2017). Regional Office for the Eastern Mediterranean. Libya health profile 2015. https://www.emro.who.int/images/stories/libya/sara_3__service_availability_and_readiness_assessment_final.pdf?ua=1 (Retrieved March 29, 2025)
World Health Organization. (2012). Trends in maternal mortality: 1990 to 2010 -- WHO, UNICEF, UNFPA and The World Bank estimates. https://www.who.int/reproductivehealth/publications/monitoring/9789241503631/en/. (Retrieved December 16, 2024)
World Health Organization, Regional Office for the Eastern Mediterranean (WHO EMRO). (2017). Service availability and readiness assessment (SARA) report. Available from http://www.emro.who.int/lby/libya-infocus/service-availability-and-readiness-assessment-sara-report.htm (Retrieved September 30, 2025)
World Bank Group. (2024). Sudan Overview: Development news, research data. https://www.worldbank.org/en/country/sudan/overview (Retrieved October 28, 2024).
World Health Organization. (2002). Technical Discussion. Health under difficult circumstances: The impact of war, disasters and sanctions on the health of populations (No. EM/RC49/Tech. Disc. 1).
Yazdi-Feyzabadi, V., Zolfagharnasab, A., Naghavi, S., Behzadi, A., Yousefi, M. and Bazyar, World bank Group. (2024). Libya. https://genderdata.worldbank.org/en/economies/libya (Retrieved March 29, 2025).
Zveriev, O. (2024). Nature of Economic Sanctions and Reasons for their Application: Economy of Ukraine, 67(1(746), pp. 40–53. doi: 10.15407/economyukr.2024.01.040.
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