This paper reviews the impact of trade embargoes
on health, health services and food security drawing
on data available from Cuba, Haiti and Iraq. The
argument is made that the impact of trade embargoes
encompasses much more than restrictions on the
availability of medicine. The case studies also
suggest that mothers and children are not necessarily
the only vulnerable group, and that studying changes
in the health and mortality of under fives is more
indicative than those of infants under one year old.
The examples of Cuba and Iraq also highlight the
importance of strengthening health monitoring
systems, and of reforming health policy towards
focused public health measures to maximise the use
of scarce resources and stimulate preventive
measures. However, trade embargoes cause
macroeconomic shocks and economic and social
disruption on a scale that cannot be mitigated by
humanitarian aid, and which affects the well-being
of a population beyond their state of health.
Three prerequisites for effective humanitarian advocacy
are, therefore, reliability of data, integrity of the source
and a credible link between the observed outcomes and
the existing sanctions regime. The last section of the paper
critically examines the current practice of measuring health
impacts of sanctions, with particular emphasis on the case
of Iraq. It identifies persistent weaknesses and suggests
steps for improvement in future humanitarian assessments.