Western Sanctions Prevent Humanitarian Organizations from Saving Lives

  • Middle East Policy

    Middle East Policy has been one of the world’s most cited publications on the region since its inception in 1982, and our Breaking Analysis series makes high-quality, diverse analysis available to a broader audience.

Shannon Beacom

This essay is part of the MEPC’s Emerging Voices series, highlighting scholarship from rising academics focused on Middle Eastern studies. Author Shannon Beacom is a M.A. graduate from the Johns Hopkins School of Advanced International Studies (SAIS). Her studies focus on the Middle East and North Africa, protest movements, and political systems.

Foreign policy practitioners often tout Western sanctions on the Middle East as the magical foreign policy tool that allows nations to constrain the activities of adversaries without using military or human personnel. However, the COVID-19 pandemic highlighted how sanctions also drastically hamper humanitarian aid, especially in regions prone to natural disasters and conflict. Granted, sanctions regimes are supposed to have a humanitarian exemption that allows food and medicine into the country, but in reality, this does not always happen. Human rights organizations estimated that the 1990s sanctions on Iraq killed more than 500,000 children by increasing the infant mortality rate. When Iran experienced the H1N1 virus in the fall of 2019, sanctions may have contributed to over 1,600 deaths. Between 2006 to 2016 vaccination rate dropped from 95% to 60% among Syrian children.

Sanctions advocates claim that humanitarian exemptions provide enough space for organizations to work, but on-the-ground reality can tell a different story. For example, a European company refused to sell specialized bandages for patients in Iran with a rare, genetic skin disorder out of fear of violating sanctions. In 2018, a large Syria-based humanitarian organization reported difficulties importing medical devices such as spare parts for computed tomography (cat scan) machines because those parts fell under a dual-use category of U.S. sanctions, meaning they could be used for non-medical, potentially harmful purposes. In general, organizations in Iran and Syria continue to experience difficulties importing medicine and health supplies because of the increased cost of or general prohibition on importing raw materials.

How should the international community attempt to fix the gap between sanctions and humanitarian aid work? Although there are no easy solutions, sticking to the status quo means that innocent people will continue to bear the burden of sanctions unfairly. Any potential solution must work on two levels: the first is a general streamlining of the exemption process and adding clarifications in sanction legislation that specifically protect the work of humanitarian organizations. The second is creating a “white list” of organizations and goods that would not be affected by sanctions. 

The primary issue humanitarian organizations run into when dealing with sanctions is the large cross-cutting web of international sanctions. Not only can there be multiple national sanctions regimes (i.e., U.S., U.K., France), but there can also be regional (i.e., E.U.) and international (i.e., U.N.) regimes as well. Therefore, it is logistically challenging for organizations to decipher differing exemption protocols in providing aid to sanctioned countries. Furthermore, sanctions are written in vague and confusing language, prompting private and financial sectors to avoid risk by preventing financial assets from entering a sanctioned country or shutting down accounts of organizations that work in sanctioned countries. These risk-averse behaviors, in turn, hamstring organizations from moving financial assets in and out of countries, which affects their ability to do any work. Thus, the first step to establishing an effective sanction system is to clarify acceptable activities for organizations and streamline exemption processes. 

Clarifying what humanitarian organizations can do in sanctioned countries would reassure financial actors that they would not violate sanction restrictions. Defining acceptable activities would also limit the chilling effect that causes organizations to constrain their activities to avoid contravening sanctions. It is also necessary to streamline the process for organizations to obtain exemptions. For example, the U.S., the E.U., and the U.N. all have different exemption processes, and it is often unclear what exemption organizations need to work in sanctioned countries. While the E.U. has created an interactive sanctions map to help streamline information on sanction regimes, the U.S. and U.N. do not have a similar tool. The U.S. especially should simplify the exemption process to be more explicit in what exemptions are necessary and provide a faster licensing process for organizations to get emergency licenses when necessary. 

The better solution to lessen the impact of sanctions on humanitarian aid work is to create a “white list” of organizations and goods that can be allowed to work without fear of sanctions violations. The organizations on the white list should also be allowed to apply for exemptions through a fast-track process that reduces the time spent waiting for exemptions. Ideally, the white list would allow for pre-approved organizations to worry less about running into sanctions and reassure the financial sector that they won’t face fines for supporting  specific organizations. In addition, the white list of goods would ensure that essential medicines and equipment are allowed into  sanctioned countries without needing to apply for exemptions. 

While maintaining a white list of organizations and goods seems like an easy fix to the sanctions problem,  organizations resist creating a white list because of a few valid concerns, particularly in the form of politicization. First, the organizations worry that a white list would cause more harm than good. For example, organizations are concerned about what it would mean to be on the white list and if the designation would compromise their neutrality. Second, deciding who controls the list and the eligibility criteria for inclusion on it is no easy task. Finally, it is necessary to establish  what goods are included on the list and what happens during a crisis if specific medicine and goods are needed that are not on the pre-determined list.  

These problems arising from a white list are valid but should not prevent discussions on overcoming them. Having clear guidelines created by organizations and sanctioning powers for the white list could be one way to ensure the neutrality tenet is maintained. The U.N. should also be the only governing body of the white list, which could limit its politicization and prevent every country from creating its own white list. For the list of goods, organizations and sanctioning nations must work together to produce an essentials list and create a fast-tracked exemption for medicine and goods needed in crises. 

The impact of sanctions on humanitarian work is well documented and well known, but the discussions on fixing this problem are almost non-existent. As a result, policymakers will continue to use sanctions, which will invariably affect humanitarian work. To fix or at least lessen the impact of sanctions on aid delivery, a dialogue between humanitarian organizations and sanctioning powers is necessary. The first level of streamlining exemption protocols and clarifying language to sanctions legislation can and should be done. On the other hand, the white list will need to come from the discussions as all parties will need to agree on definitions and actions. The COVID-19 pandemic reopened the debate for reconciling sanctions and humanitarian work. Still, now all parties must step up to the plate and address the problem, or innocent people will continue to suffer.



  • Middle East Policy

    Middle East Policy has been one of the world’s most cited publications on the region since its inception in 1982, and our Breaking Analysis series makes high-quality, diverse analysis available to a broader audience.

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