38 Million Lives: Sanctions, Starvation, and the Machinery of Structural Violence

From Gaza’s siege to global sanctions, starvation and economic warfare are claiming lives on a scale rivaling history’s worst atrocities — all in the name of power.

The people of Gaza are being deliberately starved. The scale of this man-made catastrophe — a cruel and seemingly terminal phase in what many have called Israel’s genocide — is almost impossible to convey in words.

“The level of urban starvation in Gaza has not been seen since the Dutch Hunger Winter and the siege of Leningrad during the Second World War,” wrote famine expert Alex de Waal in the London Review of Books earlier this year.

Those words were penned in February. Since then, the situation has only deteriorated. Today, at least one in three Gazans endures entire days without food. At the same time, thousands of humanitarian aid trucks — including over 6,000 from the United Nations Relief and Works Agency (UNRWA) alone — stand idle at border crossings, blocked by Israeli occupation forces. “This is unlike anything we have seen in this century,” said Ross Smith, Director of Emergencies at the UN World Food Programme. Every man, woman, and child in Gaza is now at risk of slow, agonizing death by starvation.

Yet Gaza is not an isolated tragedy. It is a concentrated expression — a brutal microcosm — of a much wider crisis of structural violence that global imperialism imposes daily on the world’s working and oppressed peoples. Most of its victims do not die from bombs or bullets. They perish through calculated deprivation — the steady erosion of life through hunger, poverty, and the dismantling of social systems, engineered as part of an international order built for extraction and domination.

Economic sanctions are one of the deadliest tools in this arsenal. Far from being a “humane” alternative to war, sanctions silently kill on a scale that rivals the bloodiest conflicts in modern history. A landmark study by the Center for Economic and Policy Research, published in The Lancet Global Health, found that US and European Union sanctions contributed to 38 million deaths across 152 countries between 1971 and 2021. In the past decade alone, they have claimed roughly 560,000 lives every year — the equivalent of 1,500 people per day, a death toll comparable to Nazi Germany’s siege of Leningrad.

The narrative that sanctions “pressure rogue regimes” without harming civilians collapses under this evidence. The reality, long known to those who suffer under them, is that sanctions operate as weapons of mass destruction — less visible than bombs, but no less lethal. Over the period studied, their death toll rivals that of all armed conflicts and genocides combined — many of which were themselves fuelled or accompanied by sanctions imposed by the same powers.

Today, roughly a quarter of the world’s nations live under US, EU, or UN sanctions — many imposed unilaterally by Washington without UN Security Council authorization. This is no coincidence. Sanctions are part of a broader architecture of domination that includes covert operations, aerial bombardment, propaganda, political isolation, and economic strangulation. Like medieval sieges, they aim to deny nations the means to survive, to erode state capacity, and to break the will of entire populations.

The cruelty is often explicit. In April 1960, a US State Department memo on Cuba recommended actions to “decrease monetary and real wages, to bring about hunger, desperation and overthrow of government.” In Iraq during the 1990s, UN reports estimated that US-led sanctions killed half a million children. When asked if this was an acceptable price, then-Secretary of State Madeleine Albright replied, “We think the price is worth it.”

Such statements strip away the diplomatic veneer. Sanctions are not “measures for peace” — they are instruments of collective punishment, in direct violation of international humanitarian law.

Professor Ali Kadri, in his seminal work The Accumulation of Waste, describes this as “structural genocide” — the ongoing destruction of human life and the natural world to sustain the profitability of global capitalism. Imperialism, he argues, has become an apparatus of death: devaluing and wasting people in order to preserve the economic dominance of a few.

This is precisely what we see in Gaza, where starvation serves as a weapon to weaken, maim, and exhaust. A starving body cannot resist; a limbless child will not wield a weapon. Imperialism seeks not merely to conquer territory, but to grind human dignity into submission — replacing resistance with desperation, until land, labour, and resources can be seized at will.

The juxtaposition is obscene: in a world of overflowing granaries and mountains of surplus food, Gaza’s people are denied even a crumb. This reflects a broader global reality — where immense abundance exists side by side with manufactured scarcity, enforced by walls, borders, and the machinery of militarized exclusion.

As young Palestinian poet Taqwa Al Wawi writes from Gaza:

In a world of full plates
And overflowing shelves,
A crumb of bread is rare.

What will we eat
When there is no food?

The answer to that question will define not only Gaza’s future, but the moral character of our age. To ignore it is to be complicit — in Gaza, in the Global South, and everywhere that sanctions, sieges, and economic warfare grind away the lives of the poor.