Do sanctions kill babies?

Yes, says Ioana Petrescu, albeit temporarily and (I would add) maybe not in the big picture.

Economic sanctions are the West’s knee-jerk response to nasty actions by nasty regimes. Make nastiness more costly, the logic goes, and maybe we’ll make the regime less nasty, see a less nasty regime replace them, or deter aspiring nasties elsewhere from indulging their nastiest desires.

One worry: what about the non-nasty citizens who suffer as well? Sanctions can lead to price spikes, scarcity, and a withdrawal of aid. In this case, who really suffers?

In a new paper, Ioana looks at the effect of exposure to sanctions in utero on a child’s risk of mortality, birth weight, and later-life height. Babies get compared to cohorts born later, and thus not exposed to the shock, and babies in developing countries where no sanctions occurred.

Her result: decreases in birth weight and increases in mortality, especially in the first year or two of the sanctions, with effects diminishing. Decreases in long term health (indicated by height) when sanctions are most intense.

The temporary effect is interesting. It suggests that regimes are finding their way around the sanctions, or that nations and households adjust; the initial shock disrupts nutrition and incomes, but within a year or two families figure out how to meet their health needs in the new sanctioned world they live in.

Ioana’s results strike me as sensible, but deserve a few cautionary notes.

Most of all, we should be worried that the actions that led to sanctions (e.g. a repressive crackdown) diminish health directly, rather than the sanctions themselves. Another worry: perhaps declining health and incomes precede (or cause?) the nasty actions that lead to international sanctioning. Both kinds of endogeneity would bias us to thinking sanctions look worse than they are.

If I wanted to strengthen the causal case, I might see if there are countries that were ‘almost sanctioned’ and compare those to ones that were ‘nearly not sanctioned’ and see if we see the same result. This strikes me as a better counterfactual, if the cases exist in any number.

Even so, Ioana’s policy advice makes excellent sense: there’s enough risk we are hurting the poor that sanctions should be married, when possible, with pro-poor humanitarian aid (especially aid targeted to pregnant mothers). I might add that travel bans and asset freezing may be more targeted and more effective, not least because they likely impoverish fewer innocents, but also because they give less-nasty politicians in country an added edge.

Last, any policymaker reading this paper should remember that other parameters are important.

Most of all, we should probably consider the health and welfare gains that could come if sanctions succeed. If sanctions promote better government, which leads to better health for all, then the two-year harm to some children could lead to decades of better health for later generations. Ioana has another paper that suggests this may be true.

The decision to sanction is replete with such terrible moral trade-offs. I am sometimes happy to be just an academic and not someone who actually has to make these hard decisions.