Economic sanctions are often portrayed as peaceful alternatives to war, yet their impact on public health is devastating. This 2024 systematic review in BMC Public Health examines 59 studies from 11 countries to map how sanctions affect health systems and populations. Using World Health Organization frameworks, the authors trace both direct and indirect damage. Directly, sanctions cut off essential medicines, vaccines, and equipment, collapse financing, and drive doctors and researchers to leave. Indirectly, they cripple food security, employment, and mental health. Hospitals in Iran, Iraq, and Syria ran out of drugs for chronic and cancer care; supplies like sterilizers and prosthetics vanished despite “humanitarian exemptions.” Financial barriers and shipping bans made vital imports impossible. Sanctions also attack the social determinants of health. Food imports plummet, prices soar, and currencies collapse, pushing millions into poverty. Stress, depression, and violence rise as families struggle to survive. Malnutrition and disease follow — especially among women and children. On average, sanctions shorten life expectancy by up to 1.5 years. The authors argue that sanctions function as weapons of economic and biological disruption. They call for international health diplomacy to protect medical supplies and monitor civilian impacts, ensuring humanitarian exemptions work in practice. Sanctions that cripple health care systems undermine the United Nations Sustainable Development Goals and breach ethical commitments to civilian welfare. Ultimately, this research reframes economic sanctions as a public-health emergency — one that demands the same urgency, compassion, and global solidarity as any epidemic. Produced by Cognivault — insight, intelligence, and innovation made clear.