Venezuela’s military is practicing its readiness for war, as the US continues its troop build-up in the Caribbean. Earlier, the US confirmed its largest aircraft carrier had arrived in the region.
In international diplomacy, economic sanctions are often portrayed as a clean and humane alternative to war, a supposedly civilised way to pressure governments into compliance with international law without shedding blood. Yet this reassuring narrative hides a devastating truth: sanctions can destroy the health and wellbeing of ordinary people. While they are intended to weaken regimes, they often end up crippling the targeted state’s ability to provide basic healthcare to the very citizens those measures claim to protect. The mechanisms meant to safeguard civilians and allow humanitarian aid frequently collapse, leaving the most vulnerable to pay the highest price for political decisions made far from their reach.
The result is a form of economic warfare that kills not through bombs or bullets, but through the slow erosion of health systems, medicines, and human dignity.
Our recent correspondence in The Lancet examines this reality in the context of the United Nations Security Council’s decision on September 28, 2025, to reimpose multilateral sanctions on Iran. In the piece, we do not take a position on the Security Council’s decision to reimpose multilateral sanctions; rather, our focus is squarely on the potential consequences of this move for Iran’s population, particularly given the severe health impacts seen under previous sanctions. Drawing on evidence from the pre-2015 sanctions period, our analysis in The Lancet shows how these measures shattered Iran’s health system and reveals a deeper structural failure within the international sanctions regime to protect the fundamental right to health.
The findings reveal that sanctions are not merely diplomatic instruments; they are public health interventions with deadly consequences.
The impact of sanctions on public health is not theoretical; it is measurable in years of life lost. A comprehensive cross-national analysis has shown that the imposition of UN sanctions is directly linked to a significant decline in life expectancy. On average, countries under such sanctions experience a reduction of around 1.2 to 1.4 years in life expectancy, with women disproportionately affected.
This is not collateral damage. It is evidence that sanctions function as a weapon against the health of entire populations. The deprivation is slow and often invisible, with hospitals running out of medicines, treatments delayed, and patients dying not from disease itself but from policies that make care inaccessible.
On paper, sanctions regimes almost always include “humanitarian exemptions” to allow the import of essential goods such as food and medicine. In practice, these safeguards often exist only in name. As our Lancet correspondence highlights, during previous UN sanctions on Iran, there was no dedicated UN mechanism to verify whether these exemptions were actually functioning.
The result was catastrophic. The sanctions disrupted medicine imports, driving price spikes of up to 300 percent for some antiepileptic drugs. As millions of patients were forced to forego reliable treatment, counterfeit and expired medicines flooded the market, endangering countless lives. These were not unintended glitches; they were the predictable outcomes of a sanctions system designed without accountability or monitoring.
The UN bodies responsible for overseeing the sanctions on Iran also operated with a dangerously narrow focus. The Sanctions Committee and its panel of experts were primarily concerned with tracking compliance with nuclear restrictions, such as monitoring uranium enrichment, while failing to assess how these measures affected people’s access to medicine, medical equipment, or healthcare more broadly.
Their reports contained no systematic evaluation of the sanctions’ humanitarian impact, revealing a persistent institutional blind spot. Technical compliance was monitored down to the last centrifuge, yet the suffering of ordinary Iranians was left unrecorded. This oversight is not unique to Iran; it reflects a wider pattern in global sanctions policy, where the political objective takes precedence over the human cost.
The damage caused by sanctions does not end with the official restrictions themselves. A more subtle but equally destructive process, known as “overcompliance”, often magnifies the humanitarian crisis. This happens when companies and banks become excessively cautious, refusing to engage in transactions that are in fact legally permitted, including those involving medicines and medical equipment, for fear of breaching complex sanctions rules.
Our correspondence in The Lancet highlights how this excessive caution deepens the suffering of ordinary people. Overcompliance by pharmaceutical and medical device companies and financial institutions unnecessarily raises prices, fuels corruption, and opens the door to low-quality or counterfeit alternatives. It also creates a shadow market of intermediaries who claim to know how to move medical supplies under sanctions, increasing both costs and risks. In some cases, even legitimate distributors seeking to import approved medicines have found themselves inadvertently caught up in unlawful activities.
The result is a further tightening of the blockade on a country’s health system, even where humanitarian exemptions supposedly exist. Overcompliance has become one of the most insidious and least accountable aspects of modern sanctions regimes, quietly cutting off access to life-saving care while allowing policymakers to deny responsibility.
The evidence is unambiguous. Without strong and actively monitored safeguards, sanctions become a blunt instrument that inflicts immense suffering on those least able to bear it. These are not unfortunate side effects, but direct and foreseeable consequences of policies applied without regard for their human cost.
The lesson from Iran, and from decades of similar experiences elsewhere, is that economic sanctions must never be imposed without independent systems to protect the right to health. This means establishing effective humanitarian payment channels, monitoring the real-time availability of essential medicines and medical supplies, and assigning oversight to a technical panel capable of assessing the full health impact of sanctions on civilian populations.
Sanctions are often justified in the name of human rights, yet they can quietly destroy the very lives they claim to defend. The international community must recognise that the protection of health is not an optional consideration, but a fundamental obligation. If sanctions are to remain part of global diplomacy, they must be reimagined with public health at their core, not left to erode it.
Forty-two migrants, including 29 from Sudan, eight from Somalia, three from Cameroon and two from Nigeria, have been missing at sea and presumed dead since their boat overturned off the coast of Libya, according to the United Nations International Organization for Migration (IOM).
Their rubber vessel, packed with 49 migrants, capsized on November 3, six hours after departing the northwestern coastal town of Zuwara, the IOM said on Wednesday, citing survivors.
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Seven of the passengers survived six days adrift at sea and were rescued on November 8 by a Libyan search and rescue crew, said the IOM.
The accident would mark the latest deadly crossing attempt in the central Mediterranean Sea, where more than 1,000 migrants trying to reach Europe have died this year, according to figures from the IOM’s Missing Migrants Project.
The latest shipwreck demonstrates “the urgent need for strengthened regional cooperation, expanded safe and regular migration pathways, and more effective search and rescue operations to prevent further loss of life”, said the IOM.
It also comes amid growing backlash towards the conduct of Libya’s coastguard and other authorities, which have long faced accusations of violence and abuse towards migrants while at sea and within their borders.
Between 2016 and September 2025, Libya’s coastguard committed at least 60 violent maritime incidents, according to a recent report by the NGO Sea-Watch. The incidents included shooting at boats carrying refugees and asylum seekers, abandoning people at sea and hindering rescue operations.
Last week, a coalition of 13 European search and rescue organisations suspended cooperation with Libya’s maritime rescue coordination centre over alleged rights violations. They accused Libya’s coastguard of being an “illegitimate actor”, amounting to a “decentralised network of armed militias equipped and trained with EU funds”.
“We will not be coerced into communicating our operational position to EU-funded armed militias, shooting at people fleeing to safety and our rescue crews,” said the alliance.
The central Mediterranean is the busiest route for irregular travel to the European Union, with more than 58,000 attempted crossings between January and October this year, according to the EU’s border agency Frontex.
Libya, home to about 867,055 asylum seekers and refugees, has emerged as a main transit route for those trying to reach Europe.
Ukraine has suspended Justice Minister German Galushchenko for his alleged involvement in a corruption scandal involving the state-run nuclear power company, Energoatom, during his tenure as the country’s energy minister.
Prime Minister Yulia Svyrydenko announced on Wednesday that Galushchenko had been suspended from his duties, which will be carried out by Deputy Justice Minister for European Integration Lyudmyla Sugak.
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Galushchenko, who served as energy minister for four years before taking over the justice portfolio in July, is accused of profiting from a scheme that laundered money from Energoatom.
Ukraine’s Pravda news outlet reported that anticorruption authorities raided Galushchenko’s offices on Monday.
In a statement, Galushchenko said he had spoken with the prime minister and agreed his suspension is appropriate while he defends his case.
“A political decision must be made, and only then can all the details be sorted out,” said Galushchenko. “I believe that suspension for the duration of the investigation is a civilised and correct scenario. I will defend myself in court and prove my position.”
According to Ukraine’s Specialised Anti-Corruption Prosecutor’s Office (SAPO), the alleged $100m scheme was orchestrated by businessman Timur Mindich, a close ally of President Volodymyr Zelenskyy.
SAPO’s investigators say Galushchenko helped Mindich manage illicit financial flows in the energy sector, while contractors working with Energoatom were forced to pay bribes of 10 to 15 percent to avoid losing contracts or facing payment delays.
Accusations of kickbacks in the energy sector are particularly sensitive in Ukraine, much of which is facing lengthy daily blackouts as it fends off massive Russian attacks on its infrastructure.
The scandal also highlights a potential challenge to Ukraine’s European Union membership bid, for which eradicating corruption remains a key condition.
Addressing the country on Monday, Zelenskyy urged full cooperation with the anticorruption inquiry and said anyone implicated should be held to account.
WATCH: A video provided by a former military guard shows soldiers torturing two detainees at an infantry base in Mandalay region in October 2021.
Al Jazeera has also gathered testimonies from several military defectors who confirm that deaths in custody are common.
A senior officer, “AK”, who asked for a pseudonym to protect his identity, defected from the military after being forced to take part in an extrajudicial killing operation. He alleges that the murder of captured urban fighters is sanctioned at the highest level.
AK described a night in early 2024 when four suspected urban fighters were bound, blindfolded and taken away from one of the military’s deadliest interrogation facilities.
The four prisoners, suspected assassins, were tortured so badly that they had to be propped up by soldiers as they were taken to a waiting pickup truck. Surrounded by armed guards, the four were then transported to a quiet road away from the city and forced to kneel beside a ditch.
AK said a senior officer ordered the soldiers to shoot the men with pistols to avoid unnecessary noise.
The suspects were shot from behind, AK said, but they did not die immediately. As the rebels bled on the ground, the soldiers grew restless waiting for them to die, so they shot them again, then again.
“I don’t think they knew that was the moment they would die, until they heard bullets … their deaths were so brutal I couldn’t sleep for a week,” AK told Al Jazeera.
The men’s bodies were then transferred to a military hospital, where AK says doctors signed certificates that obscured their cause of death. Medical staff employed by the military are often pressured to cover up such murders, he says.
Al Jazeera has seen photos of three of the men’s bodies, along with leaked copies of the official death report, which says they were killed while trying to escape. The injuries visible in the photos do not match that claim. One photo, AK pointed out, shows one of the men with his eyes covered and his hands tied, challenging the account that he had been trying to get away.
Claiming that prisoners were killed while trying to flee is a common narrative used by the military to cover up extrajudicial killings, the former senior officer said.
Some of the details about the executions that AK shared have been omitted here due to concern about reprisals. But to verify this incident, Al Jazeera triangulated testimonies and leaked documents with local media reports and interviews with former military and civil society organisation sources.
Critically, AK explained such murders could not take place without the approval of senior military officials.
“No one could leave that detention centre without approval from the top,” he said.
Al Jazeera also spoke with two former army doctors who served on different bases after the coup. Both said they were prevented from providing medical attention to civilians aligned with the resistance who had serious injuries. After the coup, they said, it became common practice for senior military doctors to fake the causes of death of detainees who had been killed or left to die in custody.
The doctors, who requested anonymity, confirmed that such cover-ups by military leaders are both organised and strategic, allowing detainees to be murdered or left to die while the regime avoids accountability.
United States President Donald Trump has threatened to sue the British public broadcaster, the BBC, for $1bn in the latest of a series of actions he is taking against major news outlets.
Trump’s lawyers said the BBC violated Florida defamation law by editing a video clip in a 2024 Panorama documentary – aired just one week before the November presidential election – to give the impression that he had actively encouraged his supporters to riot at Capitol Hill in January 2021 after he lost the presidential election to Joe Biden.
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In the BBC documentary, Trump is shown delivering a fiery speech before the confirmation of the election result in Washington, DC, on January 6, 2021. In it, he says, “We fight like hell”, directly after telling supporters, “We’re going to walk down to the Capitol”. However, editors had spliced together two unrelated sentences, which were in fact 54 minutes apart, to make it sound like he was encouraging his supporters to riot.
In a letter sent to the BBC by his counsel, Alejandro Brito, Trump has demanded a retraction of the documentary, which, he says, contains “malicious, disparaging” edits. He has also demanded payments to “appropriately compensate President Trump for the harm caused”.
The broadcaster has been given until Friday 22:00 GMT to respond, or, Brito said, he will be “left with no alternative but to enforce his legal and equitable rights, all of which are expressly reserved and are not waived, including by filing legal action for no less than $1,000,000,000 in damages”.
It is understood that he would file a suit in the US, not the United Kingdom.
The BBC has been mired in accusations of institutional bias since a leaked memo by a former consultant accused it of airing “false, defamatory, disparaging, misleading, and inflammatory statements” about Trump, as well as in other areas of coverage.
The leak was followed by a public apology from BBC chair Samir Shah for the “error of judgement” over the editing of Trump’s speech and the resignations of Director General Tim Davie and Chief Executive of News Deborah Turness on Sunday.
Emma Thompson, a reputation management lawyer at the UK law firm Keystone Law, said, technically, Trump has a good case against the BBC. “If you slice a video and conflate two comments in order to drive a narrative, that’s exactly what libel is,” Thompson told Al Jazeera.
However, media experts say it is typically very difficult for public figures like Trump to win defamation cases under US law.
David Erdos, professor of law at the University of Cambridge, said a US court would first have to establish “what sort of meaning should be ascribed to what is being published”, validating or contradicting Trump’s claim that the message conveyed by the edited footage was misleading.
But as opposed to UK law, where defamation cases rest on whether the published information was false or misleading, in the US, the plaintiff must prove “not only that it was false, but that there was reckless disregard of falsity”.
In other words, US law requires proving malice, which sets an “incredibly high bar” for suing for defamation. “One would have to prove falsity or that they [the BBC] showed reckless disregard of falsity – and we obviously don’t know that,” Erdos told Al Jazeera.
“Even if something is defamatory – and seriously so – unless you can show that the person knew the statement was false, then the claim will be thrown out.”
Thompson, of Keystone Law, said the First Amendment of the US Constitution guarantees freedom of speech, protecting a wide range of expression and putting the burden of proof squarely on the claimant – the US president in this case.
She described the requirement of proving malicious intent as “unbelievably difficult”. “You can’t prove what somebody else is thinking [unless] you have evidential proof like emails or notes of a meeting,” the lawyer said. “You have to show that the act was intentional and you have to show that the act was intended for the person to be harmed, whether reputationally or financially.”
Trump’s lawyers have claimed the BBC’s broadcast caused Trump “overwhelming financial and reputational harm” and demanded that the British company issue an apology and payments that “appropriately compensate President Trump for the harm caused”.
Proving reputational harm has been caused by a publication or broadcast is easier if financial loss is involved. “A company could claim it lost a contract because of an article [in the news],” Thompson said. But establishing whether the standing of a US president has been harmed would be much harder.
Trump would, however, have the timing of the publication on his side as an “aggravating factor”, she said. The BBC broadcast its documentary shortly before the November 2024 US presidential election, and Trump’s legal team is arguing that this was a clear attempt to influence the election.
Gavin Phillipson, professor of law at the University of Bristol, said under US law, plaintiffs must substantiate their claim of reputational harm by showing “how many people heard the allegation or saw the media report in question”.
In this instance, the BBC service, including iPlayer, its main streaming platform, is not available in the US. “This would be a hurdle – to show that the Panorama documentary has caused damage to his reputation in Florida,” Phillipson said.
While he could potentially bring the case before a UK court – which sets a lower bar for proving defamation claims – he would be unlikely to win anything approaching the amounts won when claimants are successful in the US.
Phillipson said the amount of $1bn proposed by Trump is “ridiculous” and would never be accepted by a UK court, where the maximum payout recorded in similar cases was 350,000 pounds ($461,000).
Erdos, the Cambridge lecturer, said the European Court of Human Rights (ECHR) has recognised that large lawsuits, especially for defamation, deter freedom of expression. “It’s been acknowledged that freedom of expression can be chilled by this sort of amount,” he said.
Several US media companies, including CBS and ABC News, have paid tens of millions of dollars to settle lawsuits filed by the US president.
In July this year, Paramount, the parent company of CBS News, agreed to pay him $16m over the editing of a 2024 interview aired by CBS, its subsidiary.
The case was brought over a broadcast of 60 Minutes featuring then-Vice President Kamala Harris, which Trump alleged had been deceptively edited to benefit the Democratic Party before the 2024 election. Trump initially sought $10bn in damages, later raising the claim to $20bn.
In December last year, ABC, owned by Disney, agreed to pay $15m to settle a defamation suit filed over on-air comments made by anchor George Stephanopoulos that Trump had been “found liable for raping” writer E Jean Carroll.
The BBC could follow the example of these broadcasters and settle a lawsuit, or follow The New York Times and fight back. Trump hit the news organisation with a complaint last year, asking for $15bn in damages over its coverage of his relationship with the late convicted sex offender, Jeffrey Epstein.