Who Pays the Price? Sanctions, Inequality, and the Collapse of Health Justice -By Fransiscus Nanga Roka

Sanction, as a clean meaning bloodless way of punishing leery governments has long been sold as an opening into the hearts and minds. No bomb, no boot and battlefield. Just numbers, restrictions, and policies.

This narrative, however, is dangerously misleading.

Now sanctions do not eliminate violence. They move it from the battlefield into the blood. And the people who pay for these attacks are not the policymakers, they aim it at but patients whom they leave behind.

The Myth of Targeted Pressure

Theoretically, unilateral sanctions are “targeted” penalties. They are intended to push elites, limit regimes and force people into new behaviours. Alone, they are blunt instruments that shatter entire public systems — most conspicuously health care.

Hospitals are unable to import critical medicines when financial channels go out of order. Life-saving equipment is no longer accessible because supply chains collapse. As seen in many parts of the world when currency devalues, treatment becomes inaccessible.

That does not equal political pressure. Expand to see more See comments It is systemic deprivation.

As a kid with leukaemia, she would not care whether an oncology drug shortage was due to sanctions or corruption. No pregnant female should ever died an access to emergency care because of “geopolitical strategy.” She risks it, she suffers — and sometimes dies.

Sanctions do not discriminate. But suffering does.

Inequality as Collateral Damage

If sanctions were just ineffective they would be an annoyance. But the worst thing about these laws is they are not even dog eat dog bad; they are structurally unequal.

The powerful will always be able to find loopholes. Elites secure private healthcare abroad. Governments diverts funds from other purposes in order to safeguard political stability. Wealth insulates.

The hungry and poor, while the rich escape.

Sanctions take vulnerability, inequality, marginalization and precarity that already exist in the workplace and make it exposure. When access to healthcare is restricted, women and children; the elderly and chronically sick become collateral damage of decisions over which they had no say.

This is not accidental. It is systemic.

This is because sanctions operate through and amplify global structures of power. They sanction nations but destroy populations already on the margin.

The Silent Disintegration of Health Justice

The moral foundation of health justice is a simple one: access to healthcare should not be based on politics, class or geography.

Sanctions dismantle that principle.

You craft a world in which only through acquiescing to mindless geopolitical requirements, will one have access to medicine. When the right to health is a matter of negotiation. Where survival itself is politicized.

This is not simply a policy failure. It is a moral rupture.

The right to health is a fundamental one, protected under international law. But the sanctions regimes routinely violate it without accountability. They inhabit a space beyond the law excused as sovereign, permitted as necessity and disregarded from the perspective of consequence.

Legalese clouds over abusive realities.

Invisible Violence, Real Consequences

The most perilous nature of sanctions lies in the very forget that they are silent.

No headlines, supply chain disruptions. Untreated diabetes — no breaking news. Cancer therapies these days take longer because of the global outrage at some manufacturers

One that, crucially for the analysis of fighting and dying in civil wars, only adds violence when someone shoots somebody. They are labeled shortages, inefficiencies, tragic consequences.

Yet make no mistake: when the policies consciously limit access to life-saving supplies, we are walking on a fine line between governing and harming.

Sanctions do not pull the genral. But who gets the medicine is their choice.

Who Pays the Price?

This is the question that public policy makers rarely bother answering.

Not the architects of sanctions. Not the political class that they want to pressure.

No, the patient who cannot obtain insulin.

The kid that doesn’t receive the vaccine.

Family Given The Choice Between Food And Treatment

That is the unseens: The invisible 99% who are most affected by a decision-making process, but not included in it.

Rethinking Power, Reclaiming Humanity

The world can either go in one direction or the other.

Either keep treating sanctions as a tool of policy like any other — or face them for what they are, an instrument of structural violence pushing away the possibility to access life itself.

This does not imply letting governments that violate international norms off the hook. It means acknowledging that current modes of enforcement are doing violence every bit as profound and devastating as the violations they seek to remedy.

If the purpose of international order is to preserve human dignity, any policy systematically denying access to healthcare needs reviewing.

Because a neutral system cannot protect rights, whose erosion it has facilitated.

It is complicit.

Final Word

Sanctions are not bloodless.

They rearrange the geography of agony.

They deepen inequality.

They transform health into privilege.

And finally, they answer their own question:

Who pays the price?

The answer is painfully plain:

That were never supposed to exist.

Fransiscus Nanga Roka

Faculty of Law University 17 August 1945 Surabaya Indonesia