Systemic thread

The Dollar Empire

Sanctions, debt traps, and vassal states — how the US extracts without invading, and why the body count is mostly children.

564,258

Estimated excess deaths per year from US and EU sanctions, 1971–2021. 51% are children under five.
Source: Lancet Global Health, 2025

The evidence

564,258 excess deaths per year — the hidden body count of US and EU sanctions, 1971–2021

In 2025, the Lancet Global Health published a peer-reviewed study estimating the excess mortality attributable to US and EU sanctions regimes from 1971 through 2021. The number: approximately 564,258 excess deaths per year. Fifty-one percent of those deaths — the majority — are children under five.

This is not a fringe academic estimate. The Lancet is one of the most prestigious medical journals in the world. The methodology is conservative: excess mortality compared to comparable unsanctioned countries during the same periods. The authors account for confounders. The number is almost certainly an undercount.

To put the scale in context: at that rate, over fifty years, US-led sanctions have produced mortality comparable to the highest-casualty armed conflicts in modern history. The difference is that these deaths happen slowly, in pediatric wards and food-insecure households, and they rarely appear on the front page of any newspaper.

The US government refers to sanctions as a "foreign policy tool" and a "peaceful alternative to war." The Lancet has now quantified what that alternative looks like from the receiving end. The empire does not need bombs to kill people. It needs a Treasury department and a dollar-denominated global financial system.

Iraq, 1990–2003

"We think the price is worth it" — 500,000 Iraqi children dead under US sanctions, and a Secretary of State who said it plainly

In 1996, CBS News correspondent Lesley Stahl asked Secretary of State Madeleine Albright about UNICEF's estimate that 500,000 Iraqi children had died as a result of US-led sanctions since the Gulf War. Albright's response, delivered without hesitation on national television:

"We think the price is worth it."

Half a million children. Worth it. The targets of the sanctions — Saddam Hussein's government — were largely unaffected. Hussein remained in power. His inner circle continued to live in palaces. The people who paid "the price" were the children of the country he nominally governed.

This is the essential logic of sanctions: they are designed to cause enough suffering to a country's civilian population that the government yields to US demands. When that mechanism fails — when the government is sufficiently insulated from its own population's suffering — the civilians die and the government stays. US policy analysts call this "leverage." The children are called "collateral."

The UN Special Rapporteur on Human Rights documented medicine and food shortages throughout the sanctions period. Water treatment infrastructure, unable to get replacement parts classified as "dual-use," collapsed. Infant mortality spiked. The sanctions lasted thirteen years, until the US simply invaded instead.

Venezuela, 2017–2019

40,000 deaths in two years — documented mortality attributable to US sanctions on Venezuela

In April 2019, the Center for Economic and Policy Research published a study by economists Mark Weisbrot and Jeffrey Sachs analyzing the human cost of US sanctions imposed on Venezuela from 2017 through 2018. Their estimate: approximately 40,000 deaths attributable to sanctions in those two years alone.

The mechanism was straightforward. US sanctions in 2017 and 2018 blocked Venezuela's access to international credit markets and targeted the oil sector that funded roughly 90% of Venezuela's hard currency earnings. Oil revenues collapsed. Venezuela could no longer finance food and medicine imports at pre-sanctions levels. The public health system — already strained — disintegrated. People died waiting for treatments that had been routine.

US officials described the sanctions as targeting "the Maduro regime." Weisbrot and Sachs documented who actually bore the cost: patients who could not get insulin, dialysis, or chemotherapy. The 40,000 figure covers only 2017 and 2018. Sanctions intensified through 2019 and beyond.

The US government's stated rationale was to pressure a government it had determined was illegitimate. The population that bore the mortality — overwhelmingly poor and working class — did not vote for Maduro's policies, had no ability to change them, and had no recourse against the Treasury department that was killing them.

Cuba, 1960–present

The 60-year embargo: 184-to-2 votes in the UN General Assembly, and the US still doesn't care

The United States has maintained a comprehensive embargo on Cuba since 1960 — sixty-five years as of 2025. No other country in the world has been subject to a US sanctions regime of this duration.

Each year, the United Nations General Assembly votes on a resolution calling for an end to the embargo. The results have become a ritual of global consensus versus American exception. In 2023, the vote was 187 in favor of ending the embargo, 2 opposed — the United States and Israel. The votes have been similarly lopsided for decades.

The Cuban government cites the embargo as having cost the Cuban economy over $130 billion in cumulative damage. The US Treasury's Office of Foreign Assets Control has levied hundreds of millions in fines on third-country banks and companies that conducted ordinary business with Cuba — enforcing the embargo extraterritorially, on foreign companies, under threat of losing access to the US financial system.

The embargo does not target the Cuban government. The Cuban government has endured for sixty-five years. It targets ordinary Cubans — their medicine, their remittances, their ability to engage in international commerce. The world votes to end it. The US continues it. This is not foreign policy by democratic consensus. It is imperial prerogative, enforced by dollar control.

The mechanism

The dollar's reserve currency status is the spine of the empire — it is why sanctions work, and why developing countries cannot escape debt

Sanctions work because of the dollar. This is not an abstraction. The United States dollar constitutes approximately 58% of global foreign exchange reserves(IMF Currency Composition of Official Foreign Exchange Reserves, 2024). Most international trade — including most oil — is priced, invoiced, and settled in dollars, even between countries that have no direct relationship with the United States.

The implication: any transaction denominated in dollars passes through the US banking system at some point. US-based correspondent banks clear dollar transactions globally. SWIFT, the messaging infrastructure for international banking, is subject to US pressure. The Treasury Department's Office of Foreign Assets Control can designate any individual, company, or government entity, making them effectively untouchable in the global financial system — because any institution that processes their transactions risks losing access to dollar clearing.

The petrodollar arrangement — an informal but durable agreement negotiated with Saudi Arabia in the 1970s — amplifies this. Saudi Arabia prices oil exclusively in US dollars and recycles its export revenues into US Treasury bonds. Other OPEC members followed. The result: any country that imports oil must first acquire dollars, which means holding dollars in reserve, which sustains dollar demand globally, which sustains dollar primacy, which sustains US sanctioning power. The entire structure is circular and self-reinforcing.

When Russia invaded Ukraine in 2022, the US and EU froze approximately $300 billion in Russian central bank reserves held in Western institutions. This was not a military operation. It was a financial one — possible because those reserves were held in dollar-denominated instruments in Western banks. The lesson was heard globally. The BRICS+ expansion of 2024, China and Russia's development of alternative settlement systems (CIPS, SPFS), and the push toward yuan-denominated oil contracts are all responses to the same lesson: holding dollars means being subject to US power, and there is no appeal.

The vassal mechanism

Build it, borrow for it, owe forever: how IMF loans and World Bank infrastructure turned sovereign debt into structural control

In 2004, former chief economist for a major US consulting firm John Perkins published what he described as a confession. The mechanism he described — since documented independently in academic literature by economists including Joseph Stiglitz and Dani Rodrik — works as follows:

A developing country is offered a loan, typically through the World Bank, USAID, or a consortium of private US banks, for "development" infrastructure — power plants, ports, highways. The loan terms require that construction contracts go to US firms (Bechtel, Halliburton, KBR, and their successors). The infrastructure is built. The country owns it nominally. Foreign contractors operate it. The local population does not gain the technical capacity to maintain it independently.

The loans come due. The country — whose economy was not transformed by infrastructure it cannot operate, whose growth projections proved inflated, whose loan terms assumed conditions that did not materialize — cannot pay. Restructuring follows. The IMF arrives with "structural adjustment" conditions: privatize state enterprises (utilities, telecoms, water systems), cut social spending, deregulate capital flows, reduce import tariffs. National assets are sold at distressed prices to foreign investors. The country pays interest on the original loan indefinitely.

Stiglitz, who was Chief Economist of the World Bank from 1997 to 2000, documented the pattern extensively after leaving. In Globalization and Its Discontents (2002), he described IMF structural adjustment programs in sub-Saharan Africa, Southeast Asia, and Latin America as consistently producing outcomes worse than their stated objectives — not because of bad luck, but because the conditions imposed reflected the interests of the creditors more than the needs of the borrowers.

Argentina is the canonical modern case. The country has been through multiple IMF bailout programs across decades, each involving structural adjustment, each producing economic crisis, each leading to another program. The 2018 IMF package was the largest in IMF history at the time: $57 billion. The 2025 Trump-era financing for the Milei government — $40+ billion in new IMF and US Treasury facilities — is the latest iteration of the same pattern. The loan becomes the leash.

Colonial extraction

The countries richest in resources are often the poorest in outcomes — because the profits flow to shareholders abroad

Economists call it the "resource curse": countries richly endowed with extractable natural resources — oil, copper, cobalt, uranium, lithium — tend to have worse long-term economic development outcomes than comparable countries without those resources. The mechanism is not mysterious. The wealth flows out before it can compound domestically.

Nigeria: Shell has operated in the Niger Delta since 1958. The Delta contains approximately 37 billion barrels of proven reserves. It is also one of the most heavily polluted regions on Earth. The communities near extraction sites have documented rates of contaminated water, respiratory illness, and agricultural collapse. Shell has paid billions in legal settlements for oil spills. The Nigerian government has received oil revenues — much of which has been captured by political elites, a pattern that IMF and World Bank-designed governance structures have repeatedly failed to correct.

The Democratic Republic of Congo contains approximately 70% of the world's cobalt reserves — the mineral used in lithium-ion batteries, including those in every iPhone and electric vehicle. The cobalt is largely mined by hand, sometimes by children, in conditions documented by Amnesty International and other human rights organizations. The profits flow to trading companies headquartered in Switzerland (Glencore), whose shareholders are concentrated in the wealthiest countries on Earth.

Bolivia's lithium reserves — among the largest in the world — were effectively nationalized by the Morales government. In 2019, Morales was removed in a coup following disputed elections. The interim government moved to reverse the lithium nationalization. Elon Musk, asked on Twitter about the coup, replied: "We will coup whoever we want! Deal with it." He deleted the tweet. The lithium remains in play.

The pattern

The list: Iran, Chile, Indonesia, Argentina, Egypt, Haiti, and the architecture of dependency that replaced direct colonialism

The modern vassal state is not governed by a colonial administrator. It is governed by its own elected or appointed leaders — operating within a framework of debt obligations, military aid dependencies, and trade arrangements that effectively limit their policy choices to a narrow band compatible with US interests. When a leader attempts to exceed those limits, the mechanisms of correction are predictable.

Iran, 1953. Prime Minister Mosaddegh nationalized Iranian oil. The CIA and MI6 executed a coup. The Shah was restored. SAVAK — the CIA-trained secret police — ran the country for 26 years. The 1979 revolution that produced the Islamic Republic is the direct downstream consequence of the 1953 coup.

Chile, 1973. President Salvador Allende nationalized copper. The CIA funded opposition and backed the military. General Pinochet executed a coup on September 11, 1973. Allende died. 3,200 Chileans were killed; 38,000 were tortured (per the Valech Commission). The copper mines were privatized. "Kissinger told the CIA that 'we should do everything we could to wreck the Chilean economy.'" — US Senate, Church Committee.

Indonesia, 1965. The US-backed military coup killed between 500,000 and one million alleged communists. The victim lists — provided to the military by the US Embassy — included labor organizers, teachers, and PKI members. Suharto's 31-year dictatorship followed. The country was opened to IMF and World Bank programs, foreign investment, and resource extraction. Vincent Bevins, in The Jakarta Method, documents how Indonesia became the template: the coup model was explicitly exported to Brazil, Guatemala, Chile, and other countries.

Haiti. The most sanctioned-and-occupied country in the Western Hemisphere has been under various forms of US financial and military control for most of the twentieth century. The US occupation from 1915 to 1934 rewrote the Haitian constitution to allow foreign land ownership. French colonial reparations — paid by Haiti to French slaveholders for the "crime" of the Haitian Revolution — were not fully paid off until 2010. A UN peacekeeping mission introduced cholera to the country in 2010, killing approximately 10,000 Haitians. The UN offered $400 million in remediation and paid $0.

Egypt. Since the Camp David Accords of 1979, the US has provided Egypt approximately $83 billion in foreign aid — the second-largest recipient in US history after Israel. The bulk of the aid is military. It does not fund Egyptian social programs. It funds the Egyptian military, which purchases US-manufactured weapons, employs US-trained officers, and maintains a government that has been consistently willing to suppress domestic opposition, police its border with Gaza, and maintain peace with Israel. The aid is a subsidy to the US defense industry and a leash on Egyptian foreign policy, denominated in billions of dollars and laundered through the word "alliance."

The Negotiator

The empire is mostly invisible. The body count is mostly children. The mechanism is mostly accounting. The reason it works is the dollar.

The US empire does not need boots on the ground to extract. It needs a Treasury department, a reserve currency, a network of multilateral lending institutions, and a legal architecture that makes compliance with US financial rules a precondition for participation in the global economy.

The mechanisms documented in this thread — sanctions that kill children, structural adjustment programs that privatize water, resource extraction that produces poverty in rich countries, coups that protect corporate interests — are not bugs in the system. They are features of a foreign policy explicitly designed to maintain US economic primacy across the global south.

The billionaire class is the primary beneficiary. Glencore shareholders receive DRC cobalt profits. Exxon-Mobil shareholders receive Nigerian and Iraqi oil profits. BlackRock manages sovereign wealth funds whose structure reflects IMF-imposed capital account liberalization. The defense contractors whose weapons go to Egypt and Saudi Arabia are publicly traded companies. The banks that earn fees from dollar clearing are among the most profitable corporations on Earth.

The Negotiator's manifesto argues: a just world would be one in which the US would be unable to use sanctions to impose its will, unable to sink countries into debt via extortionate loans, unable to send corporations to plunder natural resources and hold governments hostage through those loans. That world does not require the US to stop being powerful. It requires the US to stop using its power to extract from the people who have the least ability to resist.

The BRICS+ expansion, the de-dollarization push, the alternative payment systems China and Russia are building — these are not liberation movements. They are responses to the same lesson that the dollar empire has been teaching for seventy years: the more aggressively you weaponize financial access, the more incentive other countries have to build alternatives. The contradiction is structural. The empire that depends on dollar primacy for its sanctioning power is undermining dollar primacy through its use of sanctioning power. Triffin's dilemma in geopolitical form.