Global Lessons from Economic Blockades: Comparative Impacts on Health Systems with Emphasis on Dental Care in Yemen – A PRISMA-ScR–Guided Scoping Review
TL;DR
Direct oral-health evidence was sparse, but multiple sources described dental supply disruption, infection-control constraints, and increased unmet need, and the health impact of sanctions/blockades is mediated by governance, exemption feasibility, and system resilience.
Abstract
Background: Economic sanctions, embargoes, and blockades are globalization-related policy instruments that reshape cross-border trade, financial flows, and humanitarian access, with downstream effects on health systems. Oral health services are particularly vulnerable because they depend on stable international supply chains for dental materials, local anesthesia, and infection-control consumables. Objectives: To map and synthesize the available evidence on how economic blockades/sanctions affect health systems and oral health, and to derive transferable lessons relevant to Yemen. Methods: A scoping review guided by the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) was conducted. Medical Literature Analysis and Retrieval System Online (MEDLINE)/PubMed, Web of Science, Scopus, the World Health Organization Institutional Repository for Information Sharing (WHO IRIS), ReliefWeb, and targeted United Nations (UN)/humanitarian sources were searched from inception to 05 December 2025. Eligible sources included peer-reviewed empirical studies and rigorously produced reports linking sanctions/embargoes/blockades to health-system outcomes and/or oral-health outcomes. Screening and data charting were performed by the author using pre-specified criteria; uncertainties were resolved by inclusion at screening and documented at full text. Results: Of 150 records identified, 50 duplicates were removed before screening. One hundred records were screened; 20 reports were sought for retrieval; 15 were assessed for eligibility; and 10 sources of evidence were included (Cuba, Iraq, Haiti, South Africa, Yemen). Across settings, recurring pathways included constrained imports (medicines, fuel, and clinical consumables), macro-financing shocks, infrastructure degradation, workforce attrition, reduced service availability, and widening inequities. Direct oral-health evidence was sparse, but multiple sources described dental supply disruption, infection-control constraints, and increased unmet need. Conclusions: The health impact of sanctions/blockades is mediated by governance, exemption feasibility, and system resilience. Protecting primary care, prevention, and essential supply chains can buffer harm, whereas fragile systems incur disproportionate losses. For Yemen, priorities include protected medical/dental supply corridors, workable financial/banking channels for exempt goods, integration of essential oral health into humanitarian health packages, and reinforcement of public primary care and prevention.