This chapter considers the role of humanitarian aid in situations of siege. It discusses a further mode of dispossession and immiseration, that of de-development. De-development is distinct from under-development in that it removes even the possibility of independent development of the targeted population. The effects of colonialism on the health of subject populations is well documented, as are the impacts of policies like structural adjustment programmes imposed by the International Monetary Fund and the World Bank, and austerity. De-development is a denial of sovereignty and local control within a society, usually imposed by an occupying power. Sovereignty is violated whenever sanctions regimes are put into place, ministries of health are targeted, and humanitarian organisations attempt to provide health services without proper coordination. There exists an established literature on the deleterious effects of political violence on public health, including service provision and the overall health of the affected society.