Gaza death toll was a third higher than official figures, says Lancet study
The number of “violent deaths” in Gaza during the first 16 months of Israel’s genocidal war exceeded 75,000 - far higher than official figures at the time, according to a new paper published in The Lancet Global Health journal.
The Gaza Mortality Survey estimated 75,200 “violent deaths” in Gaza between 7 October 2023 and 5 January 2025.
On that date in 2025, the Palestinian health ministry reported the death toll at 49,090. The new study, published on Wednesday, suggests that the actual figure was about 35 percent higher.
Researchers also found that the proportion of women, children and elderly people killed in Gaza, as reported by health officials, was accurate.
The study found that 42,200 women, children and elderly suffered violent deaths by 5 January 2025, comprising 56 percent of the total.
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“The combined evidence suggests that, as of 5 January 2025, 3.4% of the population of the Gaza Strip had been killed violently and there have been a substantial number of non-violent deaths caused indirectly by the conflict,” the authors of the study wrote.
The authors include an economist, demographer, epidemiologist and survey specialists.
One of the authors, Michael Spagat, a professor of economics at Royal Holloway, said the study suggested an additional 8,200 deaths in Gaza up until January 2025 were attributable to indirect effects, including malnutrition and untreated disease.
The study involved interviews with 2,000 households representing 9,729 individuals in Gaza. They were carefully selected to represent the population, and were asked to give details about deaths among family members. The survey was run by experienced Palestinian pollsters.
The study does not include the period of the genocide and renewed Israeli offensive from March to October, during which a famine was declared in Gaza due to the blockade on aid.
Ministry figures 'conservative and reliable'
The researchers said it was, to their knowledge, the first population-representative household survey conducted during Israel's war on Gaza.
"These results underscore the feasibility of mortality surveillance in highly challenging conflict settings and provide a crucial empirical foundation for assessing the true human cost of the conflict," they said.
As of this week, the health ministry says at least 72,063 people have been killed by Israeli forces since October 2023.
Israel has long questioned the health ministry’s figures, but last month an Israeli military official said that the army accepted that about 70,000 people had been killed in Gaza.
Researchers said that the health ministry’s figures were reliable, despite working under "extraordinary constraints". They said that the figures provided a conservative “floor” rather than an over count.
“The validation of [Ministry of Health] reporting through multiple independent methodologies supports the reliability of its administrative casualty recording systems even under extreme conditions,” the study said.
In November, the Max Planck Institute for Demographic Research estimated that 78,318 people were killed in Gaza between 7 October 2023 and 31 December 2024 - almost exactly the same period as the Lancet study.
A study published by the Lancet last year estimated that the health ministry's death toll for the first nine months of the genocide was undercounted by 41 percent.
It estimated that 64,260 people were killed by June 2024 - well above the official figure of 37,877.
That study used "capture-recapture" modelling, which relied on probability, while the new research made a mathematical estimation using empirical verification through survey interviews.
"Our finding that MoH figures undercount violent deaths by approximately 35 percent closely aligns with the capture–recapture estimates," the new study said.
"This rare validation between survey and capture–recapture methodologies strengthens confidence in both approaches."
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