'Death Outlives War': Analysis Estimates Post-9/11 ​US Conflicts Killed Over 4.5 Million

The post-9/11 War on Terror may have caused at least 4.5 million deaths in around half a dozen countries, according to a report published Monday by the preeminent academic institution studying the costs, casualties, and consequences of a war in which U.S. bombs and bullets are still killing and wounding people in multiple nations.

The new report from the Costs of War Project at Brown University's Watson Institute for International and Public Affairs shows "how death outlives war" by examining people killed indirectly by the War on Terror in Afghanistan, Iraq, Libya, Pakistan, Somalia, Syria, and Yemen.

"In a place like Afghanistan, the pressing question is whether any death can today be considered unrelated to war," Stephanie Savell, Costs of War co-director and author of the report, said in a statement. "Wars often kill far more people indirectly than in direct combat, particularly young children."

The publication "reviews the latest research to examine the causal pathways that have led to an estimated 3.6-3.7 million indirect deaths in post-9/11 war zones," while "the total death toll in these war zones could be at least 4.5-4.6 million and counting, though the precise mortality figure remains unknown."

As The Washington Post—which first reported on the analysis—details:

Since 2010, a team of 50 scholars, legal experts, human rights practitioners, and physicians participating in theCosts of War project have kept their own calculations. According to their latest assessment, more than 906,000 people, including 387,000 civilians, died directly from post-9/11 wars. Another 38 million people have been displaced or made refugees. The U.S. federal government, meanwhile, has spent over $8 trillion on these wars, the research suggests.

But Savell said the research indicates that exponentially more people, especially children and the most impoverished and marginalized populations, have been killed by the effects of war—mounting poverty, food insecurity, environmental contamination, the ongoing trauma of violence, and the destruction of health and public infrastructure, along with private property and means of livelihood.

According to the report, "The large majority of indirect war deaths occur due to malnutrition, pregnancy and birth-related problems, and many illnesses including infectious diseases and noncommunicable diseases like cancer."

One 2012 study found that more than half of the babies born in the Iraqi city of Fallujah between 2007 and 2010 had birth defects. Among the pregnant woman surveyed in the study, more than 45% experienced miscarriages in the two-year period following the 2004 U.S. assaults on Fallujah. Geiger counter readings of depleted uranium-contaminated sites in densely populated Iraqi urban areas have consistently shown radiation levels that are 1,000 to 1,900 times higher than normal.

The study also found that some deaths "also result from injuries due to war's destruction of infrastructure such as traffic signals and from reverberating trauma and interpersonal violence."

Savell said that "warring parties who damage infrastructure with an impact on population health have a moral responsibility to provide quick and effective assistance and repairs."

"The United States government, while not solely responsible for the damage, has a significant obligation to invest in humanitarian assistance and reconstruction in post-9/11 war zones," she added. "The U.S. government could do far more than it currently is to act on this responsibility."