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the lancet
'Unfathomable': Lancet Study Estimates Gaza Death Toll May Exceed 186,000
"The horror unfolding in Gaza is unquestionably a genocide, and the full extent of that horror won't be truly known until it comes to an end," said one political analyst.
Jul 08, 2024
Amid the decimation of Gaza's healthcare system and Israel's relentless attacks on the enclave, officials have struggled to account for all the Palestinians who have been killed since the Israel Defense Forces began its assault in October—and a new analysis shows how "indirect" killings will likely push the death toll of the war to what one peace advocate called an "unfathomable" number.
In a letter published in the medical journal The Lancet on July 5, three public health experts cited a previous official death toll of 37,396, but pointed out that "armed conflicts have indirect health implications beyond the direct harm from violence," making it likely that the total number of deaths of Palestinians so far is much higher—and could ultimately reach close to 200,000, if not more.
"Even if the conflict ends immediately, there will continue to be many indirect deaths in the coming months and years from causes such as reproductive, communicable, and noncommunicable disease," wrote the authors. "The total death toll is expected to be large given the intensity of this conflict."
Since the authors researched the analysis, the death toll has grown to 38,193, according to Gaza health officials.
The authors wrote that an untold number of Palestinians in Gaza have died as a result of destroyed healthcare infrastructure and an inability to get medical care, starvation amid Israel's near-total blockade on humanitarian aid, and the loss of funding to the United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA), one of the "very few humanitarian organizations" still working in Gaza.
Rasha Khatib of the Advocate Aurora Research Institute, Martin McKee of the London School of Hygiene and Tropical Medicine, and Salim Yusuf of McMaster University and Hamilton Health Sciences noted that "in recent conflicts, such indirect deaths range from three to 15 times the number of direct deaths."
"Applying a conservative estimate of four indirect deaths per one direct death to the 37,396 deaths reported, it is not implausible to estimate that up to 186,000 or even more deaths could be attributable to the current conflict in Gaza."
Using the 2022 population estimate of more than 2.3 million people, the projected total death toll "would translate to 7%-9% of the total population in the Gaza Strip," reads the study.
Anthropologist Jason Hickle said the study pointed to "apocalyptic figures" in Gaza.
The Gaza Health Ministry's death count has been questioned since Israel began its bombardment of the enclave, with U.S. President Joe Biden saying in October that he had "no confidence" in officials' reports and the U.N. revising its civilian death toll in May as the Health Ministry amended its reporting of unidentified bodies.
Despite that change, wrote the authors, "the number of reported deaths is likely an underestimate," both because of "indirect" causes of death and the probability that thousands of Palestinians are still buried under rubble left behind by Israeli air-strikes.
"The U.N. estimates that, by February 29, 2024, 35% of buildings in the Gaza Strip had been destroyed, so the number of bodies still buried in the rubble is likely substantial, with estimates of more than 10,000," reads the analysis.
The authors also dismissed claims by Israeli authorities and others who have contested the Health Ministry's figures, noting that the Israeli intelligence services, the World Health Organization, and the United Nations "all agree that claims of data fabrication leveled against the Palestinian authorities in Gaza over its death toll are 'implausible.'"
Considering statements by top-level Israeli officials regarding their intent to "thin the population" of Gaza, "to a minimum," as Prime Minister Benjamin Netanyahu has said, political analyst Omar Baddar said the estimated true death toll "isn't all that surprising."
The analysis was published days before the Israeli news outlet +972 Magazine published an article drawing from interviews with six Israeli soldiers who described how they "routinely executed Palestinian civilians simply because they entered an area that the military defined as a 'no-go zone'" and followed a "systematic policy of setting Palestinian homes on fire after occupying them."
Andre Damon of the World Socialist Web Sitesaid the projected death toll outlined in The Lancet represents "a systematic effort to exterminate the Palestinian people: armed, funded, and led by the U.S."
Israel faces an ongoing South Africa-led genocide case at the International Court of Justice.
The authors of the study said that "an immediate and urgent cease-fire in the Gaza Strip is essential, accompanied by measures to enable the distribution of medical supplies, food, clean water, and other resources for basic human needs."
"At the same time, there is a need to record the scale and nature of suffering in this conflict," they wrote. "Documenting the true scale is crucial for ensuring historical accountability and acknowledging the full cost of the war."
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Reducing Air Pollution Could Play 'Major Role' in Fighting Antimicrobial Resistance: Study
For the first time, researchers have linked air pollution with antibiotic-resistant microbes.
Aug 08, 2023
A study published this week in the U.K. medical journal The Lancet is the first to link air pollution with antimicrobial resistance, a growing public health threat around the world.
"Antibiotic resistance is an increasingly global issue, causing millions of deaths worldwide every year," the Chinese and British authors wrote in the study, which used data collected from more than 100 countries over nearly 20 years. "Our analysis presents strong evidence that increasing levels of air pollution are associated with increased risk of antibiotic resistance."
"The findings have substantial policy and environmental implications by presenting a new pathway to combat clinical antibiotic resistance by controlling environmental pollution," the researchers added.
Hong Chen, a professor at Zhejiang University in China and the study's lead author, toldThe Guardian that "antibiotic resistance and air pollution are each in their own right among the greatest threats to global health."
"Until now, we didn't have a clear picture of the possible links between the two, but this work suggests the benefits of controlling air pollution could be twofold: Not only will it reduce the harmful effects of poor air quality, it could also play a major role in combating the rise and spread of antibiotic-resistant bacteria," Chen added.
A paper published in The Lancet last year attributed 1.27 million deaths worldwide in 2019 to antimicrobial resistance—more people than perished from malaria or AIDS that year. The United Nations Environmental Program warned last month that "if unchecked, [antimicrobial resistance] could shave $3.4 trillion off GDP annually and push 24 million more people into extreme poverty in the next decade."
Other research estimated that by 2050, as many as 10 million people could die annually around the world due to drug-resistant bacteria and microbes, a higher death toll than cancer.
Air pollution is already responsible for around 1 in 5 global deaths, according to multiple studies published in recent years.
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The Lancet: Fossil Fuels Are Killing Us... Quitting Them Can Save Us
Comparing coal, oil, and gas addiction to the last generation's effort to kick the tobacco habit, doctors say that quitting would be the best thing humanity can do for its long-term health
Jun 23, 2015
The bad news is very bad, indeed. But first, the good news: "Responding to climate change could be the biggest global health opportunity of this century."
That message is the silver lining in a comprehensive newly published report by The Lancet, the UK-based medical journal. The report explores the complex intersection between global human health and climate change.
"It took on entrenched interests such as the tobacco industry and led the fight against HIV/AIDS. Now is the time for us to lead the way in responding to another great threat to human and environmental health."
-- Prof. Peng Gong, Tsinghua University
The wide-ranging and peer-reviewed report--titled Health and climate change: policy responses to protect public health--declares that the negative impacts of human-caused global warming have put at risk some of the world's most impressive health gains over the last half-century. What's more, it says, continued use of fossil fuels is leading humanity to a future in which infectious disease patterns, air pollution, food insecurity and malnutrition, involuntary migration, displacement, and violent conflict will all be made worse.
"Climate change," said commission co-chairman Dr. Anthony Costello, a pediatrician and director of the Global Health Institute at the University College of London, "has the potential to reverse the health gains from economic development that have been made in recent decades - not just through the direct effects on health from a changing and more unstable climate, but through indirect means such as increased migration and reduced social stability. Our analysis clearly shows that by tackling climate change, we can also benefit our health. Tackling climate change represents one of the greatest opportunities to benefit human health for generations to come."
Put together by the newly formed Lancet Commission on Health and Climate Change--described as a major new collaboration between international climate scientists and geographers, social and environmental scientists, biodiversity experts, engineers, and energy policy experts, economists, political scientists and public policy experts, and health professionals--the report is the most up-to-date and comprehensive of its kind. Though many studies have been performed on the subject, the commission argues the "catastrophic risk to human health posed by climate change" has been grossly "underestimated" by others.
The four key findings of the report include:
1. The effects of climate change threaten to undermine the last half-century of gains in development and global health. The impacts are being felt today, and future projections represent an unacceptably high and potentially catastrophic risk to human health.
2. Tackling climate change could be the greatest global health opportunity of the 21st century.
3. Achieving a decarbonized global economy and securing the public health benefits it offers is no longer primarily a technological or economic question - it is now a political one.
4. Climate change is fundamentally an issue of human health, and health professionals have a vital role to play in accelerating progress on mitigation and adaptation policies.
"When health professionals shout 'emergency,' politicians everywhere should listen." --Mike Childs, Friends of the Earth"Climate Change is a medical emergency," said Dr. Hugh Montgomery, commission co-chair and director of the UCL Institute for Human Health and Performance. "It thus demands an emergency response."
Rising global temperatures fueling increasing extreme weather events, crop failures, water scarcity, and other crises, Montgomery says the report is an attempt to make it clear that drastic and immediate action should be taken. "Under such circumstances," he said, "no doctor would consider a series of annual case discussions and aspirations adequate, yet this is exactly how the global response to climate change is proceeding."
In a companion paper published alongside the larger report, commission members Helena Wang and Richard Horton explained why human health impacts are an essential part of the larger argument regarding climate change:
When climate change is framed as a health issue, rather than purely as an environmental, economic, or technological challenge, it becomes clear that we are facing a predicament that strikes at the heart of humanity. Health puts a human face on what can sometimes seem to be a distant threat. By making the case for climate change as a health issue, we hope that the civilizational crisis we face will achieve greater public resonance. Public concerns about the health effects of climate change, such as undernutrition and food insecurity, have the potential to accelerate political action in ways that attention to carbon dioxide emissions alone do not.
Responding to the report's findings and warnings, Mike Childs, the head of policy for Friends of the Earth-UK, said the message from one of the world's foremost institutions on public health has given powerful new evidence that "radical action is urgently required" to avoid further climate catastrophe.
"When health professionals shout 'emergency'," Childs said, "politicians everywhere should listen."
Going from diagnosis to prescribing a remedy, the doctors and scientists involved with the report--who equated the human health emergency of climate change with previous physician-led fights against tobacco use and HIV/AIDS--argue the crisis of anthropogenic climate change demands--as a matter of "medical necessity"--the rapid phase-out of fossil fuels (with special emphasis on coal) from the global energy mix. In addition, the authors say their data on global human health support a recommendation for an international carbon price.
"The health community has responded to many grave threats to health in the past," said another commission co-chair, Professor Peng Gong of Tsinghua University in Beijing, China. "It took on entrenched interests such as the tobacco industry and led the fight against HIV/AIDS. Now is the time for us to respond to another great threat to human and environmental health."
The Commission argues that human health would vastly improve in a less-polluted world free from fossil fuels. "Virtually everything you want to do to tackle climate change has health benefits," said Dr. Costello. "We're going to cut heart attacks, strokes, diabetes."
The following video, produced by the Commission and released alongside the report, also explains:
As Wang and Horton conclude in their remarks, "Climate change is the defining challenge of our generation. Health professionals must mobilize now to address this challenge and protect the health and well-being of future generations."
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