But what does the figure actually reference? The letter, which is speculative, and not a peer-reviewed article, makes the estimate that up to 186,000 deaths could be attributable to the current conflict due to “indirect health implications”.
This figure was decided by multiplying the current death toll, as reported by the Hamas-run Gaza health ministry, by five. The forward-looking estimate does not suggest that 186,000 have been killed in the 9 months of war so far.
The death toll in Gaza has long been difficult to report accurately. This is not unusual in wartime, but worsened by the specific situation in Gaza. Relying on the Gaza health ministry, figures are often revised.
The Hamas health ministry reports deaths recorded in hospitals, deaths reported by family members, and deaths from “reliable media reports”.
The letter sent to the Lancet was signed by Radha Khatib, Martin McKee, and Salim Yusuf. Khatib – the lead signatory – works at Birzeit University, near Ramallah, which has been outspoken on the war in Gaza. On October 15, Birzet called for international academic instituions to “take concrete action to stop the genocidal war on the Palestinian people and to end Israeli settler colonialism”.
Khatib has also previously shared Anti-Israel posts on social media. During the 2014 war in Gaza, she shared an article which stated there are “no ‘Both Sides’”. She also posted: “Palestinian violence is the inevitable response to… occupation and apartheid-like inequality. Violence therefore will only end when the occupation and Israeli apartheid end”.
Hillel Neuer, Executive Director of United Nations Watch, criticised the validity of the letter in the Lancet. “Nowhere does the lancet say this amount ‘were killed in the last 9 months,’” he shared on social media.