A groundbreaking study published in the Lancet medical journal has revealed that the death toll during the early phase of the two-year war in Gaza was significantly higher than previously reported by local authorities. The research, released on Wednesday, estimates that more than 75,000 people were killed in the first 16 months of the conflict, a figure at least 25,000 greater than the death toll announced at the time.
Accurate Demographic Reporting Confirmed
The study also found that reporting by the Gaza health ministry regarding the demographics of those killed was accurate. Specifically, it confirmed that 42,200 women, children, and elderly individuals died between 7 October 2023 and 5 January 2025, comprising 56% of violent deaths in Gaza. This period began with Hamas's surprise attack into Israel, which triggered a devastating Israeli offensive.
Methodology and Findings
Conducted by a team including an economist, demographer, epidemiologist, and survey specialists, the research was based on a representative survey of 2,000 families in Gaza. Experienced Palestinian pollsters, known for their work in the region, administered the survey to gather detailed information on deaths among family members. The authors noted in the Lancet Global Health that 3-4% of Gaza's population had been killed violently by 5 January 2025, with additional non-violent deaths indirectly caused by the conflict.
Michael Spagat, a professor of economics at Royal Holloway, University of London and one of the study's authors, emphasized the sensitivity of the survey. He stated that having Palestinians both ask and answer the questions was crucial due to the potentially upsetting nature of the topic. Spagat, with over 20 years of experience in conflict casualty calculation, estimated that 8,200 deaths in Gaza from October 2023 to January 2025 were attributable to indirect effects such as malnutrition or untreated disease.
Disputes and Comparisons
The exact death toll in Gaza has been a subject of intense dispute. However, last month, a senior Israeli security officer acknowledged that figures compiled by Gaza health authorities were broadly accurate, marking a reversal after years of official criticism. The officer cited approximately 70,000 Palestinians killed by Israeli attacks since October 2023, excluding missing persons.
Gaza health authorities now report that the direct toll from Israeli attacks has exceeded 71,660, including over 570 deaths since a ceasefire took effect in October 2025. The new Lancet study suggests the official death toll was a substantial undercount, similar to previous research that estimated a 40% lower figure during the war's first nine months.
Contradictions and Broader Context
The study contradicts Israeli officials' claims that their attacks killed an almost equal number of combatants and non-combatants. It covers the most intense and lethal period of Israel's offensive but not the peak of the humanitarian crisis, which included a UN-backed declaration of famine in August last year.
In November, research from the Max Planck Institute for Demographic Research estimated 78,318 deaths in Gaza between 7 October 2023 and 31 December 2024, aligning closely with the new study's timeframe. However, that research suggested a higher number of indirect deaths, contributing to a 44% reduction in life expectancy in Gaza for 2023 and 47% for 2024.
Challenges in Accurate Accounting
Spagat highlighted the challenges in reaching a definitive death toll, noting that figures in the recent study have significant margins of error. He questioned a 2024 Lancet study that estimated four indirect deaths for every direct death, explaining that conflict circumstances vary widely. For instance, in Kosovo, most deaths were violent, whereas in Darfur, indirect deaths were more prevalent. In Gaza, factors like a well-trained medical system and the territory's small size allowed aid to reach people more effectively.
Spagat cautioned against desensitization to the death toll, stating, "I would push back on the notion that this is a small number of deaths. I think we're experiencing desensitisation effects... But, yes, it's much lower than what many people say and believe." He added that a full accounting of all deaths in Gaza may require a multimillion-pound research project and could take a long time, if it ever happens.
