Last week, the Lancet, a well-respected British medical journal, published a letter from three academics – Rasha Khatib, Martin McKee, and Salim Yusuf – discussing the death toll in Gaza.

The letter, which is not peer-reviewed, suggests that, if the death toll in Gaza is 37 396, then it is “not implausible” to estimate that up to 186 000 deaths could be attributed to the war at some point in the future.

Already, the figure has taken on a life of its own. Zarah Sultana, writing on X, said “The Lancet - the most prestigious medical journal in the world - conservatively estimates that the death toll in Gaza could be 186,000 or more. That’s 8% of the population”. The “Gaza Genocide” entry on Wikipedia already cites the figure.

A former UN official also shared that “1 in every 12 Gaza inhabitants [have been] killed in the last 9 months of genocide”.

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.