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Estimating the Death Toll of the War on Gaza

An analysis of the MoH methodology, the exacerbating challenges it faces as the war continues, and estimates from independent researchers and humanitarian organisations.

An analysis of the MoH methodology, the exacerbating challenges it faces as the war continues, and estimates from independent researchers and humanitarian organisations.

Introduction

Since the start of the war on Gaza on Oct 7 2023, the Ministry of Health (MoH) and Government Media Office (GMO) have been producing statistical reports of casualties. As of Oct 17 2024, the official number of casualties stands at 43.157.

Official MoH counts

The truthfulness of this data has been corroborated by independent analyses. However, an increasing number of experts argue it significantly underestimates the true death toll of the war waged by Israel.

In this article, we will attempt to provide an analysis of the MoH methodology, the exacerbating challenges it faces as the war continues, and estimates from independent researchers and humanitarian organisations. Our objective, more than a year into the ongoing genocide, is to advocate for a more accurate picture of the human cost of the war that unfolds in Gaza.

Below is the final result of our review of expert estimates. These numbers far exceed official counts, while being based on conservative estimates of the true death toll of the Gaza genocide.

Official counts vs independent estimates

According to these conservative estimates, today we are beyond 200.000 dead.

Methodology used by MoH and GMO

The methodology adopted by the MoH and the GMO consists in only counting the deaths that meet both of the following criteria:

  • people killed by direct military action (bombing, gunshot, etc.)
  • bodies that reach healthcare facilities and are officially documented

The people whose bodies are under rubble (estimated at >10.000) or who die from the indirect effects of war (starvation, illness) are not included in these figures (though the MoH does have enough historical data to estimate those numbers).

Several independent analyses from the UN, WHO, researchers, and the IDF have confirmed that the data is accurate. This data is processed and made available by the Tech For Palestine datasets project.

Both the cumulative counts and the casualty reports of Israel’s daily attacks come from the MoH: these are the figures widely reported, and often dismissed, by media and politicians.

The MoH cites two primary reasons for their methodology:

  • To preempt accusations of overestimating the death toll: “counter the narrative of the occupation that we are exaggerating and that all those killed are combatants”
  • To protect the dignity of those killed in the war: “Each of these individuals is more than just a number; each one carries a unique story, a profound tragedy, a home filled with memories, and a family left grieving — don’t they deserve to be remembered?”

Even with these inherently conservative numbers, the extent of human suffering in Gaza is unprecedented:

Increasing challenges to the MoH’s methodology

The MoH’s and GMO’s reporting has predictably been beset with the consequences of documenting the death toll of one of the deadliest and most destructive military aggressions in history.

The official counts are systematically questioned, criticised, and derided: by media, politicians (“no confidence in the numbers that the Palestinians are using” - Biden), and in public discourse.

The reporting work done by the Gaza state apparatus is routinely presented as being inaccurate, exaggerated, and Hamas misinformation. This figure is used to question allegations of genocide, and to discount the rise of famine and epidemics, among the myriad other effects of war. The tapering-off of the death curve is pointed to as proof that protests are overblown, that Israel is showing restraint.

As the war goes on, the challenges of accurately tracking not only the number, but also the identities, of those killed are only exacerbating. Given its methodology, the reasons why the MoH would struggle with maintaining its reporting is obvious: “the healthcare infrastructure in the Gaza strip […] completely obliterated”, siege conditions lead to frequent system outages, medics on the ground consistently reporting an inability to cope with the daily influx of dead, injured, and sick, regular mass casualty events with an average of 376 people killed or injured per day, the larger context of destruction (66% of infrastructure damaged or destroyed, 90% of the population displaced, …), among many other reasons.

To maintain reporting accuracy while preserving victims’ dignity, the MoH has adapted by partly sourcing its data from credible media sources and emergency first responders, while also tasking a judicial committee with verifying reported deaths. But the very sources the MoH now has to rely on are being systematically destroyed, intimidated, or prevented from carrying out their duties. Foreign press is not allowed into Gaza, its offices shut down. Medics, journalists, police, humanitarian workers are targeted (in a way that is “intentional or indicative of reckless incompetence”), as reported by a number of organisations.

While some researchers find their resilience remarkable, the MoH’s efforts to keep reporting the data while adapting to an ever more challenging context are also being attacked as proof of inconsistency, ill-intention, and overestimating the damage.

Limitations of the MoH methodology

The need for the MoH to only report the deaths due to direct military action witnessed by healthcare professionals and largely identified (deaths that are undeniably due to war and undeniably real) is vindicated by the onslaught of scepticism these figures still generate in the media (see the important work done by Newscord and Accountable Media in documenting the erasure of Palestinian suffering in media), politics, and often the general public: if the MoH had strived to paint a more representative picture, at the inevitable expense of having less hard data to buttress its claims, it’s reasonable to presume that the only figures being reported outside of Gaza today would be those of the Israeli government (who until recently refused to acknowledge any civilian deaths). Thanks to MoH’s risk-averse approach, the casualty data made public has at least some legitimacy.

However, the limitations of this methodology become more and more apparent as the war goes on. Despite the indisputability of Palestinian suffering before the start of the war, the MoH’s reporting strategy was not designed for genocide. It was not designed for a year of continued armed aggression, for a year of siege, a year of targeting medical staff, a year of that figure growing from 5 to 10 to 20 to 40 thousand, a year of unwavering Western weapon sales to Israel, a year of the media manufacturing consent for genocide. In those conditions, the methodology is self-defeating: the dead accumulate, capacity for reporting falls, and the resulting decrease in numbers is paraded as a positive sign, dampening the sense of urgency for support. When one pushes this reasoning to its logical extreme (complete collapse of the state apparatus and healthcare infrastructure, the silencing of every journalist, etc.), the official counts will indeed stop increasing, and genocide will have officially stopped.

Expert estimates of the human cost of the war on Gaza

The MoH contends with the dilemma where bringing any change to its methodology, whether it increases or decreases the accuracy, will lead to the credibility of its data being further attacked. However, given the limitations of the MoH methodology, uncritically reporting the official figures further frames the conversation in most mainstream media, where, at best, the figures are presented as the absolute upper bound.

Consequently, the work of independent researchers is vital in providing a counterweight to the MoH’s limitations and attempting to estimate the true human cost of the war. The full death toll is even larger: it includes those killed by Israel during a year of genocide, but also the Israeli killed in the Hamas attack on October 7th 2024 and the thousands being killed by the IDF today in Lebanon.

More than that, given the above description of the official methodology, it is evident that these counts do not claim to and cannot represent the true number of casualties of the war on Gaza. Reporting on expert estimates serves to acknowledge the full scale of human suffering, honouring victims who may not be included in official tallies. It provides a scientifically-grounded counterpoint to potential underreporting, maintaining integrity in casualty documentation. Importantly, these estimates challenge narratives that may downplay the severity of the conflict’s impact on civilians.

4 main sources of estimates have been selected based on the author credentials, the methodology used, and their uptake in the humanitarian/scientific literature. Informal sources exist - medics and journalists on the ground consistently maintain that the true death toll is several times higher than the official figures (with estimates anywhere from 5 to 10+ times more): these estimates are not included, but do corroborate the magnitude of the numbers given below.

The Lancet - Counting the dead in Gaza: difficult but essential - 186.000 estimated as of June 2024

A letter published in June 2024 in The Lancet by researchers Dr. Rasha Khatib, Dr. Martin McKee, and Dr. Salim Yusuf estimated that up to 186.000 deaths could be attributable to the conflict as of June 2024. This estimate uses a low multiplier of 4 indirect deaths for every direct death reported officially, given that historical casualty data shows that indirect deaths represent 3-15 times the number of direct deaths.

Explicitly described as an underestimate: “a conservative estimate of four indirect deaths per one direct death”

Crisis in Gaza - Scenario-based Health Impact Projections, Report One: 7 February to 6 August 2024 - 86.218 projected by August 2024

A report by humanitarian experts, published in February 2024, projected potential death tolls under different scenarios for the period of February to August 2024, based on a “combination of publicly available data, expert consultations, and peer-reviewed research to estimate excess deaths, taking into account the limitations and biases of different data sources”. Even in base scenarios without major escalation or epidemics, the projected excess deaths significantly exceeded official counts.

The ceasefire scenario is unfortunately not valid today. There is a case to be made for the escalation scenario (especially with the spread of Israel’s war to Lebanon and current events in Northern Gaza) and for the epidemics scenario (the Gaza Healthcare Letters, signed by 99 US health professionals returning from Gaza, holds that “epidemics are raging in Gaza”). However, we only included the base scenario estimate without epidemics.

Explicitly described as an underestimate: “Expert judgements and data from other conflicts may have led us to make conservative estimates”

Gaza Healthcare Letters - USA Letter - 118.908 estimated as of October 2024

The USA letter, published in October 2024, gives the following estimate of indirect deaths: 10.000 people buried under the rubble, a conservative estimate of 62,413 deaths from malnutrition and disease (based on IPC’s estimates of mortality due to catastrophe and emergency levels of starvation), and a conservative estimate of 5.000 deaths in patients with chronic diseases. In addition to the official war-related deaths, the total represents “at least 118,908”.

This estimate does not include estimated deaths from infectious diseases, birth complications, etc. The most detailed estimate we have (Crisis in Gaza) places those deaths at 8-20% of total, for base and epidemics scenario, respectively.

Explicitly described as an underestimate: “These are the most conservative estimates of the death toll that can be made with the given available data as of September 30, 2024. It is highly likely that the real number of deaths in Gaza from this conflict is far higher than this most conservative estimate.”

Devi Sridhar - Scientists are closing in on the true, horrifying scale of death and disease in Gaza - 335.000 projected by December 2024

Prof Devi Sridhar, chair of global public health at the University of Edinburgh, estimated in September 2024 that the death toll could reach 335,000 by the end of 2024, based on extrapolations from earlier studies and ongoing conflict dynamics.

Devi Sridhar’s previous estimate was 500.000 by Dec 2024, which she revised based on The Lancet study’s estimate. She explicitly acknowledged that this revised figure was based on a “very conservative” estimate.

The Sridhar’s estimate has been quoted as the lower bound of the true death toll by Francesca Albanese, UN Special Rapporteur on occupied Palestinian territories, who gave a range of 15-20% of the population (386.000-440.000). Though Albanese is one of the leading experts on Gaza and her post, while building on Sridhar’s estimate, could stand on its own, we chose not to include it as a separate estimate, in order to keep with a conservative approach to this article.

Reconciling the estimates

We reviewed the analyses linked above and, after extracting the figures, drew a trendline to reconcile the estimates. The code, data, and charts are available on GitHub. Here’s the resulting chart:

Official counts vs official estimates

Compare with the chart given in the introduction: these estimates dwarf the official counts, and yet every estimate provided here is explicitly described as “conservative” by its authors. The reasons for this are multiple: challenges in data collection, the potential for underestimation in conflict zones, as well as the political climate.

While extracting estimates, we also chose the lower bounds whenever a range was given.

To repeat: the red line you see in this chart, which indicates that the death toll today is beyond 200,000 dead, is extrapolated from the most conservative estimates, for a conflict that is already deadly beyond comparison across a range of lenses.

Unlike the official counts, the trendline here does not show a downward inflection point, but is linear until 2025 (date of the latest estimate available).

As with the rest of our assumptions, this would be the best case scenario, barring a ceasefire. A more probable evolution would be an upward inflection: we’d expect to see an acceleration in deaths if the war continues, as indirect deaths from the causes below will ramp up:

The deaths due to the effects of war will be long-ranging, and the inflection point might take years to materialise.

Going forward

The discrepancy between official counts and expert estimates shows that the task of accurately counting casualties in Gaza remains fraught with challenges. While official counts provide a baseline, they likely underestimate the true toll of the conflict due to methodological limitations and practical obstacles. Conservative expert estimates, which factor in indirect deaths and use various projection methods, suggest that the actual death toll may be significantly higher, exceeding 200.000 as of October 2024.

Accurate casualty reporting in conflict zones is vital:

  • it informs the scale and nature of humanitarian aid required
  • it plays a role in assessments of proportionality and potential war crimes investigations
  • it can influence peace negotiations and conflict resolution efforts
  • it is required for historical memory and post-conflict reconciliation efforts

The official figures are the absolute lowest possible death toll of Israel’s ongoing war. This fact lies outside of political leanings, outside of group membership. We will continue working on this issue, in collaboration with other organisations, experts, and journalists.

As the conflict continues, it is crucial to support efforts for comprehensive and transparent casualty reporting. This includes protecting healthcare workers, journalists, and humanitarian staff who play vital roles in documenting the human cost of war.

Only through an understanding of the conflict’s impact can the international community respond effectively and work towards a resolution that prevents further loss of life. Going beyond those figures is a question of integrity for researchers and journalists. It is a question of fairness and humanity for politicians and decision-makers. It is about not letting the horror of genocide be overlooked or minimised in public discourse.

It is about showing the true human cost of the war on Gaza.

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