Lancet’s 186k estimate is not reliable

A Misrepresented Projection, Not a Verified Count

In July 2024, The Lancet published a Correspondence (not a peer-reviewed study) suggesting that the Gaza death toll could reach up to 186,000. This figure quickly made global headlines, but was widely misunderstood. One of the authors, Martin McKee, later clarified that the figure was “purely illustrative” and that the letter “has been greatly misquoted and misinterpreted.”[1] In reality, the 186,000 figure was not presented as a current death toll, but as a long-term cumulative projection, based on assumptions about indirect mortality from other wars, not on verified data from Gaza.

Questionable Methodology and Assumptions

The authors of the Lancet letter reached their estimate by multiplying the reported direct death toll by five, extrapolating from other conflicts where indirect deaths, caused by factors like infrastructure collapse, famine, and disease, far outnumbered deaths from violence.[2] However, this approach is highly problematic in the Gaza context. Gaza is a densely urban area with functioning international NGOs, health monitors, and ongoing data collection. As Professor Michael Spagat, a leading expert on conflict mortality, wrote: “This is not an empirical estimate, it is a speculative upper-bound projection built on weak foundations.[2] Similarly, Peter Singer, former WHO adviser, criticized the figure as “taking one unreliable number and multiplying it by another unreliable number to get a bigger unreliable number”.[3] The projection also fails to account for real-time monitoring and humanitarian access, which are far more robust in Gaza today than in many of the conflicts the Lancet authors referenced.

A Pattern of Overestimation

This is not the first time The Lancet has published controversial casualty figures. In 2006, it estimated that over 600,000 Iraqis had died in the war,[4] a number that was later widely discredited.[5] The American Association for Public Opinion Research (AAPOR) found that the lead author, Dr. Gilbert Burnham, violated ethical standards by refusing to disclose key methodological details. A more rigorous survey conducted by the Iraq Family Health Survey Study Group (IFHS) placed the number of violent deaths at approximately 151,000.[5] For more, see Robert, Adam, “Lives and Statistics: Are 90% of War Victims Civilians? published by reputable academic publisher Taylor&Francis.

The Gaza projection appears to repeat the same methodological errors.

The 186,000 figure has been widely criticized by experts across disciplines:

  • Prof. Martin McKee, one of the authors, clarified the 186,000 figure was not a real count but a theoretical illustration.[1]
  • Prof. Michael Spagat emphasized the estimate lacks empirical support.[2]
  • Dr. Peter Singer criticized the math behind it as “unreliable multiplied by unreliable“.[3]
  • Assistant Professor Jessica Trisko Darden, writing in The Forward, noted it “lumps civilians and combatants together” and relies on unverifiable assumptions.[6]

And by others

  • The blog Hodjasblog accused The Lancet of bias, stating that “they only trust the science that fits their politics”.[7]
  • The American Jewish Committee (AJC) issued a formal request to The Lancet to retract the letter, calling the figure “unsubstantiated and dangerously misleading”.[8]

References

  1. a b Merlin, Ohad (2024), ‘186,000 Gazans dead’: Lancet magazine publishes new blood libel, retrieved 5 August 2025
  2. a b c Overton, Iain (2024-07-10). "A critical analysis of The Lancet's letter "Counting the Dead in Gaza: Difficult but Essential". Professor Mike Spagat reviews the claim the total Gaza death toll may reach upwards of 186,000". AOAV. Retrieved 2025-08-04.
  3. a b Gilbert, Andrew (2024-11-16). "Concerns regarding Gaza mortality estimates". The Lancet. 404 (10466): 1927–1928. doi:10.1016/S0140-6736(24)01682-9. ISSN 0140-6736. PMID 39510112.
  4. https://brusselstribunal.org/pdf/lancet111006.pdf
  5. a b Roberts, Adam (2010-07-01). "Lives and Statistics: Are 90% of War Victims Civilians?". Survival. 52 (3): 115–136. doi:10.1080/00396338.2010.494880. ISSN 0039-6338.
  6. Darden, Jessica Trisko (2024-07-09). "Has Israel really killed up to 186,000 people in Gaza? How to understand the numbers war". The Forward. Retrieved 2025-08-04.
  7. "Three peer-reviewed studies in The Lancet about Gaza all have severe methodological flaws. They only "trust the science" that fits their politics. – Hodjanernes blog" (in Danish). Retrieved 2025-08-04.
  8. "AJC Urges Retraction of Lancet Letter with Unsubstantiated Projected Gaza Death Toll | AJC". www.ajc.org. 2024-07-10. Retrieved 2025-08-04.