How Many Have Really Died in Gaza? An Analysis of the Death Toll

By any definition, the Gaza War is one of the most intense conflicts being fought anywhere on Earth — comparable to those in Ukraine or Sudan in terms of sheer destruction. Yet, while Gaza may be one of the biggest wars currently taking place, it is also one of the most mysterious. Not in the sense that few are talking about it — the conflict dominates news coverage — but in the sense that even the most straightforward facts are bitterly disputed.

Perhaps nothing causes so much ill-feeling as the question of the war’s death toll. Ever since Israel launched its military response to the slaughter on October 7th, a simultaneous war of narratives has erupted in the media. On one side are those who want to play down the extent of Gaza’s suffering for political ends.

On the other are those who have a vested interest in inflating the casualty figures. Caught in the middle, the truth can sometimes feel like it’s getting crushed into nothing. Thankfully, there are still serious researchers out there — researchers who perform painstaking work, trying to assess Gaza’s true death toll in a way that is free from spin and bias.

The Staggering Costs of War and Why the Numbers Matter

Glimpsed in headlines, the numbers can look unbelievable. Over 40,500 Palestinians dead, according to the UN, with perhaps 10,000 missing under the rubble. Around 60 percent of all buildings in Gaza damaged or destroyed.

Compared to other conflicts, these numbers are staggering. In its half-yearly report into global violence, the Armed Conflict Location and Event Data Project (ACLED) recently described how “Palestine witnessed 39,800 reported fatalities from July 2023 to the end of June 2024, displacing the previous most deadly conflict, Ukraine, where ACLED recorded more than 37,300 deaths in the same time period.” Such sky-high figures are important beyond mere humanitarian reasons.

They are part of the reason why Israel now faces two cases in international courts: one for war crimes, and one for genocide. Yet, for all their obvious salience, there is another intriguing aspect to these numbers. Almost no one can agree on whether they are even close to being right.

It is not merely that the Israel Defense Forces and Hamas disagree on the number of people killed in Gaza. There is so much anger and misinformation swirling around this topic that sensible discourse feels almost impossible. Researchers and statisticians who have attempted to approach this vital question as coolly and dispassionately as possible have made findings that deserve careful examination.

But first, there is something that needs to be addressed: why it is currently so hard to get an accurate death toll.

How Gaza’s Health Ministry Counted the Dead — and Why It Broke Down

When Israel’s bombardment began, the Palestinian Ministry of Health’s Gaza branch (usually abbreviated to MoH) did what it had done in previous conflicts. It began releasing death tolls based on the bodies that passed through its morgue system. Although run by Hamas, the MoH’s work in this area had been judged as reasonably accurate in previous wars.

Royal Holloway expert — and board member of violence-tracking non-profit Every Casualty Counts — Professor Mike Spagat has credited this to a “simple and transparent” system. “For each person killed, the MoH recorded the name, the age, the sex and a national ID number. The national ID number is particularly important because these ID numbers are assigned by the Israeli authorities, who maintain the Gazan population register.”

This meant Israel could check any name on the list to make sure it belonged to a real person, resulting in a mostly accurate count. And signs are that — despite skepticism from US officials — this is exactly what happened when the war began in October 2023. The MoH logged bodies as normal and produced a fairly accurate death toll.

Researchers from Johns Hopkins and the London School of Hygiene and Tropical Medicine ran separate studies on those early figures and found “no evidence” of inflated data into November. The non-profit Airwars also ran its own study, where it managed to verify most of the names on a sample list of 3,000. Clearly, the system used at the start of the conflict produced numbers that were reasonably on target.

Until, suddenly, they were not. Towards the end of November 2023, the quality of data gathered by the MoH began to dip. The reason was the destruction of the Gazan healthcare system.

At the beginning of October 2023, Gaza had 36 functioning hospitals. By mid-June 2024, the Guardian reports that this number had plunged to 17. In their words: “the rest were entirely destroyed.”

This destruction meant many bodies no longer passed through morgues. As early as December — two months into the war — the MoH seems to have recognized this was impacting the quality of their data. So they decided to supplement their morgue data with that from other sources.

It would be this necessary decision — more than any other — that wound up creating such confusion over the true death toll.

Media Sourcing, Online Forms, and the Transparency Problem

The idea that a war might be so destructive that counting bodies becomes impossible is not new. There are some well-established alternative methods for assessing an ongoing conflict’s death toll. One is to use reports found in reputable media.

This is one of the methods the MoH adopted to combat the lack of data from destroyed hospitals. The Economist states the first media-sourced casualty figures began appearing in the death counts in mid-November of 2023. As Every Casualty Counts has written: “Media monitoring is a perfectly respectable way of monitoring recorded deaths in armed conflict.

Lots of organizations do this all around the world.” One current example is the joint count the BBC and independent Russian outlet Mediazona are undertaking into the true cost of the Ukraine War. Along with other methods like visiting graveyards and war memorials, the team monitors local Russian media for obituary notices.

What makes the BBC-Mediazona count so respected is that it is incredibly transparent in its methodology. It is also extremely stringent, and it has to be. To avoid duplications, vast teams are required to process data and double and triple check every single name.

Unfortunately, the Gazan MoH keeps its media-sourcing methods opaque. Every Casualty Counts explains: “To assess the reliability of this revised system, we would need to know what methodology the MoH uses to record deaths from media sources. We also need to see a database containing these reported deaths and the sources that report them.

Unfortunately, this information has not been made public.” To be clear, this does not mean that the MoH figures are bunkum. They could be using methodology every bit as rigorous as the BBC uses for its Russian casualty figures.

In that case, one would expect to find a small number of duplications, but a list that is otherwise pretty solid. The trouble is that this is not known for a fact. Unless the data sets are released, there will always be a question mark hanging over some of these figures.

At the same time that it began using media sources, the MoH also created a process for people to register the death of family members simply by filling out an online form. The logic was that this would capture casualties lost under rubble or otherwise unreported, but — combined with the use of media reports — it also opened the door to repeated instances of double-counting. The Economist looked at data from April 30th.

By that day, the cumulative number of dead recorded through the morgue system was slightly over 20,000. Adding on the deaths from media reports took the figure far over 30,000. With the publicly reported fatalities, the number closed in on 40,000.

The Named List: A Minimum Baseline for Wartime Deaths

There is also the matter of civilian casualty ratios. A huge controversy erupted when the UN revised its civilian death toll downwards. Many took that as proof that the MoH’s figures were flawed.

But the UN was not only using MoH figures. It was combining them with a ratio of civilian dead provided by Gaza’s Government Media Office (GMO). This was problematic because the GMO is a Hamas propaganda department.

While the MoH has a track record in previous conflicts of reasonable accuracy, the GMO and “accuracy” should not even be in the same sentence. Since October 2023, the GMO has claimed that 70 percent of the Gazan dead are women and children. Initially, that was close to the truth — in the first weeks, the MoH list of the dead was nearly 64 percent women and children.

Since then, the figure has sharply fallen. In June, an AP News analysis showed the real number is likely closer to 38 percent. The MoH does sporadically release a set of data that can be taken for a good baseline.

Known as the Named List, it may be the closest available to a minimum casualty count. When the MoH releases these datasets, it always constitutes a significant moment. A list of the named dead — complete with birth dates and ID numbers — allows researchers to evaluate if the count is reasonably accurate.

So far, the answer appears to be that it is. The Named List is not perfect. Recent updates have included deaths reported by family members via online forms, as well as those processed by hospitals and morgues.

This could potentially lead to some instances of duplication. A bigger problem is that several entries are obviously flawed. A whole bunch of names have been listed with invalid ID numbers.

Every Casualty Counts explains: “Most of these invalid IDs begin with 8046, which could potentially be placeholder ID numbers for people for whom the MoH doesn’t have the correct number. We don’t know.” Despite some flawed entries, the key takeaway appears to be that the list is doing a good job.

The Economist conducted an analysis in late April and found that 84 percent of the entries were valid, with real ID numbers. The periodical also got access to an Israel Defense Forces analysis of the list from January. The IDF concluded that 83 percent of the entries were real people.

Professor Spagat came up with a similar figure in a March analysis, concluding that 84 percent were likely real. Summarizing the findings, he stated: “Yes, there needs to be more work on the data but it is still a good, largely transparent system. All subsequent work on the death toll of the war will build on this foundation.”

The last time the list was released in full, there were 28,185 entries on it. By late August, that figure had risen to 32,280 — although without the data release that would allow researchers to verify the newest casualties. As such, 28,185 can probably be taken as the absolute minimum baseline for wartime deaths in Gaza.

The Lancet Letter’s Claim of 186,000 Dead and the Indirect Death Debate

This baseline figure does not differentiate between civilians and Hamas militants. While Hamas boasted in April that only 6,000 of its fighters had died, by June the Israelis were claiming to have killed 15,000. Given that neither side provided evidence, it is hard to say how much of the baseline figure might be made up of combatants.

Either way, it still represents a staggering number. During 2014’s Gaza conflict — previously the 21st century’s deadliest clash in the strip — somewhere in the region of 2,300 Palestinians were killed. Even at its lowest count, the current Gaza War has a death toll that is orders of magnitude greater.

Yet 28,000 is merely a baseline. Others think the true death toll may be far higher. The Lancet is one of the most respected medical journals in the world.

For a study to appear within its pages, it has to go through a rigorous peer review process. However, the same is not true of the Lancet’s correspondence section. While they only publish letters from real experts, they do not require them to undergo any peer review.

Misunderstanding this basic fact has led to some incredibly skewed coverage of the Gaza letter published on July 20th. Written by Rasha Khatib, Martin McKee, and Salim Yusuf, it suggested that a jaw-dropping 186,000 deaths may be attributable to the conflict, once indirect deaths are also counted. At the crux of the writers’ figure is the phenomenon of indirect deaths — those who die not due to armed conflict directly, but because of the conditions the conflict creates: disease from a collapsed healthcare system, starvation from lack of access to food.

Such deaths are not unique to the Gaza War. The 2020 to 2022 Tigray War in Ethiopia became this century’s deadliest conflict not due to the intensity of fighting, but because a government blockade triggered a famine that may have killed hundreds of thousands. The conflict in East Timor between 1974 and 1999 saw an estimated 84,000 die due to displacement and starvation, compared to 19,000 killed in fighting.

Using thirteen recent wars, the Lancet researchers estimated that “in recent conflicts, such indirect deaths range from three to 15 times the number of direct deaths.” Taking the “conservative” estimate of four indirect deaths per every direct death, they concluded: “It is not implausible to estimate that up to 186,000 or even more deaths could be attributable to the current conflict in Gaza.” If true, this would make Gaza — with the possible exception of Ukraine — the deadliest conflict happening anywhere on Earth.

As a percentage, 186,000 would translate to nearly 8 percent of Gaza’s pre-war population.

Expert Rebuttals and the Limits of Modeling Conflict Deaths

Some NGOs on the ground in Gaza found the Lancet figures plausible. France 24 interviewed President of Doctors of the World, Jean-François Corty, who declared: “The death toll of 186,000 mentioned in The Lancet is consistent with the health, military and geopolitical situation due to the sea, air and land blockade imposed on the Gaza Strip.” Pointing to the lack of hospitals and general healthcare, Corty added that if one includes those likely to die of malnutrition or wounds in the weeks and months to come, “then yes, the figure of 186,000 deaths mentioned in The Lancet is credible.”

But not everyone was convinced. Back in February, epidemiologists at Johns Hopkins University and the London School of Hygiene and Tropical Medicine unveiled a model predicting how many would die in Gaza. The model ran three scenarios: ceasefire, escalation, and continuation at the same tempo.

If the conflict continued, the model predicted an additional 58,260 deaths by August 2024. With August in the rear-view mirror, it became clear the model was wrong. While fighting did continue at a similar tempo, the MoH reported only 9,000 deaths over the time period.

The model was out by a factor of six. This demonstrates how tricky it can be to model health outcomes in a chaotic situation. Had an epidemic taken hold or had the predicted famine occurred, the 58,000 figure might have come to pass.

But it did not. Writing for the British charity Action on Armed Violence (AOAV), Professor Spagat highlighted various areas where the Lancet letter makes flawed assumptions. Regarding the four-to-one ratio, Spagat wrote: “This ratio is plucked from table 2.3 in the Global Burden of Armed Violence report that lists ratios of indirect to direct deaths ranging from 0 to 15.7 for thirteen wars.

However, these figures come from a small, non-representative sample of conflicts, many of which differ significantly from Gaza in terms of geography, accessibility, and humanitarian conditions.” Among those differences he cites are the density of the Gaza Strip and the sheer amount of international attention focused on the conflict: “This focus can potentially mitigate the worst outcomes seen in more isolated conflicts. Despite Israeli restrictions, humanitarian aid efforts continue, and international scrutiny may influence the delivery and effectiveness of aid.”

Spagat told the New York Times: “Although humanitarian agencies are warning of catastrophic levels of hunger, there is little evidence of widespread deaths because of starvation.” He described the application of a four-to-one ratio to Gaza as “speculative at best.”

Implications: What the Evidence Suggests and What Remains Unknown

For his part, Professor Spagat seems to think the final death toll is likely to be large but nowhere near the 186,000 number. Writing for Every Casualty Counts, he laid out his assessment: “I would expect the final true number of people killed in the conflict to be in line with the figures being cited by the MoH, plus or minus 5,000 deaths.” Given the MoH is currently reporting around 40,000 dead, that means Spagat would expect to see a death toll anywhere between 35,000 and 45,000.

Even at the lower end, that is an astonishing number, equivalent to around 1.63 percent of Gaza’s pre-war population. To put that in context, the Sudan war would have to kill over 760,000 people to eliminate 1.63 percent of the country’s population of 46.87 million. So far, Sudan is estimated to have lost 150,000, or around 0.32 percent.

And Sudan is one of the biggest, most destructive wars raging anywhere on Earth. Several conclusions emerge from this analysis. First, the MoH Named List is the closest thing currently available to a reasonable minimum baseline for deaths, despite some notable flaws.

Second, while there may be a fairly good grasp of the death toll’s likely lower bounds, there is no way of knowing how many of the dead are civilians and how many are combatants. Third, many of the current mysteries swirling around the toll could be improved by the MoH being more transparent with its data. Regardless of how credible one finds the media-sourced and publicly reported deaths, the fact remains that even the Named List death toll alone is incredibly high — far in excess of any previous modern conflict seen in Gaza.

And, crucially, the war is still not over. While Every Casualty Counts reports that the tempo of daily deaths has dropped from an average of 400 in the conflict’s opening months to roughly 100, that is still a significant number of lives being lost. Figuring out the real number of dead in Gaza is crucial for ever hoping to understand the meaning of this conflict — a conflict that remains one of the most charged and divisive the world has seen in decades.

Frequently Asked Questions

Why did the quality of Gaza death toll data deteriorate after November 2023?

The Palestinian Ministry of Health’s counting system broke down because the Gazan healthcare system was destroyed during the conflict. Gaza had 36 functioning hospitals at the war’s start; by mid-June 2024 only 17 remained, meaning many bodies no longer passed through morgues. To compensate, the MoH began supplementing morgue data with media-sourced reports and an online self-reporting form for family members — methods that lack the transparency and verification rigour of the original system.

What is the Named List and why does it matter?

The Named List is a dataset periodically released by the MoH containing each recorded death’s name, age, sex, and national ID number. Because Israeli authorities maintain the Gazan population register, these ID numbers can be independently checked. Analyses by The Economist, the IDF, and Professor Mike Spagat all found roughly 83–84 percent of entries on the last full release (28,185 names) to be valid, making it the closest available minimum baseline for confirmed wartime deaths.

What did the Lancet correspondence letter claim, and why did researchers criticise it?

The letter, published in July 2024 by Khatib, McKee, and Yusuf, suggested up to 186,000 deaths may be attributable to the conflict once indirect deaths are counted. It was not peer-reviewed. Professor Spagat criticised the authors for applying a four-to-one indirect-to-direct death ratio drawn from a small, non-representative sample of thirteen conflicts that differ significantly from Gaza in geography, accessibility, and humanitarian conditions. He called the application of that ratio “speculative at best.”

How did the Johns Hopkins predictive model perform, and what does that show?

Epidemiologists at Johns Hopkins and the London School of Hygiene and Tropical Medicine published a model in early 2024 predicting an additional 58,260 deaths by August if the conflict continued at the same tempo. With August in the rear-view mirror, the MoH reported only around 9,000 deaths over that period — meaning the model was out by a factor of six. This illustrates how difficult it is to model health outcomes in chaotic conflict conditions, particularly when predicted famines and epidemics do not materialise.

What does Professor Spagat estimate as the likely final death toll?

Spagat estimates the final true death toll will be in line with the MoH’s reported figure of around 40,000, plus or minus 5,000 deaths — putting the likely range at 35,000 to 45,000. Even at the lower bound, that represents approximately 1.63 percent of Gaza’s pre-war population, a share that dwarfs the proportional toll of the Sudan conflict, itself considered one of the world’s most destructive wars.

Sources

1. https://www.ochaopt.org/content/reported-impact-snapshot-gaza-strip-21-august-2024
2. https://www.ochaopt.org/
3. https://acleddata.com/2024/07/31/palestine-is-now-the-most-dangerous-place-in-the-world-press-release/
4. https://www.economist.com/middle-east-and-africa/2024/05/23/how-many-people-have-died-in-gaza
5. https://everycasualty.org/the-breakdown-of-casualty-recording-in-gaza-since-october-2023/
6. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736
7. https://aoav.org.uk/2024/a-critical-analysis-of-the-lancets-letter-counting-the-dead-in-gaza-difficult-but-essential-professor-mike-spagat-reviews-the-claim-the-total-gaza-death-toll-may-reach-upwards-of-186000/
8. https://www.theguardian.com/world/article/2024/jul/12/gaza-death-toll-indirect-casualties
9. https://data.techforpalestine.org/docs/killed-in-gaza/
10. https://foreignpolicy.com/2024/06/10/israeli-views-gaza-war-hamas-oct-7-attack/
11. https://www.nytimes.com/2024/07/25/world/middleeast/gaza-death-toll-israel-war.html
12. https://www.france24.com/en/middle-east/20240711-more-than-186-000-dead-in-gaza-how-credible-are-the-estimates-published-on-the-lancet
13. https://www.nytimes.com/2024/07/11/world/middleeast/gaza-war-death-toll-lancet.html
14. https://apnews.com/article/israel-palestinians-gaza-deaths-women-children-e258a4c14641978a00dfb957ce348957
15. https://gaza-projections.org/