The Lancet, the prestigious peer-reviewed British medical journal, has warned that the true death toll in the Gaza genocide could be 186,000 or more.

This staggering figure amounts to 8 percent of the population of Gaza. A similar percentage of the US population would be 26 million people.

It stands as an indictment of the United States and its imperialist allies, who have funded, armed and politically defended Israel’s genocide in Gaza.

The massive death toll has been made possible by the 14,000 2,000-pound bombs provided by the US to Israel, which it has used not only to massacre tens of thousands but also to destroy all aspects of civilization in Gaza, contributing to the deaths of tens of thousands through malnutrition, communicable diseases and lack of healthcare.

The official death toll since the onset of the Israeli attack, according to Gazan government sources, is 37,396. But The Lancet noted that this figure reflects neither the thousands of people buried under the rubble nor the countless deaths caused by the deliberate destruction of Gaza’s food distribution, healthcare and sanitation systems.

In its report published Friday, titled “Counting the Dead in Gaza: Difficult but Essential,” The Lancet noted:

The number of reported deaths is likely an underestimate. The non-governmental organization Airwars undertakes detailed assessments of incidents in the Gaza Strip and often finds that not all names of identifiable victims are included in the Ministry’s list. Furthermore, the UN estimates that, by Feb. 29, 2024, 35% of buildings in the Gaza Strip had been destroyed, so the number of bodies still buried in the rubble is likely substantial, with estimates of more than 10,000.

The publication further pointed out that “Collecting data is becoming increasingly difficult for the Gaza Health Ministry due to the destruction of much of the infrastructure.”

The report warned:

The total death toll is expected to be large given the intensity of this conflict; destroyed health-care infrastructure; severe shortages of food, water, and shelter; the population’s inability to flee to safe places; and the loss of funding to UNRWA, one of the very few humanitarian organizations still active in the Gaza Strip.

The Lancet noted:

In recent conflicts, such indirect deaths range from three to 15 times the number of direct deaths. Applying a conservative estimate of four indirect deaths per one direct death to the 37,396 deaths reported, it is not implausible to estimate that up to 186,000 or even more deaths could be attributable to the current conflict in Gaza. Using the 2022 Gaza Strip population estimate of 2,375,259, this would translate to 7.9% of the total population in the Gaza Strip.

The Lancet estimate of a death toll of 186,000 is thus based on two assumptions that would tend to lower the estimated death toll. First, it starts with the government’s reported death toll of 37,396, which does not include those buried under the rubble. Then, it uses a multiple of four to estimate the “indirect” deaths caused by the war, as opposed to the multiple of 15 times the number of “direct deaths” observed in other conflicts.

There are reasons to question the validity of these low assumptions, including the fact that Israeli officials have explicitly stated a goal of killing Palestinian civilians through starvation and disease.

In November, Giora Eiland, the former head of the Israeli National Security Council, published an article in which he urged the Israeli military to create medical conditions that would cause the deaths of as many Gazan civilians as possible from preventable disease.

He wrote:

Who are the “poor” women of Gaza? They are all the mothers, sisters, or wives of Hamas murderers. … The international community warns us of a humanitarian disaster in Gaza and of severe epidemics. We must not shy away from this, as difficult as that may be. After all, severe epidemics in the south of the Gaza Strip will bring victory closer and reduce casualties among IDF soldiers.

This genocidal rhetoric is consistent with the declaration by Israeli Defense Minister Yoav Gallant of “a complete siege ... no electricity, no water, no food, no fuel. We are fighting human animals, and we act accordingly.”

In a report published last month, the United Nations commission investigating the Gaza genocide declared:

Israel has used starvation as a method of war, affecting the entire population of the Gaza Strip for decades to come, with particularly negative consequences for children.

The UN committee concluded:

At the time of writing this report, children have already died due to acute malnutrition and dehydration. Through the siege it imposed, Israel has weaponized the withholding of life-sustaining necessities, cutting off supplies of water, food, electricity, fuel, and other essential supplies, including humanitarian assistance. This constitutes collective punishment and reprisal against the civilian population, both of which are clear violations of [international humanitarian law].

The Biden administration, in covering up and defending the Gaza genocide, has claimed that the deaths of civilians are an unintended consequence of Israel’s “war against Hamas.” But these claims are belied by the statements of Israeli officials, who have made it clear that they are waging a war of extermination against the civilian population.

In October, Israeli President Isaac Herzog declared:

It’s an entire nation out there that is responsible. It’s not true this rhetoric about civilians not aware, not involved … we will fight until we break their backbone.

That same month, Israeli Prime Minister Benjamin Netanyahu stated: “You must remember what Amalek has done to you,” referring to a biblical passage that states, “Go, attack Amalek. ... Spare no one, but kill alike men and women, infants, and sucklings.”

The report by The Lancet makes it clear that the Gaza genocide is among the greatest acts of imperialist barbarism in modern history. In under one year, the United States and other imperialist powers have worked with Israel to wipe out close to a tenth of the population of one of the most densely populated urban areas in the world.

This crime is part of a global eruption of imperialist violence, aiming to subjugate the whole world under neo-colonial domination, targeting centrally Russia and China. The massive death toll in Gaza is a warning: Imperialism is prepared to carry out any crime in pursuit of its predatory interests.

The Gaza genocide must be stopped! On July 24, Israeli Prime Minister Benjamin Netanyahu will travel to Washington D.C. to give a progress report to his imperialist paymasters. We call on workers and young people to join the demonstration and meeting in Washington called for that day by the Socialist Equality Party as a critical step in building a mass anti-war movement based on the working class.