Last updated on: 1/5/2009 11:33:00 AM PST

Is the October 2006 Lancet study reporting 654,965 Iraqi deaths reliable?

General Reference (not clearly pro or con)
Robert Lichter, PhD, Professor at George Mason University, in an Oct. 13, 2006 website article titled "How the Media Covered The Lancet’s Iraqi Casualty Study," offered the following information:

"A new study has generated heavy news coverage with its finding that over 650,000 Iraqis have died as a direct or indirect result of the March 2003 US-led invasion. It has also created widespread controversy, largely because this total is far higher than any previous estimate, which creates political problems for President Bush and other supporters of the war. The study, which appeared in the British medical journal The Lancet, is a follow-up to a previous study that attracted similar criticism."

Oct. 13, 2006 Robert Lichter, PhD

View the Johns Hopkins University/Al Mustansiriya University study The Human Cost of War in Iraq: A Mortality Study, 2002-2006 603 KB
View the Oct. 12, 2006 Lancet article Mortality After the 2003 Invasion of Iraq: A Cross-Sectional Cluster Sample Survey 110 KB
View the Oct. 29, 2004 Lancet article Mortality After the 2003 Invasion of Iraq: Cluster Sample Survey 252 kB

PRO (yes)

Les Roberts, PhD, co-author of the Lancet study "Mortality After the 2003 Invasion of Iraq: A Cross-Sectional Cluster Sample Survey," in response to questions regarding the credibility of the study during an Oct. 12, 2006 interview at Democracy Now responded:

"...I just want to say that what we did, this cluster survey approach, is the standard way of measuring mortality in very poor countries where the government isn’t very functional or in times of war. And when UNICEF goes out and measures mortality in any developing country, this is what they do. When the U.S. government went at the end of the war in Kosovo or went at the end of the war in Afghanistan and the U.S. government measured the death rate, this is how they did it. And most ironically, the U.S. government has been spending millions of dollars per year, through something called the Smart Initiative, to train NGOs and UN workers to do cluster surveys to measure mortality in times of wars and disasters.

So, I think we used a very standard method. I think our results are couched appropriately in the relative imprecision of [inaudible]. It could conceivably be as few as 400,000 deaths. So we’re upfront about that. We don’t know the exact number. We just know the range, and we’re very, very confident about both the method and the results...

...And when we reported this, we didn’t say it was 655,000 deaths. We said it was 655,000 deaths, and we’re 95% sure it’s between about 400,000 and 950,000. And that range of imprecision is capturing that variance between neighborhoods that you described, some places having a lot of violence, and some not. So there is less than a 2 percent chance that the number is well below 400,000. So, you know, it’s not precise. It’s incredibly hard to do this kind of work in times of war, and I think that this is awfully good, given the conditions."

Oct. 12, 2006 - Les Roberts, PhD 

Richard Garfield, DrPH, Epidemiologist and Public Health Professor at Columbia University, stated in an Oct. 13, 2006 Christian Science Monitor article titled "Iraq Casualty Figures Open Up New Battleground":

"I loved when President Bush said 'their methodology has been pretty well discredited.' That's exactly wrong. There is no discrediting of this methodology. I don't think there's anyone who's been involved in mortality research who thinks there's a better way to do it in unsecured areas. I have never heard of any argument in this field that says there's a better way to do it."

Oct. 13, 2006 - Richard Garfield, DrPH 

Rebecca Goldin, PhD, Statistician and Professor at George Mason University, in an Oct. 17, 2006 article titled "The Science of Counting the Dead" on the website, wrote:

"While the Lancet numbers are shocking, the study’s methodology is not. The scientific community is in agreement over the statistical methods used to collect the data and the validity of the conclusions drawn by the researchers conducting the study.

War-torn countries do not have central registries to record deaths. People do not necessarily die in hospitals, and their bodies are not necessarily sent to morgues... The website Iraq Body Count (IBC) does not count excess deaths due to a deterioration of infrastructure, lack of hospitals or clean water. Nor does it count deaths not reported by the media. At least in theory, innumerable deaths occur quietly, under the radar screen of any accounting office...

There has been a wealth of material on the web attacking the Lancet study. Most of it is devoid of science, and ranges from outrage at the numbers (it’s impossible to believe it could be so high), to accusations of bias based on the authors’ views of U.S. foreign policy. Interested parties such as the Iraqi government responded quickly by calling the numbers 'inflated' and 'far from the truth,' rather than putting forward any real reasons why these numbers are unlikely to have occurred."

Oct. 17, 2006 - Rebecca Goldin, PhD 

Paul Bolton, MBBS, former Associate Professor of International Health at the Center for International Health at Boston University, in an Oct. 11, 2006 Wall Street Journal article titled "Iraqi Death Toll Exceeds 600,000, Study Estimates," responded when asked to review the survey's methodology:

"Excellent... You can't be sure of the exact number, but you can be quite sure that you are in the right ballpark."

Oct. 11, 2006 - Paul Bolton, MBBS 

Ronald Waldman, MD, MPH, Professor of Clinical Population & Family Health at the Columbia University Mailman School of Public Health, stated in an Oct. 11, 2006 Washington Post article titled "Study Claims Iraq's 'Excess' Death Toll Has Reached 655,000":

"Tried and true [methodology]... this is the best estimate of mortality we have."

Oct. 11, 2006 - Ronald Waldman, MD, MPH 

Gilbert Burnham, MD, PhD, Epidemiologist and Professor at the Bloomberg School of Public Health at Johns Hopkins University, and lead author of the Lancet paper, in an Oct. 13, 2006 Christian Science Monitor article titled "Iraq Casualty Figures Open Up New Battleground," offered the following:

"There are several ways of counting, one is simply counting the number of bodies that come to the morgue or reports from hospitals or in newspapers. The problem is those numbers may be valid from the site they're collected from but from nowhere else. So if you want to look at numbers that affect population as a whole, the best way is to do surveys.

The possibility of introducing bias in any kind of survey is real, and you spend more time designing the survey to eliminate the sources of bias than actually carrying it out... One of the real risks in this is that people report deaths that don't occur, so we did ask for death certificates. And in 92 percent of cases, they were provided."

Oct. 13, 2006 - Gilbert Burnham, MD, PhD 

CON (no)

George W. Bush, MBA, US President, in an Oct. 11, 2006 White House news conference, offered the following remarks:

"No, I don't consider it a credible report, neither does General Casey and neither do Iraqi officials. I do -- I do know that a lot of innocent people have died and that troubles me and it grieves me, and I applaud the Iraqis for their courage in the face of violence...

No question it's violent, but this report is one -- they put it out before it was pretty well -- the methodology was pretty well discredited. But, you know, I talk to people like General Casey. And of course the Iraqi government put out a statement talking about the report. Yeah? I -- you know, I stand by the figure a lot of innocent people have lost their life. Six hundred thousand, or whatever they guessed at, is just -- it's not credible."

Oct. 11, 2006 - George W. Bush, MBA 

Tony Blair, JD, British Prime Minister at the time, through his official spokesman (PMOS), in response to a question regarding the Lancet study at a press briefing on Oct. 12, 2006, responded:

"…[W]e made our view clear first in 2004. We had made it clear again, but much more important was the view of the Iraqi government, which, as recently as October, had said that the Lancet report numbers method was far from the correct. The Iraqi health ministry was the place to get the relevant figures.

The problem with this was that they were using an extrapolation technique, from a relatively small sample, from an area of Iraq which was not representative of the country as a whole. We had questioned that technique from the beginning and we continued to do so. The Lancet figure was a greater order of magnitude than of any other figure. It was not one we believed to be anywhere near accurate. That was not in anyway to downplay the seriousness of the security situation in Iraq or lessons to be learned in the wake of the tragedy of the deaths that had been caused.

It was important to remember that the deaths were being caused by terrorists, not by the Iraqi Government or the international force."

Oct. 12, 2006 - Tony Blair, JD 

George Casey, MA, US Army General, former Commander of Multi-National Force Iraq, stated in an Oct. 11, 2006 Department of Defense News Briefing:

"I have not seen the study. That 650,000 number seems way, way beyond any number that I have seen. I have not seen a number higher than 50,000. And so I do not give that much credibility at all."

Oct. 11, 2006 - George Casey , MA 

Ali al-Dabbagh, Spokesperson for the Government of Iraq, in an Oct. 11, 2006 USA Today newspaper article titled "Study Estimates 600,000 Iraqis Dead by Violence," stated:

"[The report] exceeds the reality in an unreasonable way, [and it] gives inflated numbers in a way that violates all rules of research and the precision required of research institutions... These numbers are far from the truth."

Oct. 11, 2006 - Ali al-Dabbagh 

Iraq Body Count, in an Oct. 16, 2006 press release titled "Reality Checks: Some Responses to the Latest Lancet Estimates," concluded:

"Our view is that there is considerable cause for scepticism regarding the estimates in the latest study, not least because of a very different conclusion reached by another random household survey, the United Nations 'Iraq Living Conditions Survey' (ILCS), using a comparable method but a considerably better-distributed and much larger sample. This latter study gave a much lower estimate for violent deaths up until April 2004, despite that period being associated with the smallest number of observed deaths in the latest Lancet study.

Additionally, claims that the two Lancet studies confirm each other's estimates are overstated. Both the violent and non-violent post-invasion death estimates are actually quite different in the two studies. What emerges most clearly from this study is that a multi-methodological approach and much better resourced work is required. Substantially more deaths have occurred than have been recorded so far, but their number still remains highly uncertain."

Oct. 16, 2006 - Iraq Body Count 

Borzou Daragahi, Los Angeles Times Middle Eastern Bureau Staff Writer, stated in an Oct. 11, 2006 PBS radio interview titled "Study Finds Iraq Death Toll Higher Than Previous Estimates":

"Well, we think -- the Los Angeles Times thinks these numbers are too large, depending on the extensive research we've done. Earlier this year, around June, the report was published at least in June, but the reporting was done over weeks earlier. We went to morgues, cemeteries, hospitals, health officials, and we gathered as many statistics as we could on the actual dead bodies, and the number we came up with around June was about at least 50,000.

And that kind of jibed with some of the news reports that were out there, the accumulation of news reports, in terms of the numbers killed. The U.N. says that there's about 3,000 a month being killed; that also fits in with our numbers and with morgue numbers. This number of 600,000 or more killed since the beginning of the war, it's way off our charts."

Oct. 11, 2006 - Los Angeles Times 
Borzou Daragahi 

Stephen Moore, MA, Senior Fellow at the Cato Institute, in an Oct. 18, 2006 Wall Street Journal Op-Ed article titled "655,000 War Dead?" wrote:

"After doing survey research in Iraq for nearly two years, I was surprised to read that a study by a group from Johns Hopkins University claims that 655,000 Iraqis have died as a result of the war. Don't get me wrong, there have been far too many deaths in Iraq by anyone's measure; some of them have been friends of mine. But the Johns Hopkins tally is wildly at odds with any numbers I have seen in that country. Survey results frequently have a margin of error of plus or minus 3% or 5%--not 1200%... It is highly unlikely the Johns Hopkins survey is representative of the population in Iraq."

Oct. 18, 2006 - Stephen Moore, MA