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The Report of the Iraq Inquiry
217.  The UK became one of 15 members of the “Core Group” charged with steering the
Geneva Declaration process and guiding its implementation.134
218.  The Lancet published the second Johns Hopkins Bloomberg School of Public
Health cluster sample survey of excess mortality in Iraq (direct and indirect, violent and
non‑violent deaths) on 12 October 2006.135 The first Johns Hopkins study had been
published by The Lancet in October 2004.
219.  The second study used the same (cluster sample survey) methodology as the
first study, but was based on a larger sample (1,849 households as against 988 in the
first study).
220.  The study estimated that between March 2003 and June 2006, there had been
654,965 excess Iraqi deaths and 601,027 excess violent Iraqi deaths as a consequence
of the war. The study attributed 31 percent of violent excess deaths to the coalition,
24 percent to “other” and 45 percent to “unknown”. The study also concluded that levels
of violence were increasing.
Criticisms of the Lancet studies
The 2004 and 2006 Johns Hopkins Bloomberg School of Public Health studies published
by The Lancet have been subject to several criticisms. The most significant are:
That the baseline pre‑invasion mortality rate used by the studies was lower than the
actual pre‑invasion mortality rate, leading to an over‑estimation of excess mortality
in the post‑invasion period. The second study used a pre‑invasion mortality rate of
5.5 deaths per thousand people.136 The 2008 Iraq Family Health Survey (IFHS) used
a figure of nine deaths per thousand.137
That the sample sizes were too small. The 2004 Lancet study (central estimate
98,000 excess deaths) surveyed 988 households and the 2006 Lancet study (central
estimate 655,000 excess deaths) surveyed 1,849 households. The 2008 IFHS
(central estimate 151,000 excess violent deaths) surveyed 9,345 households. The
IFHS team highlighted the implications of that difference in scale: “The estimated
number of deaths in the IFHS is about three times as high as that reported by the
Iraq Body Count. Both sources indicate that the 2006 study by Burnham et al [the
second Lancet study] considerably overestimated the number of violent deaths. For
instance, to reach the 925 violent deaths per day reported by Burnham et al for June
2005 through June 2006, as many as 87 percent of violent deaths would have been
missed in the IFHS and more than 90 percent in the Iraq Body Count. This level of
underreporting is highly improbable, given the internal and external consistency of
the data and the much larger same size and quality‑control measures taken in the
implementation of the IFHS.”
134  Geneva Declaration on Armed Violence and Development website, How does it work.
135  Burnham G, Lafta R, Doocy S and Roberts L. Mortality after the 2003 invasion of Iraq: a cross‑sectional
cluster sample survey. The Lancet 368: 1421‑1428 (2006).
136  Roberts L, Lafta R, Garfield R, Khudhairi J and Burnham G. Mortality before and after the 2003
invasion of Iraq: cluster sample survey. The Lancet 364: 1857-1864 (2004).
137  Iraq Family Health Survey Study Group. Violence‑Related Mortality in Iraq from 2002 to 2006.
The New England Journal of Medicine 358: 484-493 (2008).
208
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