Those Who Debunk Lancet Are Liars

The author commissioned the “Lancet” study recently attacked in a National Journal report and by the Wall Street Journal. He calls the criticism a “hatchet job,” fraudulent or based on innuendo.

(February 14, 2008) — (Commentary) One puzzling aspect of the news media’s coverage of the Iraq war is their squeamish treatment of Iraqi casualties. The scale of fatalities and wounded is a difficult number to calculate, but its importance should be obvious. Yet, apart from some rare and sporadic attention to mortality figures, the topic is virtually absent from the airwaves and news pages of America. This absence leaves the field to gross misunderstandings, ideological agendas, and political vendettas.

The upshot is that the American public—and U.S. policy makers, for that matter—are badly informed on a vital dimension of the war effort.

As an academic interested in the war’s violence, I commissioned a household survey in October 2005 to gauge mortality, and I naturally turned to the best professionals available—the Johns Hopkins University epidemiologists who had conducted such surveys before in Iraq, Congo, and elsewhere. Their survey of 1,850 households resulted in a shocking number: 600,000 dead by violence in the first 40 months of the war. The survey was extensively peer reviewed and published in the British medical journal, the Lancet, in October 2006.

The findings caused a ripple of interest (in part because President Bush, during a press conference, called the results “not credible”) and stirred a very lively debate among the few people interested in the methods. By and large, however, the survey passed from public view fairly quickly, and the news media continued to cite the very low numbers produced by the Iraq Body Count, a U.K.-based NGO that counts civilian deaths through English-language newspaper reports.

Another survey, this one undertaken by a private U.K. firm, Opinion Business Research (ORB), found more than one million dead through August 2007. Yet another, a much larger house-to-house survey was conducted by the Iraq Ministry of Health (MoH). This also found a sizable mortality figure—400,000 “excess deaths” (the number above the pre-war death rate), but estimated 151,000 killed by violence. The period covered was the same as the survey published in The Lancet, but was not released until January 2008.

The ORB results were almost totally ignored in the American press, and the MoH numbers, which did get one-day play, were covered incompletely. Virtually no newspaper report dug into the data tables of the Iraqi MoH report, published in the New England Journal of Medicine, for that total excess mortality figure, or to ask why the MoH report showed a flat rate for killing throughout the war when every other account shows sharp increases through 2005 and 2006. The logical explanation for this discrepancy is that people responding to interviewers from the government, and a ministry controlled by Moktada al Sadr, would not want to admit that their loved one died by violence. There were, instead, very large numbers of dead by road accidents and “unintentional injuries.” The American press completely missed this.

What some in the news media did not miss, however, was a full-scale assault on the legitimacy of the Lancet article by the National Journal, the “insider” Capitol Hill weekly.

The attack, by reporters Carl Cannon and Neil Munro, which was largely built on persistent complaints of two critics and heaps of innuendo, was largely ignored—its circulation is only about 10,000—until the Wall Street Journal picked up on one bit of their litany: that “George Soros” funded the survey. “The Lancet study was funded by anti-Bush partisans and conducted by antiwar activists posing as objective researchers,” said the January 9, 2008, editorial (titled “The Lancet’s Political Hit”) and concluded: “the Lancet study could hardly be more unreliable.” The editorial created sensation in the right-wing blogosphere and in several allied news outlets.

Let me convey what I thought was a simple and unremarkable fact I told Munro in an interview in November and one of the Lancet authors emailed Cannon the details of how the survey was funded. My center at MIT used internal funds to underwrite the survey. More than six months after the survey was commissioned, the Open Society Institute, the charitable foundation begun by Soros, provided a grant to support public education efforts of the issue. We used that to pay for some travel for lectures, a web site, and so on.

OSI, much less Soros himself (who likely was not even aware of this small grant), had nothing to do with the origination, conduct, or results of the survey. The researchers and authors did not know OSI, among other donors, had contributed. And we had hoped the survey’s findings would appear earlier in the year but were impeded by the violence in Iraq. All of this was told repeatedly to Munro and Cannon, but they choose to falsify the story. Charges of political timing were especially ludicrous, because we started more than a year before the 2006 election and tried to do the survey as quickly as possible. It was published when the data were ready.

The New York Post and the Sunday Times of London, both owned by Rupert Murdoch, followed the WSJ editorial and trumpeted the Soros connection and the supposed “fraud” which Munro and Cannon hinted. “$OROS IRAQ DEATH STORY WAS A SHAM” was a headline in the Post, which was followed by a story in which scarcely anything stated was true.

The charges of “fraud” that were also central to the National Journal piece were based on distortions or ignorance of statistical method, such as random sampling and sample size, or speculations about Iraqi field researchers fabricating data. Nothing close to proof of misdeeds was ever offered.

The two principal authors, Gilbert Burnham and Les Roberts, parried the fraud charges effectively on their web site and in letters to the editors, but of course these are rarely noticed as much as the original charges. Those charges were wholly speculative and at times based on small irregularities in the collection of data, hardly a crime in the midst of the bloodiest period of the war. For example, some death certificates were not collected from respondents; about 80 percent of the time they were. (In the Iraqi MoH survey, death certificates were never collected, making their claims about violence v. nonviolent causes unconfirmable.)

In any case, the many peer reviews of The Lancet article, including one by a special committee of the World Health Organization, gave the survey methods and operations passing grades.

Munro then went on the Glenn Beck program and suggested the Iraqi researchers were unreliable (“without U.S. supervision”) and that the Lancet authors “made it clear they wanted this study published before the election.” Both of those assertions are untrue. Beck then repeated these allegations on his radio program, and added that there was no peer review of the fatality figures, another falsehood, and “we’re getting it jammed down our throat by people who are undercover who are pulling purse strings, who are manipulating the news.”

The charge, repeated in all these media, that the Iraqi research leader, Riyadh Lafta, M.D., operated “without U.S. supervision” and was therefore suspect is particularly interesting. Munro, in a note to National Review Online, asserted that Lafta “said Allah guided the prior 2004 Lancet/Johns Hopkins death-survey,” which he also had noted in the National Journal piece. When he interviewed me he pestered me about two anonymous donors, demanding to know if either were Arab or Muslim. A pattern here is visible, one which reeks of religious prejudice.

Munro had also ignored the corroborating evidence I sent him, the 4.5 million displaced (suggesting hundreds of thousands of fatalities, drawing on the ratio of all other wars); estimates of new widows (500,000 from the war); and the other surveys done in Iraq suggesting enormous numbers of casualties (ABC/USA Today poll of March 2007, showing roughly 53% physically harmed by war). When I mentioned these things to him on the telephone, he literally screamed that such data didn’t matter, that the Lancet probe was “a hoax.” Lancet article authors also cite several cases where they were misquoted. The National Journal’s editors have been informed of their reporters’ misconduct and errors, and have not responded.

So the smear is complete—a “political hit” by the “anti-Bush billionaire,” complicity by anti-war academics, fraud by Muslims devoted to Allah—and repeated over and over in the right-wing media. Little has of this has appeared in the legitimate news media, apart from right-wing columnists like Jeff Jacoby in the Boston Globe.

One might expect that such nonsense is obvious to neutral observers, but it constitutes a kind of harassment that scholars must fend off, diverting from more important work. Gilbert Burnham, the lead author on the Lancet article, runs health clinics in Afghanistan and East Africa, and is spending inordinate amounts of time responding to the attacks. Les Roberts, a coauthor, and I have both had colleagues at our universities called by Munro to ask if they would punish us for fraud. The OSI people have also been writing letters to set the record straight. Most important, Riyadh Lafta, who has been threatened before, may be in more danger due to these attacks.

As to the issue of the human cost of the war, even the legitimate press that has avoided this kerfuffle might be intimidated from taking on the issue in depth. The fact that the National Journal hatchet job and the MoH survey appeared within days of each other sent a message to editors around the United States—one survey is “discredited” and one is legitimate. The treatment of the MoH survey that week often noted its death-by-violence number was one-fourth of the Lancet figure — forgetting, again, that total war-related mortality were much closer in both, and congruent with other surveys. The New York Times did run an editorial in early February about the dead in Iraq — the 124 journalists killed in the war.

The topic of the war’s exceptional human costs, now inflamed by these calumnies, appears to be too hot to handle. Even with all this fuss in January, no explorations of the Iraqi mortality from the war have appeared in the major dailies. No editorials, no examination of the methods (or the danger and difficulty of collecting data), no sense that the scale of killing might affect the American position, or might shed some light on U.S. war strategy, or might point to honorable exits and reconstruction obligations. Remarkably, no curiosity at all about the dead of Iraq, and what they can tell us.