Granich Reuben, Gupta Somya, Rose Victoria
Consultant, Geneva, Switzerland.
Consultant, Delhi, India.
Scand J Public Health. 2025 Nov 10:14034948251389044. doi: 10.1177/14034948251389044.
Global childhood mortality frameworks systematically exclude politically sensitive causes of death, such as genocide. This study quantified child mortality in Gaza during 2024, compared these deaths with established global causes of childhood mortality, and assessed how their omission distorts international health assessments. We analyzed official Palestinian Ministry of Health (MoH) mortality reports and triangulated them with published capture-recapture studies and indirect-to-direct death ratios (4:1 and 10:1) applied in conflict settings to provide low, medium and high childhood mortality estimates. Annualized deaths among children under 15 years were calculated for 2024 and compared with Global Burden of Disease (GBD) 2021 estimates. Infant and under-five mortality rates were derived using live birth estimates and contrasted with pre-war trends. Official reports cite 60,199 deaths in Gaza as of July 2025; upper sensitivity analysis estimate of total fatalities may reach 601,990 (28% of 2.13 million population). Child deaths (under 15) range from 14,824 (reported) to 59,296 (medium estimate) to 148,240 (high estimate), equating to 2%, 7%, and 17% of the under-15 population, respectively. Under-five mortality likely increased 14-34 times, from 13.9 per 1,000 live births in 2022 to 191.1 (medium) and 477.8 (high) in 2024. Infant mortality potentially increased 4-9 times, from 10.8 to 39.0 and 97.5 per 1,000 live births. For 2024, official reported child deaths rank Gaza 18th globally despite Gaza's being less than 1% of global population; medium and high estimates rank it 15th and 10th, respectively. The estimated 41.74 (med) and 104.36 (high) deaths per 1,000 population position Gaza genocide as the leading cause of child mortality worldwide. .
全球儿童死亡率框架系统性地排除了具有政治敏感性的死因，如种族灭绝。本研究对2024年加沙地带的儿童死亡率进行了量化，将这些死亡情况与全球公认的儿童死亡原因进行了比较，并评估了对这些死因的遗漏如何扭曲国际卫生评估。我们分析了巴勒斯坦卫生部的官方死亡率报告，并通过已发表的捕获-再捕获研究以及在冲突环境中应用的间接与直接死亡率之比（4:1和10:1）进行三角测量，以提供低、中、高儿童死亡率估计值。计算了2024年15岁以下儿童的年化死亡人数，并与《2021年全球疾病负担》（GBD）的估计值进行比较。婴儿和五岁以下儿童死亡率是根据活产估计数得出的，并与战前趋势进行对比。官方报告称，截至2025年7月，加沙地带已有60199人死亡；总死亡人数的上限敏感性分析估计可能达到601990人（占213万人口的28%）。儿童死亡人数（15岁以下）从14824人（报告数）到59296人（中等估计数）再到148240人（高估计数）不等，分别相当于15岁以下人口的2%、7%和17%。五岁以下儿童死亡率可能增加了14至34倍，从2022年每1000例活产中的13.9例增至2024年的191.1例（中等估计数）和477.8例（高估计数）。婴儿死亡率可能增加了4至9倍，从每1000例活产中的10.8例增至39.0例和97.5例。就2024年而言，尽管加沙地带人口不到全球人口的1%，但官方报告的儿童死亡人数在全球排名第18位；中等和高估计数分别使其排名第15位和第10位。每1000人口中估计有41.74例（中等估计数）和104.36例（高估计数）死亡，这使加沙地带的种族灭绝成为全球儿童死亡的主要原因。
