Measuring the True Costs of War: Consensus and Controversy

All wars generate controversy, though some more so than others. The current US-led intervention in Iraq and the catastrophic explosion of ethnic violence it incited is especially contentious. Whilst acrimonious disagreement over the raison d’etre of the Iraq war persists in capitals around the world, few deny that it has been an especially bloody and traumatic experience for Iraqi civilians. The full extent of suffering is confirmed in this week’s PLoS Medicine, which features an article by Madelyn Hicks and colleagues who consider the human costs of Iraq’s war by focusing on civilian deaths between 2003 and 2008 [1]. While offering fresh new insights on the nature and extent of violence in the country, this is not the first article that has considered deaths arising from the Iraqi conflict [2–4]. Nor is it likely to be the last. Rather, it should be set alongside a growing cannon of work originating from public health sciences and conflict studies devoted to examining the human consequences of the Iraq war. But the focus and time period investigated by Hicks and colleagues is significant: they track the characteristics of 92,000 direct civilian deaths occurring during the start, escalation, and dramatic reduction of warrelated violence. In this respect, their article builds on and goes beyond assessments undertaken in the recent past.