Critics have long said that accusations of famine in Gaza have a gaping hole right in the middle: the staggering amount of emaciated, dead bodies, part and parcel of a famine, are simply nowhere to be found.

When the Integrated Food Security Phase Classification, a United Nations-linked food security agenda, determined in August that a famine was indeed ongoing in parts of Gaza, those behind the report said that the sheer devastation in Gaza did not allow for an accurate accounting of starvation-related deaths.

Instead, they said, they were using another key criterion for famine that generally goes hand-in-hand with malnutrition deaths, and extrapolating on the former to determine the latter was taking place.

That key criterion, called mid-upper arm circumference (MUAC), appears to have never been met, according to data recently released by the Palestinian Authority. The measurement serves as an easy and generally accepted way to gauge malnutrition. The IPC standards say that when 15% of children sampled show signs of malnutrition, it’s indicative of a famine.

The IPC’s August alert, determining that famine was already taking place, said there was a rapid rise in child malnutrition, based on a two-week data sample from mid-to-late July.

The newer information, released on Sept. 17 by the “State of Palestine” Nutrition Cluster, reveals that IPC-standard age-weighted MUAC data—as opposed to the unweighted data in the IPC’s famine report—did not meet the IPC’s own famine criteria.

And without MUAC data showing famine levels, it becomes impossible for the IPC to extrapolate famine level deaths, said Mark Zlochin, a former artificial intelligence researcher who has spent months poring over data from Gaza. 

“They said that because the malnutrition was rising so rapidly, they can reasonably infer that the mortality is also rising, and they’re not just catching all the deaths that are actually occurring,” Zlochin said of the IPC. “So they need both of those parts, both the crossing of this threshold, but also the very, very rapid crossing of this threshold. So once you see that it didn’t happen, everything falls apart.”

The difference between weighted and unweighted data can be substantial, as MUAC inherently classifies smaller, younger children as malnourished at much higher rates.

“Using unweighted averages without age adjustment inflates the results,” Zlochin explained, pointing to UNRWA’s own data showing the gap between the unweighted average and the age-adjusted estimate in July to be 3.4%. A weighted average would have brought it below the fame threshold.

“This is precisely why age-weighting is mandatory under IPC methodology, and why it was applied in every previous Nutrition Cluster and IPC output,” Zlochin wrote.

The IPC’s famine report cited few examples, though, of age weighting.

“As a result, the malnutrition rate estimates are strongly skewed upwards,” Zlochin wrote.

The Palestinian Authority’s Sept. 17 data release, though, shows the age-weighted MUAC-focused mean malnutrition rate in the Gaza City area to be approximately 14.8% in the second half of July before falling substantially in August back to rates previously seen in June. 

That 14.8% measurement falls below the 15% necessary to meet famine criteria, and significantly below the 16.2% unweighted mean. At no point, according to the Palestinian Authority data, did the MUAC rate cross 15%, before it began to decline substantially in August back toward the 10.5-11% rate it hit in June.

Zlochin wrote that the updated data confirms that the IPC’s determination “was indeed based on fabricated data that misrepresented the raw, unweighted malnutrition statistics as if they were the properly age-weighted data required by IPC guidelines.”

“It was always a hoax, and those hacks knew it all along,” Zlochin wrote.

A U.N. World Food Program official told JNS in August that his agency was indeed relying on the MUAC rate in the IPC report to infer an ongoing famine.

Jean-Martin Bauer, director of food security and nutrition analysis service at the World Food Programme, told JNS that despite any evidence of malnutrition-related deaths on a scale typical under famine conditions, the reality of famine in Gaza City and surrounding areas was based on solid evidence, citing the IPC’s usage of MUAC. 

“The prevalence of malnutrition amongst children has tripled between May and July. When you have that exponential increase, it means that there’s also an exponential increase in mortality risk,” Bauer said at the time.

JNS asked Bauer how the United Nations and IPC went from mortality risks to determining that there had actually been a famine.

“The indicator we use for nutrition is mid-upper arm circumference, and it is very clear that there is a tight correlation between mid-upper arm circumference and mortality,” he said. “That is indisputable. It’s peer reviewed.”

“That’s why we feel confident that’s a good indication of the problems taking place in Gaza,” Bauer said.

Bauer said at the time that, “No liberties were taken with any data here,” adding, “There’s evidence of collapsing health systems and treated illnesses, a surge in child disease, and all that is combined with widespread malnutrition.”

Due to those factors and “exponential increase in child malnutrition in Gaza governorate and specifically in Gaza City,” the report “concludes that the famine thresholds have been exceeded in the case of Gaza City,” Bauer said. (JNS has asked the WFP for comment on the complete Nutrition Cluster data.)

MUAC-related data, however, were tenuous at best, critics say. The IPC relied on only two weeks’ worth of data for July, as opposed to a full month, and even those two weeks barely broke the MUAC threshold for famine. 

And now, with the full month of data having been published by the Palestinian Authority, along with an entire month of data from August, Zlochin said all of the previous criticism of the IPC’s Gaza methodologies, including its questionable data collection, its overreliance on UNRWA’s sampling, its inclusion of extreme outlying data and its questionable decision to rely on a two-week data subset—as opposed to a complete month—all become magnified.

“The malnutrition data is not only important by itself, but they also used it to fill the gap in the mortality data. And their argument was basically not just that malnutrition crossed the 15% threshold, but there is a very strong upward trend,” Zlochin told JNS. 

“They were talking about exponential growth; not just the 15% threshold being broken, but the additional claim that it was broken very rapidly and there was a very strong upward trend,” Zlochin said of the IPC’s claims.

But, the updated P.A. data, cross-checked against other sources, shows that the IPC employed questionable methods, such as taking MUAC data from a provider that showed lower malnutrition rates in the second half of July and moving that data to the first half.

“They drove the data for the second half higher, and artificially, they created a huge increase. They’ve spent a lot of effort to manufacture this appearance, as if the threshold wasn’t only crossed, but that it was crossed very rapidly,” he told JNS. 

A new analysis from HonestReporting board member Salo Aizenberg corroborates Zlochin’s claims. “The IPC declaration of famine on Aug. 22 would have predicted about 10,000 starvation deaths through the Oct. 10 ceasefire,” Aizenberg wrote, basing his claims on IPC standards.

However, data from Hamas and the United Nations show 192 malnutrition-related deaths occurred from the time of the famine claim until the ceasefire, including those with pre-existing conditions, reaching only 2% of the predicted total.

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