Chris​ Simms: The Iraq war, Chilcot, and cherry picking data: How to find a way forward?

Chris_simsThe first week of July 2016 was a week to remember. A cluster of war related stories dominated the media, including the 100th anniversary of the Battle of the Somme (1 July), the death of Elie Weisel on 2 July, on 3 July there was the deadliest bombing in Bagdad since 2003, three days later we had the release of the Chilcot report and the 45 minute response it drew from former Prime Minister Tony Blair, and on 8 July the deployment of NATO troops into Eastern Europe (for the first time since the end of the Cold War).

These events tend to underscore the importance of careful assessment of past mistakes and taking measures to prevent their reoccurrence. A recent editorial in The BMJ noted that whether we are speaking of apologising for the Iraq war or when things go wrong for patients, “the need to be open and honest” is fundamental and is the best pathway to learning lessons and gaining closure.

Among the core issues examined by the Chilcot report were the rationale for going to war and acknowledgement of its consequences. The following paragraphs briefly look at the Blair government’s management of evidence related to Iraqi mortality and the much debated contention that one thing the Chilcot report tells us is there were no attempts to mislead. It draws on declassified memos included in the Chilcot report, a review of Iraqi mortality studies, and related commentary.

On 17 February 2003 (a month before the invasion of Iraq) Prime Minister Tony Blair made the case for invasion, including among his reasons the description of Iraq as a “country where today, 135 out of every 1000 Iraqi children die before the age of 5.”

The Chilcot report notes that these mortality data were based on UNICEF’s Iraq Child and Maternal Mortality Survey (ICMMS), which, like most country studies of its kind, depended upon the goodwill of the country government. Detailed analysis of this survey shows that Saddam Hussein’s regime was using fear and intimidation to manipulate outcome data in order to bolster their claim that economic sanctions imposed by the UN were killing children. Declassified memos show that the Department for International Development (DfID) and the Foreign and Commonwealth Office (FCO) knew the data they had were questionable, but still used them as material that would make the best case for war.

Several UN sponsored surveys between 2005 and 2008 found that childhood mortality rates had actually been between 40 and 60 per 1000 live births. Yet when Blair was asked by Mr Chilcot on 29 January 2010 (in the last minutes of the afternoon session of the inquiry), “was the enterprise worthwhile?” in direct response, he again cited child mortality rates of 130 per 1000 live births (2000-02). He said, “That figure today is not 130, it is 40. That equates to about 50 000 young people, children [alive today who would not be if Saddam Hussein had remained in power] . . . that’s the result that getting rid of Saddam makes.”

To me the inconsistencies between these assertions and other evidence available at the time dispel the notion that there was no misleading in the lead up to the war or during the post-conflict era. Indeed, the Chilcot report raises similar concerns about manipulation of Iraqi civilian mortality data—again, by various ministries and political figures. For example, the foreign secretary argued, “We need to find ways of countering the damaging perception that civilians are being killed needlessly, and in large numbers, by Coalition forces.” Elsewhere, the report cites the following communication between FCO and Blair’s office in October 2004.

“You asked for an assessment of civilian casualties in Iraq, noting that we cannot let figures of 10-15 000 go unchallenged as if we are responsible for all of them . . . The FCO recommend(s) that we stick to publishing terrorist responsibility for civilian casualties in individual incidents. Underlying this is concern that any overall assessment of civilian casualties will show that MNF (Multi-National Force – Iraq) are responsible for significantly more than insurgents/terrorists.”

The report points out that it was a mistake a “trial (mortality) monitoring exercise initiated by No 10 in November 2004 was not completed” and that “greater efforts were not made to determine the number of civilian casualties.”

These signs of cherry picking data, of setting aside unwanted results, and of giving in to vested interests are evocative of recent efforts to tackle corruption in the scientific process. Hiding trial data that cast doubt on the safety and efficacy of drugs or succumbing to commercial or academic pressure is not dissimilar to squelching data that would undermine government policy or yielding to political pressure. When it comes to corruption of process, “we have to have many more mechanisms, much more skepticism, and much more willingness to challenge.”

According to the British NGO Iraq Body Count (IBC), the manipulation of mortality data as part of an overriding “concern to sustain support for operations Iraq” (the Chilcot report) is disgraceful. However, as IBC points out, the “report should be commended for very forensically and effectively laying it bare.” When it comes to “the need to be open and honest,” to lessons learnt and clearing the way for apologising, the report at least suggests a step in the right direction and the possibility of closure for some.

Dr Chris Simms teaches at Dalhousie University, School of Health Administration, Halifax, Canada; he spent many years living and working in Africa’s health sector.

Competing interests: None declared.