AMY GOODMAN: We continue to look at Israel war’s on Gaza, where the official death toll has topped 41,000 Palestinians, though that could be a vast undercount that doesn’t include those who remain trapped in the rubble and the people and children who have died due to chronic illnesses, infectious diseases spreading across Gaza.

Over the past 11 months, Israel has destroyed Gaza’s health system and other crucial infrastructure, placed a blockade on medications and other urgent aid. More than 2 million Palestinians living in Gaza also risk imminent famine, with children starving at a record rate. The U.N. humanitarian aid chief Martin Griffiths has said life is “draining out of Gaza at terrifying speed,” unquote.

Even some Biden administration officials have admitted the Gaza death toll could be significantly higher. This is Barbara Leaf, assistant secretary of state for Near Eastern affairs, speaking last November.

BARBARA LEAF: In this period of conflict and conditions of war, it is very difficult for any of us to assess what the rate of casualties are. We think they’re very high, frankly. And it could be that they’re even higher than are being cited. We’ll know only after the guns fall silent. So, you know, we take in sourcing from a variety of folks who are on the ground. And so, I can’t stipulate to one figure or another, but I think that it’s very possible that they’re even higher than is being reported.

AMY GOODMAN: That was Assistant Secretary of State for Near Eastern Affairs Barbara Leaf.

The prestigious British medical journal Lancet has estimated the actual death toll could be 186,000 or even higher, roughly 8% of Gaza’s population. The report looks at how war leads to indirect deaths due to shortages of medical care, food, shelter and water.

This all comes as protests continue demanding the U.S. government immediately halt its military aid to Israel and calling on Democratic presidential nominee Kamala Harris, who’s debating Donald Trump tonight in Philadelphia, to shift her policies on Gaza.

For more, we go to Washington, D.C., where we’re joined by Ralph Nader, longtime consumer advocate, corporate critic, former presidential candidate four times. He’s the author of many books, including, most recently, Let’s Start the Revolution: Tools for Displacing the Corporate State and Building a Country That Works for the People. Ralph Nader is the founder of the monthly print-only newspaper, Capitol Hill Citizen, where his front-page article in the latest issue is headlined “Exposing the Gaza Death Undercount.”

Let’s start with this undercount, what you are saying is so much higher, the death toll in Gaza, than what we understand.

RALPH NADER: Amy, this is a horrifying undercount, and it has political rationale for it. If the true count was known, it would devastate the mythology that the Biden administration and Congress are furthering, that the Israeli government does not purposely target civilian populations and, therefore, violate all kinds of U.S. laws, conditioning the shipment of weapons to Israel, and international laws.

So, I put together in this article in the Capitol Hill Citizen — people can go to CapitolHillCitizen.com and get it — the various probative evidence that shows that experts, who are blocked from getting additional data that the State Department has and is keeping secret — that the evidence shows that it’s well over 300,000. And it may double by the end of the year. In an article in The Guardian by the distinguished chair of global public health at the University of Edinburgh titled “Scientists are closing in on the true, horrifying scale of death and disease in Gaza,” she estimates over 300,000 before the end of the year, pointing out, with The Lancet report that you mentioned, that The Lancet people used a very — quote, “used a very conservative estimate, but allowed that the number could easily be much higher.”

And so, why is this happening? Why are all sides, the anti-genocide side, the Israeli, the Hamas — why are they always using these figures? Because, for different reasons, it serves their political purposes. Hamas doesn’t want the true count to be known, because it will be assailed by its own people and its international allies as unable to protect its own people and provide shelters. Netanyahu, of course, wants it lowballed for obvious reasons, and Biden for the same reason.

So, what do these scientists see? They see a tiny enclave the geographical size of Philadelphia with 2.3 million people, crowded, already sick and destitute from years of Israeli illegal embargoes, high levels of anemia among the children before October 7th, and then, starting October 8th, the Israeli military issued the genocidal orders of no food, no water, no medicine, no electricity, no fuel, and they proceeded accordingly. And so, what these scientists are seeing are what’s called the empirical evidence, that people on social media are seeing and others. With over 130,000 bombs and missiles, plus daily tank shelling, ruthless sniper fire, there’s been massive destruction of apartment buildings, congested marketplaces, refugee camps, hospitals, over 150 health clinics, masses of families huddled in schools being blown up, ambulances being blown up, bakeries destroyed, schools, universities, mosques, churches, roads, electricity networks, critical water mains — just about everyone and everything.

And some people, partisans of Netanyahu, will say, “Oh, the Israeli government never targets civilians.” Historically, they’ve always targeted civilians. Go back to the early '80s, when former Israeli ambassador and foreign minister Abba Eban wrote of Israel under then-Prime Minister Menachem Begin that Israel — and I'm quoting him — quote, “is wantonly inflicting every possible measure of death and anguish on civilian populations in a mood reminiscent of regimes which neither Mr. Begin nor I would dare to mention by name,” end-quote. And just a few years earlier, in the late '70s, Israel's leading military analyst, summing up remarks by the Israeli chief of staff, stated the following, quote, “The Israeli Army has always struck civilian populations, purposefully and consciously. The Army has never distinguished civilian [from military] targets … [but] purposefully attacked civilian targets,” end-quote.

And why is this important? Because to this day, all of the administration spokespeople are denying that Israel has targeted civilians, denying that Israel has violated international genocide laws, denying that they have violated six federal statutes conditioning shipment of weapons to foreign countries on recognizing human rights excessively. To this administration and to the Congress, all deaths of civilians are accidental. Blowing up schools sheltering refugees, well, that was a mistake. So that’s why it’s important, Amy and Juan, to get that estimate as reliably high as possible.

We are seeing possibly a million deaths before the end of the year. We have starvation. We have infectious diseases. All the doctors that you’ve had on Democracy Now! have provided the clinical evidence of what’s going on, 5,000 babies born every month into the rubble, contaminated water, horrific air pollution with heavy metals from the bombing, and no food. We’re led to believe by these 41,000 figures that 98% or more of the Palestinian population is still alive? I mean, what are they made of? Asbestos and steel? And as the doctors have said on your program, when they went back to the rubble and the broken hospitals, they didn’t meet anybody in Gaza who wasn’t sick or injured. There was an interview in February on Al Jazeera by a Gaza undertaker who’s doing this free of charge and crying every day with his assistants on the open graves. He says he’s buried 17,000 bodies, including 800 in one day, and that was back in February.

JUAN GONZÁLEZ: Ralph, I wanted to ask you — in addition to the bombings and the killings of civilians, Israel has also refused to allow foreign press to come into Gaza and has systematically been killing those journalists, those Palestinians within Gaza who are reporting. Talk about this attack on the press, that really has not gotten much outrage in the West.

RALPH NADER: Yeah, I mean, how weak can you get as a president of the United States or member of Congress when you can’t even demand that Netanyahu let foreign and Israeli journalists, including U.S. journalists, into Gaza to freely report? He’s been blocking this for years. And the Israeli military has targeted, as you indicated, Palestinian journalists. They’ve killed over 165 of them, including, in addition, members of their own family, targeting apartments, for example. They’ve killed over 200 members of UNRWA, the U.N. relief. They’re out to destroy every relief center, every food — feeding center of UNRWA, education center.

I mean, this is — right now let’s put it in comparative terms here. More Palestinians have been killed since October 8th than have been killed by the U.S. in Hiroshima, Nagasaki and Dresden. That total death toll was about 235,000-240,000 people. And those deaths were in countries, Germany and Japan, with 160 million population. Here we only have 2.3 million population. And all you’ve got to do is read the Israeli press, read Haaretz, read the statements by —

AMY GOODMAN: We have five seconds, Ralph.

RALPH NADER: — 17 Israeli human rights groups.

AMY GOODMAN: Ralph Nader, we want to thank you for being with us, longtime consumer advocate, corporate critic, four-time former presidential candidate. We’ll link to your article in the Capitol Hill Citizen, “Exposing the Gaza Death Undercount.”

That does it for our show. Watch tonight’s debate between Donald Trump and Kamala Harris at democracynow.org. I’m Amy Goodman, with Juan González.