Counting Every Life: Why Mortality Evidence Can't Be Optional in Humanitarian Crises

What if the most powerful indicator in humanitarian response was also the most neglected?

When crises unfold, we count displacement, malnutrition, and funding gaps. But months later, one question often remains unanswered - how many people died? That omission matters - because mortality data changes decisions.

As the UK Humanitarian Innovation Hub (UKHIH) and Elrha close Phase 2 of our Mortality Estimation in Humanitarian Crises Systems Innovation Partnership, this blog marks the beginning of a series exploring why mortality estimation matters, and how grantees are innovating so the humanitarian system can do it better.

Mortality: the metric that changes the conversation

Credible and timely mortality figures change conversations and decisions. As Chris Porter from FCDO put it during a 2025 panel discussion:

Mortality metrics capture crisis severity, scale, and urgency in a way few other indicators can.

Mortality data used to be central to humanitarian assessments. Over time, however, it slipped to the margins - seen as too sensitive, too political, too technically complex, or too slow to be useful. The result is a paradox: the metric that best reflects human cost in crises is often missing from decision-making altogether.

Why mortality evidence is so hard - and essential

Estimating mortality in crises is undeniably challenging. Data is incomplete. Access is constrained. Methods vary. Numbers can be contested or suppressed, particularly in politically charged settings. Different approaches can produce vastly different estimates, eroding trust and confidence. But the cost of not measuring mortality is higher.

Without credible mortality evidence the true scale of crises is underestimated; resources are allocated reactively rather than strategically; accountability weakens and advocacy relies on anecdote instead of evidence. Mortality estimation is not just a technical exercise. It is a moral and operational necessity.

From reactive funding toward systems change

UKHIH-Elrha’s current investments are built on a longer history of mortality-driven action. Funding followed mortality research in Somalia that helped trigger an unusual and early UN intervention in a subsequent developing famine in 2016. That response was not driven by malnutrition figures, but by mortality data. It was rare. And it worked.

Recently completed research established that mortality in southern Chad* was far higher than humanitarian actors had assumed, with large segments of the affected population missed entirely. This evidence forced uncomfortable reassessments, but also opened pathways to identify deaths that would otherwise have remained uncounted.

Those efforts demonstrated what's possible when rigorous methods are applied under pressure. They informed response discussions, shaped advocacy, and challenged assumptions in decision-making. But they also highlight a deeper issue:

Mortality estimation has been treated as an emergency add-on rather than a standing capability in crises contexts.

UKHIH’s first investment in mortality estimation proved decisive in a politically charged context. Rigorous work helped establish the credibility of mortality estimates from Gaza when official figures were being publicly dismissed. This evidence made it far harder for governments and global institutions to ignore the scale of civilian death, cutting through political pressure and reaffirming the role of independent science.

Building on this work, UKHIH launched the Systems Innovation Partnership in 2024 to move beyond isolated projects and towards a durable ecosystem for mortality estimation. One rooted in equitable partnerships, shared infrastructure, and long-term investment, particularly in low- and middle-income countries.

What progress looks like in practice

UKHIH-Elrha is currently the only dedicated funder focused specifically on mortality estimation in humanitarian crises. Across Phases 1 and 2, we've seen tangible signs of change:

• Stronger methods, including improved modelling approaches and shared tools and resources like the Somalia Mortality Estimation Data Observatory (S-MED)
• Deeper learning, through case studies examining how mortality evidence has influenced - or failed to influence - responses in crises
• More equitable leadership, with LMIC-based partners SIMAD Institute for Global Health (Somalia) and Evidence for Change (Kenya) playing central roles in phases 1 and 2, scaling up partnering in phase 2 with Addis Ababa University, Mekelle University (Ethiopia) and Rebuild Hope for Africa (DRC) among others.
• Broader dialogue, bringing together researchers, humanitarians, policymakers, and funders to tackle the "last mile" problem of uptake and use
• Co-funding, for longer-term, strategic investment that builds synergies and amplifies impact across the system with European Commission Humanitarian Aid (ECHO).

What this blog series will cover

This blog marks the start of a weekly series showcasing the Phase 2 consortia pushing this agenda forward.

• IMPACT Initiatives are exploring locally led mortality estimation in Somalia, Ethiopia, and the DRC, highlighting what it takes to shift ownership and trust.
• Johns Hopkins University is focusing on methodological innovation in DRC, alongside practical guidance for local decision-makers on when and how mortality estimates can be generated and used.
• Save the Children International is developing a governance mechanism among Strategic, Technical and National Stakeholders and building an online platform making guidance, tools, and technical support accessible and equitable across the sector.

Together, these consortia address not just how to count deaths, but how to ensure mortality evidence shapes response.

Counting deaths to save lives

Mortality evidence can't be optional because uncounted deaths represent a failure of accountability, a gap in our understanding, and a missed opportunity to prevent the more.

When we don’t count deaths, we're not avoiding difficult conversations - we're having them anyway, just without evidence.

The UKHIH-Elrha partnerships show we can do better. What remains is a choice: to embed mortality estimation as a non-negotiable part of crisis response, or to continue operating in the dark about the very metric that matters most.

Join us at Humanitarian Networks & Partnership Week

Hybrid session: Building What Counts: Local Leadership & Innovation in Humanitarian Mortality Estimation

• Tuesday 10 March 2026, 1100-1230 (EST) / 1500-1630 (UTC) / 1600-1730 (UTC+1) / 1800-1930 (EAT)
• In-person: CICG, Salle 11, Geneva, Switzerland. Register here
• Remote: Register here

* O’Keeffe, J et al. Manuscript in preparation.