In March 2020, The Lancet published a letter we wrote alerting the medical community to the dangers of a covid-19 outbreak in the Gaza Strip. We warned that the pandemic had “the potential to devastate one of the world’s most vulnerable populations.” [1] Since then, this fear has become reality and Palestinians in the Gaza Strip have now endured a fifth largescale Israeli military assault that has killed 256 Palestinians, including 66 children, injured nearly 2,000, and internally displaced some 107,000 people. [2,3]

As we highlighted in our letter, decades of structural violence targeting Palestinian people have brought Gaza’s healthcare system to the brink of collapse. [4] A densely populated area, the majority of Palestinians in the Gaza Strip are refugees denied their right of return since 1948. [5] Meanwhile, Israel’s illegal closure and blockade of Gaza since 2007, amounting to collective punishment, have meant that supplies for covid-19 testing, treatment, and vaccination have been severely limited. [6,7]

Although structural racism has increasingly been recognised worldwide as exacerbating the impacts of covid-19, the publication of our letter was met with what Richard Horton, the editor-in-chief of The Lancet, informed us was a threatened boycott of the journal. [8] Certain physicians from the United States and elsewhere had demanded our letter’s removal. Previously, Horton informed us, there had been a similar “sanctions” campaign against The Lancet for publishing a letter in 2014 deploring the morbidity and mortality resulting from Israeli state violence against Gaza’s besieged Palestinians. [9-10] According to Horton, the ordeal that followed took a “traumatic” personal toll on The Lancet’s employees. Subsequently, The Lancet published a special edition on Israeli healthcare that we believe disregards the historical and political forces impacting Palestinian health outcomes. [11,12] The Lancet’s publication seemed to stand as a warning to anyone who dared address Palestinian health consequences of Israel’s action, which are widely recognised as amounting to war crimes and crimes against humanity. [13]

The Lancet, we were later told, could not sustain yet another campaign of this nature and, within three days, our letter had been removed from the journal’s website. To date, formal retraction of academic articles has been reserved for papers with “pervasive error, non-reproducible research, scientific misconduct, or duplicate publication.” [14] None of this applies to our letter. In our view, The Lancet’s editorial removal of our letter constitutes a dangerous new precedent, in which an already published article, that is later deemed politically unpalatable by extra-editorial forces, ends up in an academic “no-man’s-land”—not formally retracted, yet unavailable from the journal itself.

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