The extension of academic censorship on Palestine to the medical world is, despite its pervasiveness, relatively unknown. In the latest iteration, a letter highlighting the Gaza Strip’s vulnerability to the Covid-19 pandemic was removed from The Lancet’s website after a swift pressure campaign. While the immediate effects were minimal—despite its short shelf-life, the piece is among the top 5% most discussed research publications—the chilling effect of such campaigns on writers and editors is profound and enduring. This commentary outlines the struggle to make space for discussion and academic inquiry into the health impacts of the ongoing suffering inflicted on the Palestinian people.

As Palestinians marked Land Day on March 30, The Lancet, one of the world’s oldest and most prestigious medical journals, silently removed from its website a commentary that was published three days prior. At just over 400 words, “Structural violence in the era of a new pandemic: the case of the Gaza Strip,” draws on the deep historical and political forces that have rendered the Palestinian people in the Gaza Strip particularly susceptible to an impending Covid-19 outbreak. Mirroring numerous warnings that continue to be published elsewhere, including a statement by 20 Palestinian, Israeli, and international health and human rights organizations, our commentary highlights the impact of pandemics on “populations burdened by poverty, military occupation, discrimination, and institutionalised oppression.” Its critical tone is consistent with other Lancet commentaries targeting various national and global responses to Covid-19.

While hoping the swift removal was just a technical error, our experience working on Palestine made us suspect otherwise. A hint came via the elated tweet of a Canadian endocrinologist who had been involved in prior efforts to censor scholarship connecting Israel’s occupation and human rights abuses to Palestinian health outcomes. The next day we understood the impetus behind the commentary’s sudden disappearance: a message had been circulated to the scientific community in the United States (and beyond) calling—ironically, given the hostility to similar calls directed at Israel—for a boycott of The Lancet for publishing the piece.

To understand The Lancet editorial staff’s swift decision to remove the commentary, we need to go back to 2014. At the height of Israel’s large-scale military assault on the Gaza Strip, The Lancet published “An open letter for the people in Gaza,” setting off an aggressive years-long campaign with demands that both the open letter and the editor-in-chief be removed. Neither occurred after a thorough review by The Lancet ombudsman. The controversy culminated, however, with five 2017 Lancet Series papers designed to “outline Israel’s achievements in health and health care.” While the papers commemorated one of the world’s most efficient healthcare systems, missing was any discussion of Israel’s institutionalized oppression over the Palestinian people that leaves millions without the ability to develop or even access similarly exemplary healthcare. Indeed, the authors of the introductory piece of the series decided to “not comprehensively address historical or political issues, except when directly pertaining to health,” as if there were any other comparably important factors determining the stark health (and other) inequities between Israeli-Jewish and Palestinian inhabitants of the region.

The aftermath of the publication of the 2014 letter explains how The Lancet, a high-profile outlet courageously and almost uniquely willing to cover the political and historical forces impacting Palestinian health, came to publish an entire edition—perhaps the most prominent example of “healthwashing”—that sweeps these defining issues under the rug. “An open letter for the people in Gaza” denounced Israel’s 2014 military assault on the besieged Gaza Strip, highlighting the widespread killing and severe injury of Palestinian civilians, including children. Noted was the extraordinary loss of infrastructure, leaving more than 100,000 people homeless, and the dramatic impacts of Israel’s ever-tightening blockade on access to essential medicines, food, and potable water. The authors criticized the complicity of third states, as well as that of Israeli health professionals who failed to speak out against this massacre.