More than 4.5 million people have died from wars since the Sept. 11, 2001 terrorist attacks in the US and that number continues to grow, according to a new study by Brown University in Rhode Island.  

The numbers from the Costs of War project were released Monday and the figures over the past two decades since 9/11 are staggering. 
The report estimated that nearly 1 million people (906,000-937,000) were directly killed by wars in Afghanistan, Iraq, Pakistan, Syria, Yemen, Libya and Somalia. 
In addition, more than 3.5 million people (3,588,000-3,716,000) died indirectly from war-related factors such as failed economies, extreme poverty, malnutrition and the spread of diseases such as cholera and measles. 
The casualties added together from both direct and indirect war deaths roughly total between 4.5 million to 4.6 million people, with the numbers continuing to grow from global conflicts. 
"These wars are ongoing for millions around the world who are living with and dying from their effects," said the report, which emphasized that women and children "suffer the brunt of these ongoing impacts." 
While the project does not assign blame to any particular country, the US was specifically cited for its role in many of these foreign conflicts post-9/11, especially the casualties over the past 20-plus years in Afghanistan. 
"Though in 2021 the United States withdrew military forces from Afghanistan, officially ending a war that began with its invasion 20 years prior, today Afghans are suffering and dying from war-related causes at higher rates than ever," the report continued. 
The Costs of War project said that far more research is needed to collect more adequate data "to guide life-saving interventions." 
"More studies are necessary on the impact of war’s destruction of public services, especially beyond the healthcare system, on population health," the report added. "Damage to water and sanitation systems, roads, and commercial infrastructure such as ports, for instance, have significant but less understood consequences." 
The project also called on governments around the world, including the US, to take responsibility in repairing the damage inflicted by these wars.  
"Reparations, though not easy or cheap, are imperative," the study concluded.