A decade of war in Iraq has killed roughly 134,000 Iraqi civilians and potentially contributed to the deaths of many hundreds of thousands more, according to researchers at Brown University. Their report was released ahead of the 10th anniversary of the U.S. invasion of Iraq on March 19, 2003. It says the Iraq war has cost the U.S. more than $2 trillion, including $500 billion in benefits owed to veterans.

The report says the war has devastated rather than helped Iraq, spurring militant violence, setting back women’s rights and hurting the healthcare system. Most of the more than $200 billion supposedly set aside for reconstruction in Iraq was actually used for security or lost amid rampant fraud and waste.

Some previous reports have put the death toll in Iraq significantly higher. A 2006 report published in The Lancet by researchers at Johns Hopkins University found 655,000 people had died in the first 40 months of the war both from violence and indirect causes related to the devastated infrastructure.