The Filipinos, who assisted U.S. troops in fighting the Spanish, wished to establish an independent state and, on June 12, 1898, declared independence from Spain. In 1899, fighting between the Filipino nationalists and the U.S. broke out; it took the U.S. almost fifteen years to fully subdue the insurgency. The U.S. sent 70,000 troops and suffered thousands of casualties. The Filipinos insurgents, however, suffered considerably higher casualties than the Americans. Most casualties in the war were civilians dying primarily from disease.