An unlikely war has ensued between the Government of India and the World Health Organisation (WHO), the United Nations health arm, with respect to the number of deaths caused by the pandemic Covid-19 in 2020 and 2021. The WHO has estimated that 1.5 crore deaths have happened globally due to the pandemic or its impact, and the figure is not the officially recorded 54 lakhs. Most of these deaths have happened in Southeast Asia, the Americas and Europe. And of them, 47.4 lakh deaths, close to one third of the total deaths, happened in India. India’s official toll was 4.81 lakh at the end of 2021.
Apart from the deaths directly linked to Covid-19, WHO has considered those deaths which were caused by people’s inability to access health systems overburdened by the pandemic as Covid deaths. The world body also took recourse to mathematical modelling after classifying nations per its own norms.
WHO classifies countries that have provided to it complete and nationally representative monthly all-cause mortality data for the specified period as Tier I and puts those nations that have not granted WHO access to the complete data and for which it requires the use of alternative data sources or the application of scaling factors to generate the national aggregate in Tier II. India is in the second tier.
India has questioned the very approach by which WHO arrived at the number of deaths in this country. India contends that it itself has a robust process for the registration of births and deaths. It claims its civil registration system (CRS) meticulously recorded the deaths and births, the data is authentic and published by Registrar-General of India and hence “mathematical models should not be used for projecting excess mortality numbers for India”. The government has also pointed out that WHO admitted that for 17 states it used data from websites and media reports which is a “statistically unsound and scientifically questionable” methodology. It has opposed the use of the Global Health Estimate of 2019, which considers a uniform test positivity rate for the entire country, for modelling.
It’s a “one-size-fits-all” approach and hence unacceptable. Several state governments, including those not ruled by the BJP, have questioned the process and reliability of the WHO data. Some state health ministers have even alleged that it is an attempt to defame India.
The WHO’s response has been limited to pointing out that it has good quality data to estimate excess mortality in countries with less accessibility and that it is not a “one-size-fits-all” approach. The data on Covid-19 deaths highlights the need for more investment in “resilient health systems that can sustain essential health services during crises, including stronger health information systems” according to the world body.
There is little to gainsay in this wordy war as it is about data. It is important that we have accurate and reliable data as it is critical to decision making. Rejecting the WHO methodology, questioning the results and attributing motives do not help the larger cause of the people. The government and the WHO must work together and get to the bottom of it with a common purpose of serving the people of India. Covid death data cannot remain an open question; it needs a closure.
