In a new report, the global health agency estimated that nearly 15 million people were killed either by the coronavirus or its impact on health systems. For India, it pegged the amount at 4.7 million, 10 times higher than official COVID death toll
For the period from 1 January 2020 and 31 December 2021, India officially recorded a COVID-19 death toll of 4,81,486. AFP
India and the World Health Organization (WHO) butted heads on Thursday over figures shared by the global health agency regarding coronavirus-related deaths in the country.
India contended that the WHO report, which was based off a mathematical report, was “totally removed from reality”, adding that the system of data collection was “statistically unsound and scientifically questionable”.
India’s top health experts also chimed in, rejecting the report as untenable and unfortunate.
As the WHO and India continue to trade charges, we take a closer look at what was said and what’s the debate all about.
What the WHO said?
On Thursday, the WHO said that the full death toll associated directly or indirectly with the COVID-19 pandemic (described as “excess mortality”) between 1 January 2020 and 31 December 2021 was approximately 14.9 million, with India recording 4.7 million fatalities.
For the unversed, excess mortality is calculated as the difference between the number of deaths that have occurred and the number that would be expected in the absence of the pandemic based on data from earlier years.
In its report, the WHO report pegs India’s COVID-19 excess deaths at 47,40,894 during 2020 and 2021. The government’s data for the same period puts the number at 4,81,486.
This shows that WHO’s numbers are 10 times the official figures and almost a third of COVID-19 deaths globally.
The WHO in its report said the estimates may not be regarded as the national statistics officially produced by India due to differences arising from the data and methods used by WHO.
It noted that the information from the Civil Registration System (CRS) in India for 2020 was made publicly available by the Registrar General of India (RGI) on 3 May in a report.
The newly published information in the report is being carefully examined and will be taken into consideration in revisions of the estimates.
On the methodology it used for the report, the WHO said, as per a Business Standard report, “For India, we use a variety of sources for the registered number of deaths at the state and union territory level. The information was either reported directly by the states through official reports and automatic vital registration, or by journalists who obtained death registration information through Right To Information requests.”
India’s rebuttal
The Union health ministry has refuted the WHO report, objecting to the use of mathematical models, saying validity and robustness of the models used and methodology of data collection are questionable.
“Despite India’s objection to the process, methodology and outcome of this modelling exercise, WHO has released the excess mortality estimates without adequately addressing India’s concerns,” the health ministry said in a statement.
India added that in light of authentic data published through Civil Registration System (CRS) by the Registrar General of India (RGI), mathematical models should not be used for projecting excess mortality numbers for India.
“India firmly believes that such robust and accurate data generated through Legal Framework of a Member State must be respected, accepted and used by WHO rather than relying on less than accurate mathematical projection based on non-official sources of data,” the statement stated.
The Centre further discrediting the WHO report said that the agency had relied on websites and media reports for data for 17 states and this reflected a ‘statistically unsound and scientifically questionable methodology of data collection’.
The WHO has used multiple models for projecting excess mortality figures for India, which also raises questions on the validity and robustness of the models, said India.
For instance, the WHO had earlier used the Global Health Estimates 2019 in one of its models to calculate excess mortality estimates for India. India called it out, as GHE is an estimate itself.
“A modelling approach which provides mortality estimates on the basis of another estimate, while totally disregarding the actual data available within the country, exhibits lack of academic rigour,” the statement said.
India said it rejected WHO’s use of one size fits all approach and model, which may be applicable to smaller countries but cannot be applicable to India, with its large area, diversity and a population of 1.3 billion.
Experts speak
Indian Council of Medical Research Director General Balram Bhargava, NITI Aayog Member (Health) V K Paul and AIIMS Director Randeep Guleria also rejected the WHO report.
Dr VK Paul, as per a PTI report, said India had been clearly telling the WHO with all humility and through diplomatic channels along with data and rational reasoning that it does not agree with the methodology that has been followed for the country.
“We have a similar system, we have a robust system of CRS (Civil Registration System) and we released that report yesterday and we have actual count of deaths for 2020 and as per law and the timeline the 2021 numbers will also come up,” he said.
“We want them to have used these numbers. Unfortunately, in spite of our emphatic writing, communication at the ministerial level, they have chosen to use the numbers that are based on modelling and assumptions,” Paul said.
The National Technical Advisory Group on Immunisation’s chairman, Dr NK Arora, also described the report as unfortunate.
Dr Randeep Guleria raised his reasons for his rejection of the report.
He said, “Firstly, India has a very robust system of births and deaths registration…and that data is available… WHO has not used that data. Secondly, the data that WHO has used is more on hearsay evidence, or what has been there in the media or from unconfirmed sources. That data itself is questionable. And to do a modelling on that data is not correct, and it’s not scientifically the right thing to do, especially when you have data.”
With inputs from PTI
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