Dismayed and concerned, Health Minister tells WHO assembly

India’s main grouse has been that the WHO ignored data officially collated by the Centre

Health Minister Mansukh Mandaviya said at the World Health Assembly in Geneva, at the headquarters of the World Health Organization (WHO), that India was “dismayed and concerned” over the WHO’s recent exercise on all cause excess mortality. India’s main grouse has been that the WHO ignored data that was officially collated by the Centre.

On May 5, the WHO said that there were likely 4.7 million deaths, directly or indirectly attributable to COVID-19 in India in 2020 and 2021. These are the highest, by far, for any country, and comprised nearly a third of the 15 million such deaths globally. India officially estimated only 4.8 lakh cumulative deaths linked to COVID-19 as of December 2021, which implies that the WHO estimate was nearly 10 times the government count.

Dr. Mandaviya in his address said that the Central Council of Health and Family Welfare, a representative body of Health Ministers from all States within India, had passed a unanimous resolution asking him to convey their “collective disappointment and concern” with WHO’s approach in this regard.

While India has officially contested the WHO’s excess deaths estimates, this is the first time that it has raised the matter at an international podium.

“There is a need to ensure centrality of the WHO in global architecture and increase assessed contribution to WHO in a phased manner, but that should be linked to an accountability framework, value for money approach and genuine engagement with Member States,” Dr. Mandaviya remarked, “

Excess deaths or 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. Excess mortality includes deaths associated with COVID-19 directly (due to the disease) or indirectly (due to the pandemic’s impact on health systems and society).

Days before the WHO publicised its estimates earlier this month, India made public birth and death registration data from 2020 that reported 4.75 lakh excess deaths from all causes in 2020 over 2019. This data is from the Civil Registration System (CRS) that only counts deaths registered and doesn’t break down causes of death. The total number of deaths, from all causes, in 2020 was 81.2 lakh. The Health Ministry reported only 1.49 lakh COVID-19 deaths in 2020. The WHO, on the other hand, has estimated nearly 8.2 lakh excess deaths from all causes, or twice the official number.

In the context of pandemic deaths, India has accused the WHO of using mathematical modelling to estimate deaths for India using parameters from reports such as the Global Health Estimates, test positivity data, etc., that didn’t accurately reflect the Indian situation and ignored official death estimates.

Scientists from the WHO have countered these points by stating that they relied on official data from the CRS, as well as reports that cited data accessed by Right to Information requests. They have said that they didn’t use the estimates that the Indian government has claimed they used and that they relied on official data from 17 States and one Union Territory, compared death reporting trends from previous years in these regions, and then estimated deaths for months where data wasn’t officially available.