India objects to WHO methodology projecting ‘excess mortality estimates’


India has been consistently objecting to the methodology adopted by the WHO to project excess mortality estimates based on mathematical models, the Union Health Ministry said on Thursday.

“Despite India’s objection to the process, methodology, and outcome of this modeling exercise, the WHO has released the excess mortality estimates without adequately addressing India’s concerns. India had also informed the WHO that in view of the availability 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,” it said.

Based on reports submitted by states and UTs, Vital Statistics of India, based on the CRS, are published annually by the RGI and the last such national report for the year 2019 was published in June 2021 and for 2020, on May 3, 2022, a Ministry statement said, adding that 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”.

Underlining that the WHO till date has not responded to India’s contention, it said that India had pointed out the inconsistencies in the criteria and assumption that WHO used to classify countries into Tier I and II as well as questioning the very basis for placing India in the latter, which India “doesn’t deserve”.

It also noted that WHO had also admitted that data in respect of 17 Indian states was obtained from some websites and media reports to use in their mathematical model. “Throughout the process of dialogue, engagement and communication with WHO, WHO has projected different excess mortality figures for India citing multiple models, which itself raises questions on the validity and robustness of the models used,” it said.

The ministry also said that India objected to the use of Global Health Estimates (GHE) 2019 in one of the models used by WHO for calculating excess mortality estimates for India. “GHE itself is an estimate. Therefore, a modeling 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 test positivity rate another key variable used by the WHO for Covid-19 in India was never uniform throughout the country at any point of time. Owing to its large area, diversity and a population of 1.3 billion which witnessed variable severity of the pandemic both across space and time, India consistently objected to the use of ‘one size fits all’, approach and model, which may be applicable to smaller countries but cannot be applicable to India.”

The Health Ministry said that the CRS data “clearly reveals that the narrative sought to be created based on various modeling estimates of India’s Covid-19 deaths being many times the reported figure is totally removed from reality”.

“Since RGI figures capture ‘all-cause mortality for a particular year, mortality figures of Covid-19 could at best be considered a sub-set of the ‘all-cause mortality in that year. Therefore, reliable figures released by the statutory authority captured through a rigorous process across the country are presently available for analysis and support in policy planning.”

However, it said that despite communicating this data to the WHO, it “for reasons best known to them conveniently chose to ignore” this.