“India’s basic objection has not been with the result (whatever they might have been) but rather the methodology adopted for the same,” the health ministry said, underlining that India has been in regular and in-depth technical exchange with WHO on the issue. If the model adopted is accurate and reliable, “it should be authenticated by running it for all Tier I countries and if result of such exercise may be shared with all Member States”.
The comment followed an NYT report that said India is trying to stall a WHO report on the global Covid toll by disputing the calculation of how many of its citizens died. The article states that the yet-to-be-released report has concluded that around 15 million people died worldwide by end-2021 — more than double the official total of six million reported by countries individually. More than a third of the additional 9 million deaths, the report said, are estimated to have occurred in India, which would then put the number of Covid deaths in the country at four million at least.
However, NYT said, it was unable to learn the estimates for other countries.
According to the health ministry, the WHO analysis uses mortality figures directly obtained from Tier –1 set of countries, while for Tier II countries (including India), it uses a mathematical modelling process. In fact, it is not just India, specific queries have been raised by other WHO member states like China, Iran, Bangladesh, Syria, Ethiopia and Egypt regarding the methodology, and use of “unofficial sets of data”, the ministry said.
“It is very surprising that while New York Times purportedly could obtain the alleged figures of excess Covid-19 mortality in respect to India, it was ‘unable to learn the estimates for other countries’,” health ministry said.
Strongly criticising the UN body for its methodology, the health ministry said the concern specifically includes on how the statistical model projects estimates for a country of geographical size and population of India and also fits in with other countries, which have smaller population. “Such one-size-fits-all approach and models which are true for smaller countries like Tunisia may not be applicable to India with a population of 1.3 billion. WHO is yet to share the confidence interval for the present statistical model across various countries,” it said.
Besides, the model gives two highly different sets of excess mortality estimates of when using the data from Tier-I countries and when using unverified data from 18 Indian states. “Such wide variation in estimates raises concerns about validity and accuracy of such a modelling exercise,” the health ministry said.
India along with other member countries has shared its concerns through a series of formal communications, including six letters issued to WHO between November 17, 2021 and March 2, 2022. The issues were also raised during various virtual meetings in December, January and February.
Questioning the approach followed by WHO, the ministry said the model assumes an inverse relationship between monthly temperature and monthly average deaths, which does not have any scientific backing to establish such peculiar empirical relationship. Besides, the test positivity rate for Covid-19 in India was never uniform throughout the country at any point of time, but this variation in Covid-19 positivity rate within India was not considered for modelling purposes by WHO.
“In addition, subjective approach to quantify such measures will always involve a lot of biasness, which will surely not present the real situation. WHO has also agreed about the subjective approach of this measure. However, it is still used,” the ministry said, underling that it is yet to receive “a satisfactory response” from WHO.
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