On May 5 (local time), the medical journal The Lancet published its May 6-12, 2023 issue in which it published an editorial based on dubious Covid data and press freedom ranking to target the Narendra Modi government. In the editorial “India’s ascendancy: leadership demands integrity”, the medical journal became a political lobbyist platform to defame India.
Initially, the editorial talked about India’s G20 presidency that it took over from Indonesia. It highlighted the importance of the G20 Summit scheduled to take place in India in September 2023. It talked about how India wants to amplify the voice of the Global South and use G20 goals to reflect its ambition. The Lancet claimed that the Modi government’s nationalist agenda, resistance to multilateralism and raft of pressing domestic concerns had become a hurdle in achieving its ambitions.
The Lancet then talked about different steps taken by the government to show it has the potential to become a global leader. The editorial spoke about leadership in access to medicines, a proposal to waive intellectual property during the Covid-19 pandemic, generic medicine manufacturing, Ayushman Bharat Digital Mission, Co-Win opensource platform, debt relief for low-income and middle-income countries (LMICs) and more.
However, the editorial’s author claimed that the “direction” the Modi government is taking in the country, including climate policies, raises concerns. It argued that softening language of India on coal at COP26 raised scepticism as India is the world’s third-largest CO2 emitter.
The last two paragraphs of the editorial turned political and used dubious data to target the Modi government over Covid-19 death reporting and press freedom. First, it claimed that the health data provided by the Indian government was “wholly untrustworthy”. While the government figures for deaths due to Covid-19 in India stood at over 5,30,000, WHO excess death estimates for 2020 and 2021 were near 4.7 million. In a way, Lancet claimed India is off by over 4.2 million deaths due to Covid.
It claimed that the Indian government attempted to delay the publication of WHO’s excess death figures and censored criticism during the pandemic.
India debunked claims made by WHO about excess data in April 2022
The Government of India has already debunked the claims made by the WHO over excess deaths during Covid-19 in India. On April 16, 2022, the Ministry of Health and Family Welfare (MoHFW) said in a press release that India had regular and in-depth technical exchanges with WHO over the issue of the Covid death toll. The Ministry raised concerns over the methodology used by the study to calculate the estimated number of deaths that might have occurred worldwide. The Ministry said that the analysis used the figures collected from the Tier-1 set of countries and used a mathematical modelling process for Tier-II countries, including India. It added that India does not just question the result of the analysis but the methodology itself.
The Ministry further pointed out that on several occasions, India shared its concerns with other member states via formal communications and issued six letters to WHO, once in November 2021, twice in December 2021, and again in January, February and March 2022. Four virtual meetings were also held over the issue. “During these exchanges, specific queries have been raised by India along with other member states, e.g. China, Iran, Bangladesh, Syria, Ethiopia and Egypt, regarding the methodology and use of unofficial sets of data,” the Ministry said.
The Ministry said that the ‘one size fits all’ approach might work in smaller countries, but it may not apply to India, which has a population of over 1.3 billion. “The model gives two highly different sets of excess mortality estimates 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 the validity and accuracy of such a modelling exercise,” the press release read.
It added that the modelling for Tier II countries is based on the Global Health Estimate 2019, which itself is just an estimate. The Ministry raised the question of how previous sets of estimates could be based on the present modelling exercise while disregarding the data available in the country. It also noted that while GHE 2019 was used for India, for Tier 1 countries, their own historical datasets were used. The historical data of India was ignored despite the fact that the country has a robust system of data collection and management.
The Ministry pointed out that India had no age-sex death distribution, but WHO determined standard patterns for age and sex for all countries with reported data from 61 countries. It generalized the available data to other countries, including India. “Based on this approach, India’s age-sex distribution of predicted deaths was extrapolated based on the age-sex distribution of deaths reported by four countries (Costa Rica, Israel, Paraguay and Tunisia),” the Ministry added.
In India, the test positivity rate was never uniform at any given time. However, it was not considered for modelling purposes. “Further, India has undertaken COVID-19 testing at a much faster rate than what WHO had advised. India has maintained molecular testing as the preferred testing method and used Rapid Antigen for screening purposes only. Whether these factors have been used in the model for India is still unanswered,” the Ministry said.
While WHO had agreed with India’s point of view about the subjective approach, such as school closing, workplace closing, cancelling of public events etc., it was impossible to quantify various measures of containment in such a manner for a country like India. However, it was still used for this study.
The RSF used dubious and misleading reports to rank India below authoritarian governments
The Lancet also used the recently published press freedom ranking by Reporters Without Borders, categorically based on old misleading reports and dubious data. In the recent ranking, India has been put at 161st rank, 11 ranks down from the previous ranking, which was 150. Interestingly, Reporters Without Borders has put India below authoritarian governments like Pakistan on the list. The Lancet’s editorial read, “Civil society is increasingly constrained, and violent Hindu nationalism is suppressing non-Hindu voices. Without a space for debate, activism and accountability are impossible, and India’s place as the world’s largest democracy is threatened.”
It further claimed that the “Modi government has failed to show a commitment to transparency, integrity, and equity. As a result, India risks squandering its formidable opportunities.”
RSF claims that The Lancet used are based on dubious data and misleading old reports. RSF claimed the central government is spending more than 130 billion rupees (Rs 13,000 crores) or 5 billion euros a year on print and online media ads alone. OpIndia had filed an RTI seeking information on the ad spent by the central government on different platforms, including print, outdoor advertisements, social media, radio and television. As per the reply sent by the Ministry of Information and Broadcasting of the Government of India, the actual figures are nowhere close to what RSF has claimed.
Contrary to what RSF claimed, the reply to OpIndia’s RTI categorically showed that the Modi government had reduced its ad spending considerably over the years. In FY 2014-15, it spent Rs 682.32 crores. In the next four years, the ad spend stood above Rs 900 crores. However, After the Modi government came back to power in 2019, the money spent on ads was reduced to less than half and stood at Rs 348.07 crores in FY 2019-20, followed by 209.34 crore in 2020-21, 136.05 crores in 2021-22 and 126.58 crores in FY 2022-23 till December 31, 2022.
RSF claimed GoI spent Rs 13,000 crores only in print and online media ads. In reality, the ad spent on all formats (television, print, radio, outdoor, digital cinema, SMS, internet and misc) since the Modi government came to power stood under Rs 1,000 crores. It has been using the numbers for over a year but did not care to check the data provided by the government. Nor did the Lancet try to verify it.
Instead of relying on authentic data and reports, The Lancet cunningly used studies that go against India to target the fastest-growing economy in its editorial.
The Lancet’s history of targeting India
This is not the first time the medical journal The Lancet has targeted India using dubious data. In May 2021, an article targeting Prime Minister Modi over the Coronavirus crisis in India. In strong words, it placed the entire burden for the crisis at the feet of the Prime Minister while giving every other political party a free pass. The article itself was riddled with a series of inaccuracies in terms of data that can be interpreted by laymen as well. The Lancet argued for a national lockdown, ignoring the fact that the vast majority of India is already under partial or full lockdown.
There were fundamental issues with the sources cited by The Lancet in the article as well. It said at one point, “The Institute for Health Metrics and Evaluation estimates that India will see a staggering 1 million deaths from COVID-19 by Aug 1.” There are multiple things that are wrong with the IHME projections. For instance, according to the projections, 195,135 people had already succumbed to Covid-19 in India by the 1st of September 2020. At that point in time, the reported deaths were just over 66 thousand. The death toll in India even after the deadly second wave stands at 5,31,707.
