On excess deaths in India in 2021, India’s rise in the Human Development Index, improved infant and maternal mortality rates, climate changed-linked health issues, and more
This past week has offered a glut of data as far as health statistics are concerned: specifically, India- related data has emerged, giving us an occasion to evaluate where we stand, on many health fronts. While we must certainly celebrate the successes, hard won, it is also incumbent upon us to mark out areas of concern, and push these sectors into the public realm to collectively urge action from the State.
Firstly, the data of deaths during 2021, was finally unveiled, justifying many media accounts of excess deaths of COVID in India, at that time hotly contested by the Indian government. Now, official statistics say that India reported 21 lakh additional deaths in 2021 compared with 2020. After five years, the report on births and deaths released by the Registrar General of India, mentioned that the two lockdown years reported 5,74,198 COVID-19 deaths. The COVID-19 dashboard maintained by the Union Ministry of Health says that, as on May 5, the total number of deaths induced by the pandemic stood at 5,33,665.
The report said that among the leading groups of causes, diseases of the circulatory system, including pulmonary ailments, constituted 29.8% of the total number of medically certified deaths, followed by deaths caused by COVID-19 at 17.3%; deaths caused by diseases of the respiratory system at 12.7%; and deaths caused by certain infectious and parasitic diseases at 6.1%. COVID-19 was the second-leading cause of death in 2021; it was the third-leading cause of death in 2020. Had there not been a war in the Indian subcontinent, this report would have elicited more debate and discussion.
A World Health Organization (WHO) report had earlier estimated India’s ‘excess deaths’ for the period at 47 lakh. Another report in a top journal had cited 41 lakh ‘excess deaths’ in this period. But then, the government’s explanation flew in the face of some hardcore facts. A government official told Bindu Shajan Perappadan that ‘Excess deaths in 2020 and 2021 were not equal to deaths by COVID-19, and the increase was attributable to several reasons’.
His argument ran thus: the number of deaths documented in the CRS has been increasing over time, even in the years preceding the COVID-19 outbreak in 2020, and the preliminary analyses of the CRS data to assess cumulative deaths in 2020 and 2021 had been carried out. “Based on the three-year (2016-19) annual rate of increase of 6.42%, the expected number of deaths would be 81,31,869 in 2020, and 86,54,185 in 2021. However, the observed deaths were 81,15,882 in 2020, and 1,02,24,506 in 2021. The ‘excess deaths’, defined as observed deaths deducted from expected deaths were minus [-]15,987 and 15,70,321 in 2020 and 2021, respectively. Thus, the total excess deaths over the two-year period amounted to 15,54,334 — this is 9.3% higher than the expected deaths. This translates into about 1,249 excess deaths per one million population,” the official said.
He further argued that the increase in deaths registered in the CRS could be attributed to several reasons, including a larger population cohort, maturing reporting processes, and increased awareness of the need for registration leading to higher levels of registration. This trend has been further accentuated over the years by mandatory requirements for death certificates linked to pension schemes, social security benefits, and property issues. Moreover, the official said, compensation for death by COVID-19 required death certification, prompting registration under the CRS.
The other report that was keenly watched, did not have the Indian government bristling in defence. That is because the media reported that India went up three spots to 130 among 193 nations in Human Development Index. India continued its steady rise on the Human Development Index (HDI), ranking 130 out of 193 countries in the 2025 Human Development Report (HDR) of the United Nations Development Programme (UNDP). With its HDI value increasing from 0.676 in 2022 to 0.685 in 2023, India remains in the medium human development category, moving closer to the threshold for high human development (HDI ≥ 0.700). Also, India’s life expectancy is the highest since the inception of the index, indicating a strong recovery from the pandemic and its impact on life expectancy.
Clearly the country’s interventions to improve maternal and infant mortality and better the standards of living for the citizens of the country are showing some ameliorative effects. This was also indicated in the latest Sample Registration System data, also released last week. The Union Health Ministry claims that India outpaces global averages. Three States in India — Kerala, Maharashtra, and Tamil Nadu — have attained the U.N. Sustainable Development Goals (SDGs) targets in Maternal Mortality Rate or MMR; Under-Five Mortality Rate or U5MR; and Neonatal Mortality Rate or NMR. According to the report, eight States have already attained the MMR SDG target, including Kerala (20), Maharashtra (38), Telangana (45), Andhra Pradesh (46), Tamil Nadu (49), Jharkhand (51), Gujarat (53), and Karnataka (63). Twelve States/Union Territories have already attained the U5MR SDG target — Kerala (eight), Delhi (14), Tamil Nadu (14), Jammu & Kashmir (16), Maharashtra (16), West Bengal (20), Karnataka (21), Punjab (22), Telangana (22), Himachal Pradesh (23), Andhra Pradesh (24), and Gujarat (24).
Vijaita Singh recorded that as per the SRS, the Total Fertility Rate remains constant at 2.0 in 2021, and here is a further update on India’s latest Maternal Mortality Ratio. Afshan Yasmeen looks at the southern region’s data and reasons Karnataka’s MMR reduces to 63 per lakh live births, but is still highest among southern States. Siddharth Kumar Singh reports on public health expert K. Srinath Reddy’s position that ‘India’s healthy life expectancy lags a decade behind total lifespan’. Serena Josephine M. further outlines the Tamil Nadu success story, and records better under 5 mortality rate: In T.N., comprehensive nutritional, immunisation services pay off with steadily decreasing deaths among under-fives.
Moving from statistics-based progress to achievements in labs. A recent Study found migraine drug can reduce depressive symptoms in patients having both. In the study involving 540 patients, ‘fremanezumab’ was found to reduce days of migraine in a month and symptoms of depression, compared to a placebo (inactive substance producing no effects). The drug, administered as an injection beneath the skin (subcutaneous), is available in India.
V. Geetanath reports that NIAB scientists perform CRISPR-based genetic manipulation to identify protein to halt zoonotic infection ‘Toxoplasmosis’. Toxoplasmosis is a parasitic zoonotic infection that can be transmitted through contaminated food, especially undercooked meat. The parasitic infection caused by ‘Toxoplasma gondii’ can lead to abortion and neonatal mortality in both humans and animals, causing substantial economic losses in the livestock industry due to reproductive failure. Which makes this advance significant.
In other news, an AI tool uses selfies to predict biological age and cancer survival; and a San Francisco based company says its at-home test kit for cervical cancer was approved by the FDA.
Climate change is going nowhere, and we report on the many ramifications, this week too. Summer is in the subcontinent, and we cannot ignore the impact of a changing climate: it manifests in many forms, not the least sweat, urging our attention. Sharmila Vaidyanathan underlines the gut impact in this article Climate change is disrupting the human gut in a new path to illness. Apparently, climate-induced changes in the yield and nutritional quality of various foods could tip the balance of gut microbiota towards strains associated with malnutrition.
Dr. Amrish Patel writes on the temperature-asthma link: increasing heat is worsening symptoms in asthma patients, causing new cases among the healthy, while Dr. Ankit Sharma Decodes the link between summer and kidney stones, yes, a link exists. Aravind Unni and Shalini Sinha make the case that It is time to protect India’s workers from the heat.
Last week we reported of a new subtype of monogenic diabetes discovered by the researchers of Madras Diabetes Research Foundation and Washington University School of Medicine in St. Louis. MODY is a rare, inherited form of diabetes caused by mutations in a single gene, typically appearing in adolescents and young adults. While 13 MODY subtypes have been recognised to date, the newly-identified variant challenges long-standing assumptions about the condition, doctors said.
Drawing from climate change and staying on non communicable diseases, we talk about Manish Anand and Vidhu Gupta’s article: Sprouting sustainable, nutrition-sensitive food systems here. Food insecurity is no longer just about hunger. It now encompasses all forms of malnutrition, including diet-related non-communicable diseases (NCDs). Millions, including food producers, struggle to afford a healthy diet. They advise that nutrition-sensitive agriculture is central, requiring agricultural policies that integrate nutrition objectives by promoting the cultivation of climate-resilient, biofortified crops, enhancing crop diversity, and improving post-harvest storage systems to bolster food security and dietary quality.
Shrabana Chatterjee writes of increasing infertility and the need to stem stigma and misinformation, in context, in this article. The basic problem arises out of looking at it as a ‘woman’s problem’, she says.
In the infectious diseases bandwidth, today, we have R. Prasad reporting: Kerala reports seventh Nipah outbreak since 2018. The Hindu’s edit on the subject Greater regularity: On the Nipah virus, calls for sharing genetic sequences in public databases without any delay, in order to conduct more research. Athira Elssa Johnson argues that India needs patient-centric care and trained counsellors to manage Inflammatory Bowel Diseases burden: experts, ahead of World IBD Day on May 19. And testing for HIV becomes an issue in parts of T.N. face as a shortage of HIV test kits hits the State.
While India has a robust private health care system, it is clear that the biggest deliverer of health services in the country is the public health system and do read this important piece by Dr. C. Aravinda delineating its fault lines: Scattered public health services, fragmented governance. Dr. K. Ganapathy further talks about Medical accountability in the digital health era: the pros and the pitfalls.
Not the least, remembering the war-like situation the country was forced into last week, Dr. Kinshuk Gupta, Prof Suneela Garg and Prof Mongjam Meghachandra Singh write a timely article on Health preparedness in situations of war. An article our health managers will do well to stick by.
In the tailpiece segment of the week, the parley conversation between Dr. Meghna Singhal and Sannuthi Suresh should be highlighted for the depth of opinions it brought on. You can read, and listen to this conversation moderated by me, on the link: Is social media defining self-worth? What is clear is that snooping on your adolescent’s social media use is not going to get you anywhere, as adults, the best thing parents can do is to ensure that the channels of communication remain open with their children.
Our explainers section did overtime this week, but that leaves us with a wealth of information that you will have access to online.
In the All you need to know series, we have
Zubeda Hamid on cystic fibrosis; Geetha Srimathi on Lafora Disease, and others write on Lupus; and the Barker hypothesis about the impact of the intrauterine atmosphere on humans.
Saurabh Khiste explains if intermittent fasting helps or harms kidney health?
We also handle a range of subjects, beginning with Is climate change increasing the levels of toxic arsenic in our rice? to Why did T.N. ban mayonnaise made from raw eggs? and as basic as Why does our temperature go up when we are ill?
There are explainers on How did India’s national health programmes contributed to increased longevity? And a video you can watch on the subject: Can drugs like Ozempic solve the obesity problem in India?
If you have a few extra moments, do read:
Vidhya P. on Celebrating the compassion, commitment and courage of nurses on Nurses Day
Elizabeth Hintz and Marlene D. Berke in The Conversation When doctors don’t believe their patients’ pain – experts explain the all-too-common experience of medical gaslighting
A silent burden: Thalassaemia patients in Karnataka battle disease with hope and hardship
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Published – May 13, 2025 04:03 pm IST
