Data insight

Dramatic shifts in the global mortality distribution

The rich-country share in measured mortality has recently quintupled

As the chart below illustrates, we have seen massive changes in the global mortality distribution since the beginning of 2021. On January 8, the share of high-income countries (the non-developing world) reached a maximum of 60%. Between January 8 and July 20, it plunged to 6% – a tenth of its value earlier this year!

This was mirrored in a shift of mortality to the developing world. Upper-middle-income countries (UMICs) saw the share increase from 32% to 56%. But the greatest increase was for the lower-middle-income countries (LMICs): from 8% to 26%. This was driven by India. For low-income countries (LICs), the share in reported mortality went up appreciably from close to 0% to 2% but remained low overall. 

Since July 20, however, mortality dynamics started to shift again. The spread of delta meant that the high-income share went up again considerably. For the most recent developments, see the chart below. 

 

In spite of the recent increase of mortality in high-income countries, we should be very concerned about the rising share of developing-country mortality. It isn’t rising just because of the arithmetic effect of a vaccine-induced drop in rich-country mortality. No, mortality in the developing world has been climbing also in absolute termsTaking inequality in data quality into account, the real picture will likely be a lot worse as we have argued in this blog

This new stage of the pandemic, marked by vaccine inequality amidst the continued spread of new variants, is worrisome.  Delta has proven to be hyper-contagious (up to 2x relative to the ancestral Wuhan bug), it is more partially immune evasive (partial vaccination and prior COVID infection don’t protect well) and it is potentially slightly more lethal. 

While vaccines continue to work against the severe manifestations of the disease, the vast majority of the global population is not vaccinated (see chart below).  This produces in large part the shift in mortality. 

The fact that mortality is now rising again in high-income countries reflects the contagiousness of delta as well as the fact that vaccination is still incomplete and/or unbalanced leaving large segments of the population susceptible.

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