AMY GOODMAN: This is Democracy Now!, democracynow.org, The War and Peace Report. I’m Amy Goodman.

The World Health Organization is estimating the COVID-19 pandemic has killed nearly 15 million people directly or indirectly. The number is far higher than most official counts which put the global death toll at about five-and-a-half million. In its report, the World Health Organization calculated there were 14.9 million excess deaths over the past two years. This includes people who died with COVID, as well as those who died due to the pandemic’s impact on overwhelmed healthcare systems. Dr. Samira Asma of the World Health Organization talked about the agency’s findings Thursday.

DR. SAMIRA ASMA: What we released today is a staggering number of 14.9 million excess deaths since the start of the pandemic, from January 2020 to December 2021, in a period of 24 months. What we also reported today is that the majority of these deaths occurred in Southeast Asia region, followed by Europe and the Americas.

AMY GOODMAN: The WHO report also suggests 4.7 million people have died in India alone from the pandemic — far higher than India’s official death toll at just over half a million. This all comes as NBC News reports the United States has passed a grim milestone with over 1 million official COVID deaths, though many public health officials say that, too, is an undercount.

We’re joined right now by two guests. Dr. Abraar Karan is an infectious disease doctor at Stanford University in California. And Achal Prabhala is the coordinator of the AccessIBSA project, which campaigns for access to medicines in India, Brazil and South Africa. We normally speak to him in Bangalore, India, but he’s joining us today from South Africa.

Let’s begin with you, Achal. If you can talk about the massive undercount that we’re looking at, this number of 15 million people dead in the world because of the COVID pandemic?

ACHAL PRABHALA: Good morning, Amy, and good morning to your listeners.

I am surprised at the reaction of the Indian government, primarily, to the WHO report on excess deaths and its estimate of the true toll of the pandemic, especially in India. But it didn’t come as a surprise to anyone who was following mortality news through the pandemic. There have been previous estimates by independent researchers and magazines, such as The Economist, which also suggested that we were looking at numbers that were far, far higher than the official figures that were released, estimated.

I think that the most significant thing here for me as a citizen and a resident of India is the fact that the Indian government has so vociferously denied the numbers that the WHO released. And the reason that they’re loath to admit that nearly 5 million people, as opposed to a little over 500,000 people by their estimate, died during the pandemic possibly of COVID is that it points to a political failure. And the political failure is not restricted to the government’s actions or inactions during the pandemic alone, but points to a much broader political failure of failing to protect public health in the country. It’s, to me, an incredibly tragic reminder that if we can’t even count our dead or know them, how can we possibly be expected to keep them alive?

AMY GOODMAN: Talk about both places — usually you’re in India, now you’re in South Africa, both key places when it comes to the pandemic — how the governments have dealt with both differently and what you think needs to happen now. In the United States — and we’ll talk about this with Dr. Abraar Karan in a minute — with over a million deaths, this incredibly grim milestone, the funding for COVID, now far less than is being appropriated for Ukraine, has not even been approved, let alone vaccine access for the rest of the world.

ACHAL PRABHALA: There are a couple of really important things here, Amy, that are, I think, being buried under, of course, the other pressing emergencies that the world is dealing with, but also, I think, in a rush to declare the end of the pandemic in the hope that it may actually be over — and, of course, it’s not.

The first, I think, is that I’ve been on Democracy Now! several times talking about the ways in which Western governments and rich corporations who are based primarily in the West have done very little to advance vaccine inequity or to help the entire world end this pandemic faster. And often it’s set up as a death match between bad rich governments and good poor governments. I live, unfortunately, in a poor country. That’s just not the case. Poor countries have some culpability in this exercise. But they also have responsibility. And I think the thing that disappoints me a lot is that poor countries have failed, right through this pandemic, to take responsibility for what they could do themselves.

So, let’s take the TRIPS waiver, for instance. India and South Africa, about a year and a half ago, went to the World Trade Organization to ask for a pause, a temporary suspension of pharmaceutical monopolies, so that not just vaccines but things like Paxlovid, the new wonder drug from Pfizer, that, if taken a few days after being diagnosed with COVID, dramatically reduces your chance of dying due to COVID — so that drugs and vaccines in the pandemic could be more widely available. It’s been a year and a half. There’s been almost no movement — in fact, negative movement. And the truth is that India and South Africa are asking for permission to do something that they’re already allowed to do. They have a full legal right, under the World Trade Organization’s own rules and emergency exceptions, to create what we would call a national TRIPS waiver. And, in fact, the government of Brazil, surprisingly, did this last year in September without waiting for the World Trade Organization to tell them that it could do so. We’ve been asking a year and a half for permission to do something we’re already allowed to do. And at this stage of the pandemic, I think it’s ridiculous for poor countries to blame everything on what Western countries aren’t doing for them, and I think they have to begin to think very seriously about what they can do for themselves.

And the second piece of this puzzle, which I think also there’s been inaction around, is to figure out how to have access to mRNA technology. At the moment, mRNA vaccines are by far our best chance at protecting against transmission of the Omicron variant, which is why in the United States you get a Pfizer or Moderna vaccine as a booster, and you can’t actually get a J&J vaccine, or, in Europe, you can’t get an AstraZeneca vaccine as a booster. But that’s all we have. So the entire country of India has zero access to an mRNA vaccine today.

But more importantly, in about three or four months, the mRNA vaccine manufacturers are very likely to be the first vaccine makers to come up with an Omicron booster or a bivalent booster that works against Omicron and the Delta variant. They have plans to introduce these vaccines in the fall. At that point, that vaccine will be the only vaccine worth taking anywhere in the world. And 92 poor countries — about half the world’s population — has no access to those vaccines. In two years we’re likely to have things like an HIV vaccine on the mRNA platform, or cancer medicines of all kinds. None of those mRNA medicines and vaccines, now or in the future, are available to us.

But we also haven’t fully noticed, and the governments of these countries need to understand what they don’t have and figure out ways that they can get them. And I think a part of the reason that countries like India aren’t doing so is it is again an admission of political failure. The idea that they need something that they don’t have and have to work to get it, I think, points to a kind of weakness, which they don’t want to admit.

AMY GOODMAN: Of course, COVID is so personal for so many around the world. What about your own parents in India, Achal?

ACHAL PRABHALA: My parents are in their eighties, Amy. And a couple of weeks ago, they received an AstraZeneca vaccine as a booster, so they got their third shot. We don’t have fourth shots authorized in India as yet. A few weeks later, I became eligible to get the same booster, and I actually got that. I’m much younger than my parents; I don’t worry too much about myself. But my parents are in their eighties, and they, essentially, got a vaccine that provides a documented level of 0% protection against transmission of the Omicron variant, versus a slightly higher degree of protection had they been able to get an mRNA booster like you and your loved ones have got in the United States. That’s not available to us.

And the thing that irks me the most is that the government of India hasn’t noticed. The government of India hasn’t done anything about creating access to mRNA vaccines now and the mRNA technology in the future to protect us. And very few other poor countries have. And this strikes me as absurd, because what they’re doing, essentially, is trying to delay the sort of eventual failure of their efforts to contain this pandemic within their countries.

AMY GOODMAN: You’re in South Africa, usually in India, because you’re making a film, about what?

ACHAL PRABHALA: I’m making a film on how 25 years of pharmaceutical monopolies have wreaked harm around the world in unprecedented levels and fundamentally changed the world in ways that are yet to be resolved, in ways that were evident in pockets of people who had HIV or hepatitis C or certain kinds of cancers, but then, once the pandemic hit, became a universal concern, which is yet to be resolved but is a powerful force in the world that’s been shaping it in a way that I think very few of us have noticed.

AMY GOODMAN: Achal Prabhala is coordinator of AccessIBSA. IBSA stands for I-B-S-A, India, Brazil, South Africa.