Dr. Philip Setel, a research professor of epidemiology in UNC's School of Public Health, termed the lack of official data a "scandal of invisibility" in the lead paper of 'Who Counts?' series in the medical journal The Lancet, and proposed to deal with it by urgently implementing the collection of vital statistics.
He says that without vital statistics, officials can make only "educated guesses" based on models about the numbers of deaths due to various causes in their populations.
The article titled 'A Scandal of Invisibility: Making Everyone Count by Counting Everyone' also reveals that over the past 30 years, there has been a persistent failure to establish, support and sustain civil registries and to ensure that causes of death are accurately known in the world's poorest countries.
"In sub-Saharan Africa fewer than 10 countries have routine vital statistics systems that produce usable data, and mortality data is reported from only four. Reliable data on levels of adult death - let alone causes of death - simply do not exist for most countries in Africa and Asia, where a large majority of deaths occur at home," Dr. Setel wrote in the paper.
The researcher also said that there was no conclusive evidence that the more than 80 billion dollars spent by International donors in 2004 on overseas medical aid was making any difference in preventing deaths, including those from AIDS, tuberculosis and malaria.
He recommended focusing on other cost-effective interim measures like data collection through national census, until civil registration systems could be rebuilt.