Who counts? – a test of our humanity

In the Comment which opens the Series, The Lancet’s editor Dr Richard Horton says: “This ‘scandal of invisibility’ means that millions of human beings are born and die without leaving any record of their existence. Over three-quarters of them are to be found in sub-Saharan Africa and South-East Asia.”

The imprint of a person’s existence confirms their citizenship and represents the first step in securing their right to life, freedom, and protection. Counting human lives is a pressing priority, and the Who Counts? Team says there has been widespread neglect of the issue and little progress in four decades.

Dr Horton says: “Today, less than a third of the world’s population is covered by accurate data on births and deaths. Far greater global urgency needs to be injected into this challenge.”

Further, he calls for robust and effective national statistics systems at country level, strong government ministries, legal systems, civil service and local information networks, as well as a vocal civil society to press governments to act. He says: “The health sector can be an important catalyst in this effort.”

He concludes: “Globally, there is a gap. No single UN agency currently has responsibility for registering births and deaths. This absence has led the Who Counts? team to call for a new international body to improve civil registration efforts. But they concede that the likelihood of a new organisation being inaugurated is low. In the interim, they urge donors and global partners to do more to promote and support registration systems. Ultimately, this campaign is about how much each of us values the life of every other human being. It is a test of our humanity.”