The World Health Organization on Thursday announced that nearly 15 million people died as a direct or indirect result of the coronavirus pandemic in 2020 and 2021—almost three times as many as officially reported.

Data submitted by governments to the WHO indicated that Covid-19 had killed roughly 5.4 million people around the globe by the end of last year. But according to the WHO’s new 2020 and 2021 estimate of “excess mortality”—how many more people died worldwide than would be expected in the absence of the pandemic—the first two years of the ongoing public health emergency led to approximately 14.9 million excess deaths.

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The U.N.’s latest report on excess mortality comes one day before a World Trade Organization council is expected to vote on a corporate-friendly alternative to India and South Africa’s popular proposal to waive the intellectual property monopolies that are preventing generic manufacturers from boosting the production of lifesaving vaccines, tests, and treatments.

“How can it be that in the face of a global pandemic that has taken 15 million lives and destroyed billions more livelihoods, in two years the WTO cannot get out of the way of global access to medicines that governments paid pharmaceutical firms billions to develop and distribute?” Lori Wallach, director of Rethink Trade at the American Economic Liberties Project, asked earlier this week.