WHO comes under fire for handling of 2009 H1N1 swine flu pandemic

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Think back to the height of the H1N1 epidemic last year. We were a little scared.

People wanted vaccinations and couldn’t get them. Children and pregnant women were said to be the most vulnerable. Emergency rooms were clogged, and hospitals set up tents in parking lots to handle the overflow of patients. And there were deaths. Somewhere between 8,870 and 18,300 deaths, according to the Centers for Disease Control.

So the threat was real. But imagine how you’d feel if you found out that the extent and strength of the pandemic was exaggerated – by people who stood to make money from the sale of the vaccinations.

That’s exactly what a The British Medical Journal is alleging in its current issue. In a joint investigation with the Bureau of Investigative Journalism, their report says that the top scientists who convinced the World Health Organization – the WHO – to declare H1N1 a global pandemic had financial ties to the companies who sold the vaccines. And that the more the pandemic was emphasized and exaggerated, the more they stood to gain.

From the British Medical Journal:

“A joint investigation by the BMJ and the Bureau of Investigative Journalism has uncovered evidence that raises troubling questions about how WHO managed conflicts of interest among the scientists who advised its pandemic planning, and about the transparency of the science underlying its advice to governments. Was it appropriate for WHO to take advice from experts who had declarable financial and research ties with pharmaceutical companies producing antivirals and influenza vaccines? Why was key WHO guidance authored by an influenza expert who had received payment for other work from Roche, manufacturers of oseltamivir, and GlaxoSmithKline, manufacturers of zanamivir? And why does the composition of the emergency committee from which [Margaret] Chan [director general of WHO] sought guidance remain a secret known only to those within WHO? We are left wondering whether major public health organizations are able to effectively manage the conflicts of interest that are inherent in medical science.

“Already WHO’s handling of the pandemic has led to an unprecedented number of reviews and inquiries by organizations including the Council of Europe, European Parliament, and WHO itself, following allegations of industry influence. Dr Chan has dismissed these as "conspiracies," and earlier this year, during a speech at the Centers for Disease Control and Prevention in Atlanta, she said: "WHO anticipated close scrutiny of its decisions, but we did not anticipate that we would be accused, by some European politicians, of having declared a fake pandemic on the advice of experts with ties to the pharmaceutical industry and something personal to gain from increased industry profits."

The sticky part here is that the WHO, the pharmaceutical companies and the global public health system all rely on the same pool of scientific experts. Criticism is also being leveled at the WHO for not disclosing the financial interests of its experts; the WHO says that was to protect the experts themselves.

The journal Nature News rebuts the BMJ story, addressing concerns about a lack of substantiation and follow-through in the report itself. It notes, among other things, that large orders for the H1N1 vaccine had been placed worldwide before it was declared a pandemic; that the WHO’s revision of exactly what constitutes a pandemic was actually finished months before H1N1 was declared one; and that the experts who had connections to the pharmaceutical companies had, in fact, declared those connections, but they weren’t made public by the WHO.

From Nature News:

“David Ozonoff, an epidemiologist at the Boston University School of Public Health in Massachusetts, says that the reports "smear" the scientists involved in pandemic planning by "insinuating" that they would have offered different advice had they not had a relationship with drug companies. "This is a pretty serious charge," he says.

"We think this is the researcher's reading into it, not necessarily ours," the BMJ authors respond.

Here’s the complete story from the British Medical Journal:
http://www.bmj.com/cgi/content/full/340/jun03_4/c2912

The Centers for Disease Control and Prevention’s page of 2009-2010 H1N1 flu statistics:
http://www.cdc.gov/h1n1flu/estimates_2009_h1n1.htm

And the story in Nature News:
http://www.nature.com/news/2010/100608/full/465672a.html

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