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http://www.washingtonpost.com/wp-dyn/content/article/2010/06/04/AR2010060403034.\

html?hpid=topnews

Reports accuse WHO of exaggerating H1N1 threat, possible ties to drug makers

(Possible ties to drug makers? Surely that must be wrong.) 

By Rob Stein

Washington Post Staff Writer

Friday, June 4, 2010; 3:52 PM

European criticism of the World Health Organization's handling of the H1N1

pandemic intensified Friday with the release of two reports that accused the

agency of exaggerating the threat posed by the virus and failing to disclose

possible influence by the pharmaceutical industry on its recommendations for how

countries should respond.

The WHO's response caused widespread, unnecessary fear and prompted countries

around the world to waste millions of dollars, according to one report. At the

same time, the Geneva-based arm of the United Nations relied on advice from

experts with ties to drug makers in developing the guidelines it used to

encourage countries to stockpile millions of doses of antiviral medications,

according to the second report.

The reports outlined the drumbeat of criticism that has arisen, primarily in

Europe, of how the world's leading health organization responded to the first

influenza pandemic in more than four decades.

" For WHO, its credibility has been badly damaged, " wrote Fiona Godlee, the

editor of the BMJ, a prominent British medical journal, that published one of

the reports. " WHO must act now to restore its credibility. "

A spokesman for the WHO, along with several independent experts, however,

strongly disputed the reports, saying they misrepresented the seriousness of the

pandemic and the WHO's response, which was carefully formulated and necessary

given the potential threat.

" The idea that we declared a pandemic when there wasn't a pandemic is both

historically inaccurate and downright irresponsible, " said WHO spokesman

Hartl in a telephone interview. " There is no doubt that this was a pandemic. To

insinuate that this was not a pandemic is very disrespectful to the people who

died from it. "

The first report, released in Paris, came from the Social, Health and Family

Affairs Committee of the Parliamentary Assembly of the Council of Europe, which

launched an investigation in response to allegations that the WHO's response to

the pandemic was influenced by drug companies that make antiviral drugs and

vaccines.

" The parliamentary assembly is alarmed about the way in which the H1N1 influenza

pandemic has been handled, not only by the World Health Organization (WHO), but

also by the competent health authorities at the level of the European Union and

at national level, " the 18-page draft report states.

" It is particularly troubled by some of the consequences of decisions taken and

advice given leading to distortion of priorities of public health services

across Europe, waste of large sums of public money, and also unjustified scares

and fears about health risks faced by the European public at large, " according

to the report.

The second report, a joint investigation by the BMJ and the Bureau of

Investigative Journalism, which is based in London, criticized 2004 guidelines

the WHO developed based in part on the advice of three experts who received

consulting fees from the two leading manufacturers of antiviral drugs used

against the virus, Roche and GlaxoKline.

" We are left wondering whether major public health organizations are able to

effectively manage the conflicts of interest that are inherent in medical

science, " the report states.

Hartl dismissed those charges.

" WHO would say categorically that it believes that it has not been subject to

undue conflict-of-interest. We know that some experts that come to our

committees have contact with industry. It would be surprising if they didn't

because the best experts are sought by all organizations, " Hartl said. " We feel

that the guidelines produced were certainly not subject to undue influence. "

Several other experts also defended the agency.

" Twenty-twenty hindsight can always second guess the decisions of public health

officials, " said Levi, executive director of the Trust for America's

Health, a private nonprofit group. " But this kind of condemnation of public

health officials who made the most prudent decisions based on available

knowledge could well backfire in future emergencies: I fear that public health

officials will draw the lesson that they should wait for greater scientific

certainty before responding in the future -- and we could pay for that

overcaution with many lives lost. "

In response to the criticism, the WHO has launched two investigations, including

one by an independent panel of experts led by Harvey Fineberg, who heads the

Institute of Medicine at the U.S. National Academy of Sciences.

" These reports raise questions about potential, inappropriate influences on WHO

decision-making in the assessment and response to the 2009 H1N1 pandemic and,

more generally, question practices employed by WHO to guard against conflict of

interest among its expert advisers, " Fineberg said in an e-mail. " These topics

are among those that will be fully considered by our review committee. "

 

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