History Lesson from June 21, 2010
The World Health Organisation, (WHO) born in 1948 with the lofty ideal of providing leadership on global health matters, stands discredited by a major scandal over declaring a “pandemic-that-never-really-was” to benefit pharmaceutical companies. Till today, the world body has been unable to produce conclusive evidence to the contrary.
It started with the WHO tweaking the definition of pandemic which helped it to declare H1N1 or swine flu as a pandemic in June 2009. Earlier, for an outbreak to be declared a pandemic it had to be “several, simultaneous epidemics worldwide with enormous numbers of deaths and illness”. The WHO dropped the last two conditions about serious illness and lots of deaths from the definition. On June 11, when the pandemic was declared, though nearly 30,000 confirmed H1N1 cases had been reported from 74 countries, only 144 people had died. Hence, by the old definition H1N1 would not have qualified as a pandemic. So far, the WHO has been unable to explain satisfactorily why the definition had to be changed. Various European countries had signed so-called “sleeping” contracts with large pharmaceutical groups which would take effect only on the declaration of a pandemic by the WHO. This has fueled the allegation that the WHO rushed into declaring a pandemic under pressure from the powerful pharmaceutical lobby.
To make matters worse, an investigation by the British Medical Journal (BMJ) along with the Bureau of Investigative Journalism in London revealed that scientists, who gave advice on which vaccines and how many of it member-countries should buy, had financial ties to various pharmaceutical companies, including the manufacturers of vaccines, even the H1N1 vaccine, like GlaxoSmithKline (GSK), Novartis, Solvay, Baxter, MedImmune and Sanofi Aventis. Yet, most of these WHO experts did not declare any conflict of interest.
The Parliamentary Assembly of the Council of Europe (PACE), which initiated an inquiry into the handling of the H1N1 pandemic observed that public confidence had been eroded not only in the WHO but also in other public health authorities at the national level over the way the pandemic declaration had been handled.
All that the WHO director general, Dr Margaret Chan, said in defence to the BMJ was: “WHO needs to establish and enforce stricter rules of engagement with industry, and we are doing so.” Yet, beyond vehemently denying that commercial interests influenced the world body’s decision-making, there has been no initiative from the WHO for an open evaluation of decision-making around the pandemic, with full disclosure of the evidence behind the decisions, the names of those contributing to the decisions, and their conflicts of interest.
One lesson this surely has for national governments, especially those with limited health budgets that they cannot afford to squander away on “fake pandemics” and on stockpiling vaccines of dubious efficacy, is to be more circumspect about WHO advisories. The global epidemiological watchdog it might be, but it would pay to remember that even the WHO advisers could be on the take from drug companies and that even WHO recommendations could be driven by motives other than a pure commitment to public health.