Who if anyone got to the WHO?

By Peter Griffin 04/06/2010 5

Did scientists with links to “big pharma” fuel fear about pandemics at the World Health Organisation resulting in a massive spend-up on antiviral drugs?

UPDATE: BMJ coverage now online here.

It sounds like a conspiracy theory the anti-vax movement would dream up, but according to a joint investigation between the British Medical Journal and The Bureau of Investigative Journalism, there may be some genuine cause for concern. There certainly was a lack of disclosure around scientists who were advising the WHO who also had links to big pharmaceutical companies that also manufacture flu vaccines. The Guardian carries news on the investigation here.

The article points out:

An investigation by the British Medical Journal and the Bureau of Investigative Journalism, the not-for-profit reporting unit, shows that WHO guidance issued in 2004 was authored by three scientists who had previously received payment for other work from Roche, which makes Tamiflu, and GlaxoSmithKline (GSK), manufacturer of Relenza.

City analysts say that pharmaceutical companies banked more than $7bn (£4.8bn) as governments stockpiled drugs. The issue of transparency has risen to the forefront of public health debate after dramatic predictions last year about a swine flu pandemic did not come true.

BMJ editor Fiona Godlee concludes in her editorial, which should be up on BMJ.com soon:

As for WHO, its credibility has been badly damaged. Recovery will be fastest if it publishes its own report without delay or defensive comment; makes public the membership and conflicts of interest of its emergency committee; and develops, commits to, and monitors stricter rules of engagement with industry that keep commercial influence away from its decision making.

And this from the BMJ release (abstract for the report is here):

The investigation finds that the WHO’s 2004 guidance on the use of antivirals in a pandemic was prepared by an influenza expert who had received payment from Roche, manufacturers of oseltamivir (Tamiflu), and GSK, manufacturers of zanamivir (Relenza), for lecturing and consultancy work. The guidance concluded that … ’countries should consider developing plans for ensuring the availability of antivirals’ and that they ’will need to stockpile in advance, given that current supplies are very limited.’

In addition, the investigation found two other scientists who prepared annexes to the WHO 2004 pandemic guidelines had recent financial links to Roche.

According to Deborah Cohen of the BMJ and Philip Carter of The Bureau of Investigative Journalism, the WHO did not publicly disclose any of these conflicts of interest when it published the 2004 guidance. It is not clear whether these conflicts were notified privately by WHO to governments around the world, many of which followed its advice.

This lack of transparency is compounded by the existence of a secret ’emergency committee’ which advised WHO’s director general Margaret Chan on declaring an influenza pandemic. Significantly, the names of the 16 committee members are known only to people within WHO, and as such their possible conflicts of interest with drug companies are unknown.

The lack of disclosure is a real concern. But I don’t think these revelations prove that the reaction to swine flu was overblown, as New Zealand experts on pandemics pointed out earlier this year. Still, this plays right into the hands of those suspicious of big pharma and by default, the vaccines these companies produce. Total transparency is paramount here and WHO, it would appear, has some explaining to do to put everyone’s mind at rest.

Meanwhile, back in New Zealand, some interesting research on swine flu has just been released. We did a round-up of expert comment on it at the Science Media Centre.

5 Responses to “Who if anyone got to the WHO?”

  • I think this is being over-hyped using the benefit of information that wasn’t known at the time. Take the comment ” dramatic predictions last year about a swine flu pandemic did not come true “. OK they didn’t, but what were the dramatic predictions based on? They were based on early reports from Mexico that this new swine flu was killing a very high percentage of affected people. As it turned out, the major problem seems to have been poor quality Mexican health statistics. But what public health authority would have been applauded at the time for saying that it didn’t think there was a big problem because Mexico is a third world country, so the health authority wasn’t going to take any steps to protect its public.

    I don’t agree “The lack of disclosure is a real concern”. I think it is a small concern. It is a real concern to see the ethics of researchers being questioned in this way just because they happen to work for the private sector. This sort of commentary should be based on what was known at the time, not on hindsight. And maybe a smoking gun rather than vague accusations of guilt by association.

  • i sort of agree with you possum on one level – I totally think the WHO and health authorities around the world acted appropriately in response to the threat of swine flu… however, when there are ties between business and public bodies that set policy that have global implications, its important to know who is giving the advice and to know any particular conflicts of interest they may have. That goes for everything from climate science to pandemic planning… WHO could do better here (see there response at the link above)

  • It is certainly not a new phenomenon of WHO ‘experts’ being linked with private business. Take the lowering of BMI levels in response to the perceived obeisty epidemic. The NIH Obesity Taskforce and WHO panel consisted entirely of doctors and psychologists that run major weight-loss clinics, many of which rely on weight-loss and obesity drugs. As obesity researcher Paul Ernsberger pointed out in JAMA this conflict of interest was more bout just taking money from ‘big pharma’ – it involved individuals protecting their own livelihood – their own businesses. As Peter alludes to, openess and transperancy is needed when government health organisation (blindly) floow the advise and directives from WHO.

  • I can’t comment on bundy’s statements but the original accusations against the WHO came from a small group of left-wing politicains in the Council of Europe whose motivation appears to have been mainly anti-business. The story got more legs when it was picked up by the British. Good to see the WHO response that Peter posted in a separate blog.

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