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.