Andrew Loh

In a report published by the British Medical Journal (BMJ), the World Health Organisation’s (WHO) handling of the A/H1N1 pandemic has come in for harsh criticism. Under scrutiny is the issue of a conflict of interest between those who advised the WHO on its pandemic planning and their close ties to pharmaceutical companies, which include Roche and GlaxoSmithKline, which produced the vaccines for the virus.

The joint-report by the BMJ and the Bureau of Investigative Journalism (The Bureau) says: “Our investigation has identified key scientists involved in WHO pandemic planning who had declarable interests, some of whom are or have been funded by pharmaceutical firms that stood to gain from the guidance they were drafting. Yet these interests have never been publicly disclosed by WHO and, despite repeated requests from the BMJ /The Bureau, WHO has failed to provide any details about whether such conflicts were declared by the relevant experts and what, if anything, was done about them.”

“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?” the report asked.  “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?”

Oseltamivir (Tamiflu), and zanamivir (Relenza), were the two vaccines which authorities all over the world had prescribed to fight the influenza pandemic.

It also questioned why the composition of the emergency committee from which Dr Margaret Chan, the director general of the World Health Organization, sought guidance remains a secret known only to those within the WHO.

“A key question will be whether the pharmaceutical companies, which had invested around $4bn (£2.8bn, 3.3bn) in developing the swine flu vaccine, had supporters inside the emergency committee, who then put pressure on WHO to declare a pandemic. It was the declaring of the pandemic that triggered the contracts,” the report said.

Authored by Deborah Cohen, features editor of BMJ, and investigative journalist Philip Carter of The Bureau of Investigative Journalism (BIJ), London, the report was released a week before the one-year anniversary of the WHO’s official declaration of a pandemic on 11 June 2009.

The WHO’s handling of the pandemic had been questioned by organisations including the Council of Europe, European Parliament, and WHO itself – after concerns were raised about industry influence. The WHO, however, dismisses these as “conspiracy theories”.

Earlier in 2010, Dr Chan 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 WHO insists that “numerous safeguards are in place to manage possible conflicts of interest or their perception.”

This, however, does not deter those who are seeking answers.  British MP, Paul Flynn, for the Council of Europe Parliamentary Assembly is one of these. “Some of the outcomes of the pandemic, as illustrated in this report, have been dramatic: distortion of priorities of public health services all over Europe, waste of huge sums of public money, provocation of unjustified fear amongst Europeans, creation of health risks through vaccines and medications which might not have been sufficiently tested before being authorised in fast-track procedures, are all examples of these outcomes. These results need to be critically examined by public health authorities at all levels with a view to rebuilding public confidence in their decisions.”

Gerd Gigerenzer, director of the Centre for Adaptive Behaviour and Cognition at the Max Planck Institute in Germany, was scathing in his criticism of the WHO. “There was no scientific basis for the WHO’s estimate of 2 billion for likely H1N1 cases, and we knew little about the benefits and harms of the vaccination,” he said. “The WHO maintained this 2 billion estimate even after the winter season in Australia and New Zealand showed that only about one to two out of 1000 people were infected. Last but not least, it changed the very definition of a pandemic.”

Barbara Mintzes, assistant professor in the Department of Pharmacology and Therapeutics at the University of British Columbia, said while it is legitimate for WHO to work with industry at times she would have concerns about its involvement with a group that looks like it is for independent academics that is actually mainly industry funded, she told the BMJ/The Bureau. She added, “The Institute of Medicine has raised concerns about the need to have a firewall with medical groups. To me this does not sound like an independent group, as it is mainly funded by manufacturers.”

The report said it is not known whether information about these conflicts of interest was relayed privately to governments around the world when they were considering the advice contained in the guidelines.

Barbara Mintzes suggested that “[ideally], what you want are independent experts who are in the public sector to provide expertise on drugs and vaccines. But they can be hard to find. One solution is consult with the experts who are involved in industry, but not put them on any decision making committee. You need a firewall.”

Professor Chris Del Mar, a Cochrane Review author and expert on WHO’s Strategic Advisory Group of Experts on Immunization group said, “If it proves to be the case that authors of WHO guidance which promoted the use of certain drugs were being paid at the same time by the makers of those drugs for other work they were doing for these companies, that is reprehensible and should be condemned in the strongest possible terms.”

Source: British Medical Journal

Read also:

WHO and the pandemic flu “conspiracies” by The British Medical Journal.

WHO swine flu advisors had links to drug companies by The Bureau of Investigative Journalism.

WHO scandal exposed: Advisors received kickbacks from H1N1 vaccine manufacturers.


In Singapore, the first case of H1 N1 was reported on 27 May 2009..A 22-year old Singapore Management University student, who had flown in from New York on 26 May 2009, was admitted to the Tan Tock Seng Hospital.

10 days earlier, on 16 May 2009, the Ministry of Health (MOH) said it “will order enough H1N1 vaccines for the entire population if the World Health Organisation (WHO) gives the go-ahead for the production at a meeting in Geneva soon.” (Channelnewsasia)

On 3 November 2009, the MOH “rolled out some 50,000 doses of the vaccine to all 18 polyclinics as well as 440 family doctors…”

The Health Minister revealed then that Singapore had “managed to secure some one million dosage of the vaccine.” (Channelnewsasia)

The purchase was made from pharmaceuticals manufacturer, GlaxoSmithKline (GSK). “This is part of our phased and diversified approach in securing a sufficient quantity of the vaccine for our population,” the Ministry of Health said in a statement. According to this Reuters report, MOH “also said the GSK contract should meet immediate needs and [MOH] could secure further supplies from Commonwealth Serum Laboratories Australia Pte Ltd.”

On 22 June last year, Channelnewsasia reported the Health Minister as being “confident that almost all infected cases will be able to recover fully and that Tamiflu and Relenza remain effective against the disease.” (Channelnewsasia)

According to the Ministry of Health’s website, “Since the pandemic began last year until 29 May 2010, there have been 139 severely ill cases who required intensive care, including 26 who died as a result of H1N1 infection.” It also says that it has “sufficient doses of H1N1-2009 vaccine available for those who wish to be vaccinated.”

The MOH finally reverted its H1N1 alert to “Green” status on 12 February 2010. “Ever since last June when WHO declared H1N1 Pandemic Alert level 6, we have been waiting for this day,” the Health Minister wrote on his blog.

In 2006, according to this report by the German Deutsche Presse-Agentur, Singapore was “chosen as the storehouse supplying essential drugs if a human flu pandemic breaks out in Southeast Asia, a World Health Organization (WHO) official said..”

“Plans are to store an estimated 500,000 Tamiflu treatments in the city-state for Association of Southeast Asian Nations (ASEAN) countries. The drugs could be flown to affected countries within 24 hours.”

On 10 June 2010, Channelnewsasia reported: “A research team from Singapore has completed the world’s first study which proves that Tamiflu, when used to treat H1N1-infected patients in a specific area, can help to prevent the virus from infecting others in other locations.”

The Today newspaper, in an article on the study headlined, “First real proof that Tamiflu strategy works”, said: “The strategy is also part of the World Health Organization’s plan for containing a new influenza virus. But no real-life evidence on the effectiveness of the strategy has been available – until now.”

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