BMJ: WHO swine flu advisers had drug company ties

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World Health Organization Director General Margaret Chan Image: © LAURENT GILLIERON/epa/Corbis

Almost exactly one year ago, the World Health Organization (WHO) announced that the swine flu outbreak had reached global pandemic proportions. The announcement, made on June 11, 2009, spurred governments to order huge stocks of vaccines and prompted broad public health initiatives around the globe. And while we can all be grateful that swine flu didn’t claim as many lives as once feared, a new joint investigation conducted by the British Medical Journal (BMJ) and the Bureau of Investigative Journalism in London, points out that many of the top advisers to the WHO had ties to pharmaceutical companies manufacturing the highly-demanded vaccines — huge stockpiles of which now sit unused — and raises questions about global public health protocol in the face of future pandemics.

As the investigation points out, three of the scientists advising the WHO had ties to Roche, who make oseltamivir, or GlaxoSmithKline, manufacturers of zanamivir. Yet while these affiliations had been openly declared in previous academic work, Deborah Cohen and Philip Carter, co-authors of the investigation, point out that no such affiliations were publicly presented by the WHO.

The investigation points to several inconsistencies with regard to the WHO’s policy on transparency, including the fact that the international body has not released the identities of 16 members of an Emergency Committee formed last year expressly to tackle swine flu. As Cohen and Carter write:

“The identities of its 16 members are unknown outside WHO. This secret committee has guided WHO pandemic policy since then—including deciding when to judge that the pandemic is over… WHO says it has to keep the identities secret to protect the scientists from being influenced or targeted by industry. In a phone call to the BMJ/The Bureau in March, WHO spokesperson Gregory Hartl explained: ‘Our general principle is we want to protect the committee from outside influences.'”

WHO officials have dismissed criticism of adviser affiliations as “conspiracy theories” and expressed some incredulity regarding the intense level of scrutiny that has arisen in the absence of a more devastating pandemic. As the investigation points out, addressing the U.S. Centers for Disease Control earlier this year, Dr. Margaret Chan, the director general of the WHO, 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.”

In an editorial accompanying the investigative report, Fiona Godlee, the BMJ’s editor in chief, suggests that the WHO’s credibility has been “badly damaged” and says that forthcoming reports from European Commission, the European Parliament, and other national organizations will expand the scrutiny to other public health bodies that governed policy for the 2009 H1N1 pandemic. She also calls for the WHO to be prompt in publishing its own report, disclosing all affiliations and pledging to enforce more strict policies with regard to conflict of interest going forward.

Godlee sums up the editorial this way:

“In a briefing at the end of last year, a spokesperson for WHO said, ‘Given the discrepancy between what was expected [from the pandemic] and what has happened, a search for ulterior motives on the part of WHO and its scientific advisers is understandable, though without justification.’ The implication is that, had there been a huge death toll, the process behind WHO’s decision making would not have been subject to such scrutiny. This is almost certainly true. But it does not mean that we are wrong to ask hard questions. Neither does it make the answers we have found any less troubling. And nor does it remove from WHO the urgent need to restore its credibility and public trust before the next pandemic comes along.”

Read the full investigative report here. Read Godlee’s editorial here.

Click to find out what lessons we’ve learned from the 2009 H1N1 pandemic.