WHO Director-General responds to criticisms over agency's H1N1 response

WHO Director-General Margaret Chan on Tuesday rejected recent criticisms that her decisions to declare H1N1 (swine flu) a pandemic were impacted by her advisers' link to the pharmaceutical industry, the Associated Press reports.

"At no time, not for one second, did commercial interests enter my decision-making," Chan wrote in a letter to the editors of BMJ, which last week published a report that "questioned the way WHO managed conflicts of interest among its scientific advisers and the transparency of its advice to governments" (Engeler, 6/9).

In her statement, Chan also takes on the argument that the WHO's handling of H1N1 had unnecessarily "provoked unjustified fear."

"…[W]hen I announced the start of the pandemic, I drew attention to the fact that the worldwide number of deaths was small, and clearly stated that we did not expect to see a sudden and dramatic jump in the number of severe or fatal infections," Chan writes. "In every assessment of the pandemic, WHO consistently reminded the public that the overwhelming majority of patients experienced mild symptoms and made a rapid and full recovery, even without medical treatment" (6/8).

"…[D]ecisions to raise the level of pandemic alert were based on clearly defined virological and epidemiological criteria," Chan said, the Globe and Mail reports. "It is hard to bend these criteria, no matter what the motive."

In the statement, Chan also defended the decision to allow the members of an emergency committee that advises her on H1N1 to remain anonymous until their work is complete (Alphonso, 6/8) and pointed to an ongoing review of the WHO's performance in response to H1N1 as a sign of her agency's openness to criticism, Indo-Asian News Service/Hindustan Times reports.

"The [review] committee agreed to address criticism currently being levelled at WHO as part of its evaluation," Chan said. "I have publicly expressed my desire to see a critical, independent and transparent assessment of WHO's performance," she added (6/9).

According to Harvey Fineberg, the president of the Institute of Medicine and head of the review panel, the committee "will hear from critics of WHO when it next meets from June 30 to July 2," the AP writes.

In related news, Nature News/Scientific American reports on several challenges to the claims presented in the BMJ report. Among several points, the piece reflects on the argument presented that the declaration of H1N1 to be a pandemic "triggered the contracts" with pharmaceutical companies.

"Many countries - including the United Kingdom, France, Belgium, Finland, Canada, the Netherlands and Switzerland - had already placed large orders for H1N1 vaccine weeks before the WHO declared H1N1 a pandemic on June 11, 2009," the news service notes. "The United States, for example, ordered $649 million of pandemic H1N1 influenza vaccine antigen and $283 million of adjuvant on May 22, 2009. So the Emergency Committee could not have influenced these in any way." According to Nature News/Scientific American, the authors of the BMJ piece agreed the timeline they presented in the article was off.

The article includes comments by several influenza experts who voice support for the WHO's handling of the H1N1 pandemic (Butler, 6/8).