WHO's response to swine flu pandemic flawed

The U.N. health agency established the review committee to evaluate its performance after the 2009 global outbreak of swine flu, or H1N1. In a draft report released on Thursday, the committee said WHO performed well in many ways, but made crucial errors.

The group described WHO's definition of a pandemic and its phases as "needlessly complex," criticized the agency's decision to keep the members of its advisory committee secret, and said potential conflicts of interest among those experts, some of whom had ties to drug companies, were not well managed.

It warned that under WHO's health oversight, the world is not ready to handle a major health disaster in the future.

"The world is ill-prepared to respond to a severe influenza pandemic or to any similarly global, sustained and threatening public health emergency," experts wrote.

Despite recent progress, "the unavoidable reality is that tens of millions of people would be at risk of dying in a severe global pandemic," the report said.

The report will be presented during a meeting at WHO later this month in Geneva before being finalized. The expert group is chaired by Dr. Harvey Fineberg, president of the Institute of Medicine in Washington DC. WHO said it would only comment on the report when it is finalized.

Swine flu was a mild virus and most people infected didn't need medical treatment to recover. That led some critics to suggest WHO's declaration of a pandemic was the result of collusion with pharmaceutical companies, who made millions selling vaccines worldwide.

Those suspicions were spearheaded by groups including the Council of Europe and the medical journal BMJ, who accused WHO of relying on doctors with ties to drug companies. WHO denied pharmaceutical interests swayed their decisions but acknowledged they could have handled the outbreak better. The agency said any potential conflicts of interests were properly disclosed.

During the swine flu outbreak, WHO said declaring a pandemic was based exclusively on the virus' spread, not on its severity.

In the expert report, scientists said WHO should also have considered how serious swine flu was in its definition. The report also noted the agency altered some of its online pandemic documents without notice or explanation, inviting suspicion. Experts also said that despite WHO sending 78 million doses of swine flu shots to dozens of countries, shipments got bogged down in bureaucracy and arrived late.

"It would be terribly unfair to blame WHO because it takes the whole world to respond to (a pandemic)," said Michael Osterholm, a flu expert at the University of Minnesota, who was not on the committee. "This report is as much a commentary on the global governance of infectious diseases as it is on WHO."

The report commended WHO for rapidly sending experts to countries needing help, identifying and monitoring the swine flu virus, and making viruses available to make vaccines within weeks of the epidemic's start.

David Heymann, a former senior WHO official, said the agency should focus on ensuring people worldwide have access to pandemic vaccines in the future.

The expert group issued a series of recommendations, including creating a public health emergency fund of at least US$100 million.

More information: http://www.who.int

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