Did Big Pharma trigger flu pandemic?

Mar 19, 2011

DAEDALUS

By Andy Ho

LAST week, a panel of 27 experts 'found no evidence of malfeasance' in the World Health Organisation's handling of the last flu pandemic.

Set up to look into the application of the International Health Regulations during the pandemic, it said the world body did make crucial errors. But 'no critic... has produced any direct evidence of commercial influence on decision-making'.

However, the panel was commissioned by the WHO itself. Was it really independent? According to a study by the BMJ, formerly the British Medical Journal, about half the panel's membership also sat on the International Health Regulations committee itself.

In addition, one of its members was even the Emergency Committee chairman. This body was set up during the crisis to advise the WHO director-general, Dr Margaret Chan, on when the scientific criteria for a flu pandemic had been met.

This would determine the precise timing of an official declaration of a pandemic. Since this advice was crucial, transparency about the identities of the scientists giving that advice was paramount.

However, the WHO insisted on keeping the committee membership secret during the pandemic, allegedly to shield these boffins from pressure being exerted by Big Pharma. It also refused to divulge any conflicts of interest involving the scientists.

Yet it was at their behest that the pandemic was declared at a specific point in time. This declaration, the BMJ argued in a report last June, was what 'triggered the (vaccine) contracts' many countries, including Britain, France and Belgium, had pre- signed with Big Pharma.

Indeed, Britain's Department of Health confirmed in a May 15, 2009 announcement that 'Advance Supply Agreements signed by the government with GSK and Baxter in July 2007 (for) 132 million doses of pandemic specific vaccine' would be triggered 'if a pandemic is declared'.

So the declaration did trigger such contracts. Big money was involved: Vaccine makers had reportedly invested US$4 billion (S$5.2 billion) to make the new flu shot.

Crucially, the BMJ was able to identify several key scientists on the Emergency Committee who had tight financial ties to Roche, the manufacturer of Tamiflu, and to GlaxoSmithKline (GSK), the maker of Relenza.

The BMJ asked if some committee members had 'put pressure on the WHO to declare a flu pandemic', the first in 40 years.

Worth billions of dollars, these shots and all the stockpiled Tamiflu and Relenza now lie unused in storehouses the world over.

The BMJ also reported how the studies establishing the efficacy of these antivirals had been carried out by some scientists on the committee. However, other experts have not been able to replicate their results. Thus, the effectiveness of the two drugs themselves remains in doubt.

Last August, the committee advised Dr Chan to declare the pandemic over. Only then was its membership revealed.

A study last June issued by the health committee of the Parliamentary Assembly of the Council of Europe was equally critical of the WHO. It found that the pandemic declaration had been based on politics, not science. This had led to 'a waste of large sums of public money, and also unjustified scares and fears'.

Apart from this lack of transparency over conflicts of interest, critics have also questioned why the WHO changed the way a pandemic was defined. The WHO decided that pandemics were to be declared based simply on how fast the virus involved was spreading. The severity of the illness caused was deemed unimportant.

Severity had been a factor in the definition of a pandemic for the last 15 years. Yet, late in April 2009, just after the new bug emerged in California and Mexico, the WHO dropped severity as a criterion.

In the original definition of a pandemic, many had to be very ill and/or die from the virus. When the WHO declared this a pandemic, there were about 30,000 patients in 74 countries, with 144 fatalities. That mortality rate of less than 0.5 per cent was even lower than that of the seasonal flu.

Throughout the crisis - and long after its projections of up to 7.4 million deaths in the worst-case scenario looked increasingly unlikely - the WHO continued to refuse to admit that the early waves were mild. Instead, it even insisted that the new bug 'rapidly crowded out other circulating influenza viruses, a phenomenon... distinctly seen during pandemics'.

However, scientists from Singapore's National University Hospital reported in the BMJ last July that the new bug had 'failed to completely displace the previously dominant circulating seasonal influenza H3 subtype (which) may argue against (it) being a truly pandemic virus'.

In fact, between May 2009 and last April, there were 'decreasing numbers of (the new bug) and increasing numbers of seasonal H3N2 viruses'.

The WHO's own panel of 27 experts agreed that it should have included severity in its definition of a pandemic. It also noted that the agency had changed some of its pandemic documents available online without highlighting the changes or offering any reason for them. This could only fuel suspicion, it demurred.

But had the WHO not declared a mild flu a pandemic, far fewer people would have rushed for the flu shots or stocked up on antivirals. So was the declaration of a pandemic influenced by financial ties to Big Pharma?

Just because Dr Chan has waved off all such talk as 'conspiracies' does not mean the questions BMJ and other authorities have raised do not need to be answered.