World Health Organization denies claims that it exaggerated swine flu threat

When public health officials declared the swine flu a pandemic last year, the potential outcomes of the viral newcomer were understood even if its precise origins were not. Young but otherwise healthy people were developing devastating respiratory infections and, in an alarming number of cases, losing their lives. Fearing the worst, the World Health Organization (WHO) sounded the alarm and announced the arrival of a new pandemic.

Now, with cases of swine flu appearing to level off rather than ramp up, WHO officials find themselves fighting claims that they exaggerated the threat to benefit pharmaceutical companies working on a vaccine. The global public health organization has been defending itself in hearings before the Council of Europe, which is investigating the charges of undue influence. In calling for the investigation, Dr. Wolfgang Wodarg, a member of the council's Parliamentary Assembly, said that drug companies had tricked governments and other health care agencies into "squander(ing) tight health care resources for inefficient vaccine strategies and needlessly exposed millions of healthy people to the risk of unknown side effects of insufficiently tested vaccines."

Wodarg and other critics have suggested that the WHO declared the pandemic after receiving advice from doctors with close ties to the pharmaceutical industry - a charge Dr. Keiji Fukuda, the WHO's Special Adviser on Pandemic Influenza, strongly denies. By the time the WHO announced the pandemic, Fukuda testified last week, the swine flu had spread with "unprecedented speed," reaching 120 countries and territories in about eight weeks. The virus caused "a striking and unusual pattern of severe illnesses and deaths in younger people," and had already shown evidence of person-to-person spread.

While acknowledging that "cooperation with a range of partners, including the private sector, is essential" for meeting global public health challenges, Fukuda assured the Council of Europe that "numerous safeguards are in place to manage conflicts of interest or perceived conflicts of interest among members of WHO advisory groups and expert committees." In the end, an Emergency Committee vote to recommend a pandemic declaration was unanimous, Fukuda said.

Accusations of cozy relationships between pharmaceutical companies and medical researchers and oversight officials seem almost commonplace today, though the WHO puts an interesting twist on things. While medical ethicists may pen editorials from time to time, many researchers, medical journals and public health officials seem unwilling to be more than mildly concerned by the coziness - as long as no egregiously foul acts are committed, or caught. Perhaps the two sides have an unwritten agreement: If the pharmaceutical companies don't put (too much) pressure on medical researchers during the pre-market phase of drug development and study, medical folk won't oppose the free-for-all post-market fight to attract medical consumers, who used to be called patients. What do you think?