Questions over drug industry influence on WHO

[Posted: Fri 04/06/2010 by Deborah Condon www.irishhealth.com]

Key scientists advising the World Health Organisation (WHO) on planning for a flu pandemic had carried out paid work for pharmaceutical firms who stood to gain from the guidance these scientists were preparing, a new investigation has shown.

According to the investigation by the British Medical Journal (BMJ) and the Bureau of Investigative Journalism in the UK, the WHO's advice led to governments around the world stockpiling billions of euro of antiviral drugs as part of global pandemic preparedness plans. Yet these conflicts of interest have not been publicly disclosed by the WHO.

In fact, despite repeated requests, the WHO has failed to provide any details about whether such conflicts were declared by the relevant experts and what, if anything, was done about them.

The findings echo a recent inquiry by the Council of Europe and will fuel suspicions that the drug industry was able to exert undue influence on the WHO's decisions about the swine flu pandemic and the mass stockpiling of drugs.

The investigation found that the WHO's 2004 guidance on the use of antivirals in a pandemic was prepared by an influenza expert who had received payment from two pharmaceutical companies for lecturing and consultancy work. The guidance concluded that ‘countries should consider developing plans for ensuring the availability of antivirals' and that they ‘will need to stockpile in advance, given that current supplies are very limited'.

In addition, the investigation found two other scientists who prepared annexes to the WHO 2004 pandemic guidelines had recent financial links to a pharmaceutical company.

According to Deborah Cohen of the BMJ and Philip Carter of The Bureau of Investigative Journalism, the WHO did not publicly disclose any of these conflicts of interest when it published the 2004 guidance. It is not clear whether these conflicts were notified privately by the WHO to governments around the world, many of which followed its advice.

The investigators insisted that this lack of transparency is compounded by the existence of a secret ‘emergency committee' which advised the WHO's director general, Margaret Chan, on declaring an influenza pandemic. The names of these 16 committee members are known only to people within the WHO, and as such, their possible conflicts of interest with drug companies are unknown.

The WHO has denied any industry influence on the scientific advice it received. It said it takes conflicts of interests seriously and has the mechanisms in place to deal with them. However, the BMJ and Bureau investigation suggests that the WHO does not seem to have followed its own rules for the decision making around the pandemic.

Despite repeated requests, the WHO has refused to provide any information about the conflict of interest declarations made to it, leaving the investigators to wonder ‘whether major public health organisations are able to manage the conflicts of interest that are inherent in medical science effectively'.

Details of the investigation are published in the BMJ. In an accompanying editorial, Dr Fiona Godlee, editor in chief of the journal insisted that the WHO's credibility has been badly damaged.

She believes that ‘recovery will be fastest if it publishes its own report without delay or defensive comment, makes public the membership and conflicts of interest of its emergency committee, and develops, commits to, and monitors stricter rules of engagement with industry that keep commercial influence away from its decision making'.