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WHO fights back over criticism that it exaggerated H1N1 threat Add to ...

The H1N1 pandemic has returned - not necessarily in the number of people infected, but rather in the criticism being levelled at the World Health Organization for ostensibly exaggerating the threat.

The agency, however, is not taking the accusations lightly. Keiji Fukuda, the WHO's special adviser on pandemic influenza, came out swinging yesterday, saying such charges are scientifically inaccurate and reckless.

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"The world is going through a real pandemic. The description of it as a fake is both wrong and is irresponsible," Dr. Fukuda said in a conference call.

In recent days, the WHO has drawn criticism, primarily in Europe, that it allegedly colluded with pharmaceutical companies and overstated the threat of the H1N1 virus. The parliamentary assembly of the Council of Europe, made up of 47 countries that work to protect human rights, will hold a debate on this at the end of the month, titled Faked pandemics: a threat to health. WHO officials have been asked to testify.

Dr. Fukuda disputed all charges yesterday.

The WHO, he said, has repeatedly stressed that the pandemic could range from mild to severe. Formally declaring H1N1 a pandemic was justified because of its global spread, and it allowed countries to put in place their pandemic preparedness plans to help mitigate H1N1's reach.

"From the very beginning, WHO has gone out of its way to let everybody know that the future course of the pandemic was uncertain, that we did not have a crystal ball and could not tell you at the beginning which way it was going to go," Dr. Fukuda said.

"WHO has always been very balanced and sober in providing its assessments. We have worked very hard to neither overplay nor underplay the situation."

Further, he denied that the WHO was influenced by the pharmaceutical industry in declaring a pandemic. The WHO has strict rules in place requiring those who provide advice to disclose any financial conflicts of interest, he said.

The Public Health Agency of Canada declined comment yesterday on Dr. Fukuda's assessment of the pandemic.

Perry Kendall, British Columbia's provincial health officer, said it is easy for people to be critical with the benefit of hindsight. He said that when the new influenza virus emerged in Mexico and California, the urgency was justified and necessary. He said the WHO may consider establishing a severity-level criteria alongside the pandemic phases.

"Perhaps in retrospect, we could have developed plans that called for less than an all-or-nothing response and were sensitive to the emerging epidemiology of severity - and that will likely be the outcome of all the post-event reviews and a component of future planning," Dr. Kendall said in an e-mail.

"However, it is necessary to plan for worst-case scenariosand to be ready to launch them, and had this been an H5 type virus - which we had been planning for [and dreading]or had H1N1 mutated or acquired virulence genes, which it could easily have done - we would not be regretting our urgency."

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