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World Health Organization fires back at critics of H1N1 response

A registered nurse injects a dose of the H1N1 flu vaccine at a Toronto health clinic on Thursday, October 29, 2009

Darren Calabrese/Darren Calabrese/The Canadian Press

With the H1N1 flu all but over in many parts of the world and questions about the World Health Organization's handling of the pandemic beginning to mount, the head of the global health body has come out swinging at her critics.

Director-General Margaret Chan rejected claims that the WHO provoked unnecessary fear, and then, directing her comments to an article published in a prominent British medical journal, she dismissed suggestions that her decisions on the pandemic were influenced by ties to the pharmaceutical industry.

"At no time, not for one second, did commercial interests enter my decision-making," Dr. Chan said in a statement Tuesday.

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Her comments are in response to last week's report in the BMJ that said three scientists at the WHO received payments from Roche and GlaxoSmithKline, manufacturers of antiviral drugs, and also helped prepare pandemic guidelines in 2004 that included the use of antivirals. The WHO did not publicly disclose their conflicts of interests, the journal stated. Further, the journal asked why the names of those who sit on the emergency committee and advise Dr. Chan are shrouded in secrecy.

In an accompanying editorial, BMJ editor Fiona Godlee said the WHO's credibility had been damaged. "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," Dr. Godlee wrote.

The WHO's handling of the outbreak is being reviewed by an independent committee, which will likely report back by next year. In the meantime, Dr. Chan said the BMJ article leaves an unfair impression that the WHO's decision to declare a pandemic was partially motivated by a desire to fatten the pockets of the pharmaceutical industry, which stood to profit from the sale of the vaccine and anti-viral medications.

"The bottom line, however, is that decisions to raise the level of pandemic alert were based on clearly defined virological and epidemiological criteria. It is hard to bend these criteria, no matter what the motive," she said.

The review committee, she said, will examine the events leading up to the pandemic and the WHO will be open to its recommendations and criticisms. "Should this committee decide that the current definition of a pandemic and the phases leading up to its declaration need to be tightened or otherwise revised, this will be another recommendation that we will welcome, and act on," Dr. Chan said.

She added that the names of members on the emergency committee will be made public once their work is completed, and that the reason not to identify them beforehand is to protect them from commercial or other influences.

Influenza activity has remained low in Canada for the past few months, leaving the federal government with millions of doses of unused pandemic vaccine. A report by the Council of Europe last week accused the WHO of exaggerating the threat of H1N1, unnecessarily scaring the public and causing countries to waste millions of dollars fighting it.

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Dr. Chan said that when she announced the start of the pandemic on June 11 of last year, she also made mention of the fact that the number of deaths was small.

"In every assessment of the pandemic, WHO consistently reminded the public that the overwhelming majority of patients experienced mild symptoms and made a rapid and full recovery, even without medical treatment," Dr. Chan said.

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Caroline Alphonso is an education reporter for The Globe and Mail. More

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