Although the World Health Organization (WHO) said that its advice to governments to stockpile pandemic flu drugs was not influenced by the drug industry, it did not reveal that some of the key scientists behind this recommendation had financial links with companies which stood to benefit financially, a report by the British Medical Journal (BMJ) and the Bureau of Investigative Journalism has revealed. This report echoes an extremely critical inquiry by the Council of Europe, whose findings will also be published today (4 June), and will heighten 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 British Medical Journal wrote today:

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.

Even though the British Medical Journal (BMJ) explains that the scientists had openly declared their financial interests in other publications, WHO did not.

Many governments worldwide responded to WHO’s advise by buying enormous quantities of Tamiflu and Relenza.

A year after the so-called swine flu scare, these stocks languish, unused in warehouses as health authorities and their governments wonder what to do with them.

The Bureau of Investigative Journalism, together with the BMJ found that three researchers who contributed to the 2004 guidance had previously received money by Roche (makers of Tamiflu) and GlaxoSmithkline (makers of Relenza) for consultancy work and giving lectures – they were also involved in research for those pharmaceutical companies.

The scientists had declared their links to these companies in other situations, and explained that WHO had asked for conflict of interest forms before their experts meetings. That is not the issue. The concern is that WHO did not publicly declare this.

The BMJ had requested to see conflict of interest declarations, but they were turned down, so whether or not WHO informed governments about this privately is a mystery.

WHO director general, Margaret Chan was advised by an emergency committee with 16 members. They advised on declaring an influenza pandemic. Nobody knows who the members of this committee were, because it has been kept a secret. If nobody knows who they were, except for WHO insiders, it is impossible to know what conflicts of interests there might have been.

The WHO guidance concluded that

countries should consider developing plans for ensuring the availability of antivirals .. (they) will need to stockpile in advance, given that current supplies are very limited.

Despite claiming that it takes conflicts of interests seriously and has the mechanisms in place to deal with them, the BMJ and the Bureau suggest that WHO appears not to have followed its own rules for the decision making around the pandemic.

In an accompanying editorial, Dr Fiona Godlee, Editor in Chief of the BMJ says 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.

Conflicts of Interest
WHO and the pandemic flu “conspiracies”
Deborah Cohen, features editor, BMJ, Philip Carter, journalist, The Bureau of Investigative Journalism, London
Published 3 June 2010, doi:10.1136/bmj.c2912
BMJ 2010;340:c2912

Editorial
Conflicts of interest and pandemic flu
Fiona Godlee, editor in chief
Published 3 June 2010, doi:10.1136/bmj.c2947
BMJ 2010;340:c2947

Written by Christian Nordqvist