Investigation into drug industry influence on WHO flu pandemic decisions

An investigation by the BMJ and the Bureau of Investigative Journalism concludes that key scientists advising the World Health Organization on how to prepare for a flu pandemic had done paid work for drug companies that could benefit from these recommendations.

The report is summarized in the BMJ but a subscription is required.

In an accompanying editorial, BMJ editor Fiona Godlee writes that WHO’s credibility has been badly damaged.

Excerpts of a BMJ news release:

WHO’s advice led to governments around the world stockpiling billions of dollars of antiviral drugs as part of global pandemic preparedness plans. Yet these conflicts of interest have not been publicly disclosed by the WHO. 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.

This report echoes a highly critical inquiry by the Council of Europe, whose findings will also be published today (4 June), 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 finds 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 Roche, manufacturers of oseltamivir (Tamiflu), and GSK, manufacturers of zanamivir (Relenza), 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 Roche.

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 WHO to governments around the world, many of which followed its advice.

The WHO deny any industry influence on the scientific advice it received. It also says it takes conflicts of interests seriously and has the mechanisms in place to deal with them. But the BMJ and the Bureau suggest that WHO seems not to have followed its own rules for the decision making around the pandemic.

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