Editorial: WHO and conflicts of interest

Published in The Hindu on June 14, 2010

A year after the World Health Organisation declared an Influenza A(H1N1) pandemic, a joint investigation by the British Medical Journal (BMJ) and the Bureau of Investigative Journalism has raised “troubling questions about how WHO managed conflicts of interest among the scientists who advised its pandemic planning, and about the transparency of the science underlying its advice to governments.” The open access findings are published in the journal. While three scientists had financial ties with drug companies producing influenza drugs and vaccine, and had declared their conflicts of interest in other instances, WHO failed to disclose this. In a defensive letter sent to the journal, Margaret Chan, Director-General of WHO, admits that the “WHO needs to establish, and enforce, stricter rules of engagement with industry, and we are doing so.” However, at a January 2010 hearing of the Council of Europe’s Parliamentary Assembly, the organisation denied any industry influence on the scientific advice it received. A report by the Council of Europe has already come down heavily on WHO for its mishandling of the H1N1 influenza pandemic, which led to “distortion of priorities of public health services across Europe, and waste of large sums of public money.”

It is mandatory for authors submitting papers to leading medical journals to declare any conflict of interest, and such information becomes part of the published paper. This is a vital safeguard meant to protect the integrity of academic work. By contrast, the BMJ article points out, the investigation reveals “a system struggling to manage the inherent conflict between the pharmaceutical industry, WHO, and the global public health system, which all draw on the same pool of scientific experts.” Conflicts of interest by experts advising WHO can have serious financial and healthcare implications, especially when the world body declares a pandemic. Many developed countries spent a fortune stockpiling drugs and vaccines when they were not needed; and the healthcare systems of many developing countries were severely overstrained. One doesn’t have to buy into conspiracy theories to be able to recognise that when a pandemic is mis-diagnosed and mis-declared, only the drug companies gain. Dr. Chan has vehemently denied that commercial interests influenced the world body’s decision-making. If the idea is to regain trust, mere assurances will not do.