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EPIDEMICS
Pandemic not over, WHO flu probe hears

WHO flu experts reject charges of business influence in pandemic
Geneva (AFP) April 14, 2010 - Leading experts involved in the World Health Organisation's decision to declare a flu pandemic on Wednesday rejected accusations of undue influence from the pharmaceutical industry. The heads of panels of scientists advising the agency on vaccines and the alert said "meticulous care" was taken to avoid conflicts of interest and to keep a distance from industry as far as possible. David Salisbury, of the WHO's standing Strategic Advisory Group of Experts (SAGE) on immunisation, said candidates for the body were vetted before they joined and those with conflicts of interest were excluded.

"There has been no declaration of conflict from any SAGE member in our proceeding on A (H1N1) vaccine," he told a probe investigating the international response to the pandemic. Salisbury is director of immunisation at Britain's Department of Health. SAGE gave decisive technical advice to WHO Director General Margaret Chan last year on whether or not to produce a special vaccine for the A(H1N1) virus, the timing of production and vaccine needs. Parliamentarians conducting a Council of Europe probe have criticised the transparency of decision-making during the pandemic and especially the potential influence of the pharmaceutical industry on vaccination.

Governments have sought in recent months to cancel mass orders of hundreds of millions of dollars worth of swiftly developed special pandemic vaccines after fears about the severity of swine flu died down. Salisbury said pharmaceutical industry representatives were invited to take part in a SAGE consultations dealing with vaccine production capacity and development. "To my knowledge the industry has not done anything other than provide us with scientific information," he said. "There was at no time any attempt to influence the advice we gave, either in the timing or the content of the advice we gave."

Australian infectious disease expert John Mackenzie, head of the WHO's Emergency Committee of scientists, also defended their safeguards. "Certainly as the chair I was not approached by the pharmaceutical industry and I don't know of any member who was," he said. "I was the only person known externally so who could have been approached," he added. His body recommended an international emergency over the new flu virus and the declaration of a pandemic last June. Mackenzie said the secrecy surrounding the identities of the other members of his panel and their work was precisely aimed at protecting them from commercial or state pressure.
by Staff Writers
Geneva (AFP) April 14, 2010
Experts who planned the global drive against swine flu on Wednesday warned that the pandemic was not yet over and rejected charges they had been unduly influenced by the drug companies.

Their comments came at the end of the first meeting of an external review set up by World Health Organisation to probe the much criticised international response to the new A(H1N1) influenza virus over the past year.

"We're not here to defend or prosecute the WHO, that's not our job, we want find out what are... the lessons we can learn," to "improve" the response, review panel chairman Professor Harvey Fineberg of Washington's Institute of Medicine said afterwards.

John Mackenzie, the head of the panel advising the WHO on flu and pandemic alerts, told the probe that the alert should not be wound down before an expected second wave in the southern hemisphere.

The Australian professor of infectious diseases, who is chairman of the WHO's Emergency Committee, said he was waiting to see the course of A(H1N1) in the south's traditional autumn and winter flu seasons over the coming months.

"I don't think that we will terminate at any stage yet the public health emergency," Mackenzie said.

"Until we're certain, we can't lower our guard."

His committee played a crucial role in recommending an international emergency over the new virus and different stages of alert, including the declaration of a pandemic.

It is due to meet again in the coming two or three weeks, Mackenzie said as he shed unprecedented light on decision-making in the highly confidential committee since April 24, 2009.

He revealed that all recomendations to ramp up the alert level and maintain the pandemic status were made unanimously, often after "vigorous discussion."

They were also followed nearly word-for-word by WHO Director General Margaret Chan, he added.

The review panel's questions were prompted by evidence that A(H1N1) flu has died down with the end of the flu season in the northern hemisphere, as well as doubts about its severity in terms of death and illness.

Mackenzie -- who is also on the review, maintained that the virus was "certainly as severe" as those that sparked flu pandemics in multiple waves in 1957 and 1968, with the unusual characteristic of being more dangerous for young people and pregnant women rather than the elderly.

The issue of severity, the equity of the response for rich and poor countries, and flu communications were among the core issues raised by the 29 strong review panel in its first public discussions.

They also quizzed key actors about allegations of pharmaceutical industry influence in determining the need for special mass vaccination.

The head of a scientific panel advising the WHO on vaccines said "meticulous care" was taken to avoid conflicts of interest.

David Salisbury, of the standing Strategic Advisory Group of Experts (SAGE) on immunisation, said members of the body were vetted and there had been no declaration of conflicts in proceedings on A(H1N1) vaccine.

SAGE gave decisive technical advice to Chan last year on whether or not to produce a special vaccine for the virus and vaccine needs.

Salisbury, a senior British health official, said pharmaceutical firms were invited to take part in a consultation on vaccine production capacity.

"To my knowledge the industry has not done anything other than provide us with scientific information," he added.

"There was at no time any attempt to influence the advice we gave, either in the timing or the content of the advice we gave."

Mackenzie also underlined that the secrecy over the identities of the other members of his panel and their work was precisely designed to protect them from commercial or state pressure.

The review panel has scheduled its next meetings for the last weeks of June and September, with Internet correspondence in between, Fineberg said.

An interim report outlining its intentions will be presented to the WHO's annual assembly next month.




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EPIDEMICS
WHO pandemic probe focuses on media, Internet role
Geneva (AFP) April 13, 2010
The Internet had a disruptive impact on the handling of the flu pandemic by fanning speculation and rumours, officials said as a world health probe on Tuesday examined communications on swine flu. World Health Organisation influenza chief Keiji Fukuda told 29 health experts reviewing the international response to the pandemic that the Internet had added a new dimension to flu alerts over the ... read more

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