Topics
• Reaction to criticism
• Council of Europe motion to discuss "Faked pandemics: a threat for health"
• Definition of pandemic
• Influence from pharmaceutical industry
• Why WHO recommends vaccination
• Emergency Committee
• Strategic Advisory Group of Experts (SAGE)
• Exaggerated pandemic?
Reaction to criticism
Key messages
• Criticism is part of an outbreak cycle. It's expected. It can be good for public health if criticism highlights a failing of ours. Or it can be harmful, if unfounded assertions undermine good public health advice. We expect and indeed welcome criticism and the chance to discuss it.
• Evaluation is a necessary step and we are open to recommendations that can improve our work. When this is over, undoubtedly WHO will work with outside experts to examine its response and their findings will be made public.
Council of Europe motion to discuss "Faked pandemics: a threat for health"
Key messages
• Providing independent advice to Member States is a very important function of WHO. We take this work seriously and guard against the influence of any vested interests. We welcome any legitimate review process that can improve our work.
Definition of pandemic
Key messages
• WHO did not change the definition of pandemic in the course of this outbreak.
• A pandemic is declared when there have been verified community-level outbreaks of a new influenza virus, passing from human-to-human, in two or more countries in more than one WHO region.
• WHO pandemic preparedness guidelines and other background information is available here: http://www.who.int/csr/disease/influenza/pipguidance2009/en/index.html
• WHO's pandemic preparedness guidelines were developed in consultation with Member States and pandemic influenza experts over the course of several years. The 2005 pandemic preparedness guidelines were revised over a two year period of consultation and were finalized in February 2009. These were published in April, just as it appeared we were about to face a new pandemic.
• Some of the confusion may stem from the fact that there was a document on WHO's website for some months that said a pandemic would include "enormous amounts of cases and deaths". This was removed when it was brought to our attention. This information was never part of the formal definition of a pandemic and was never part of documents sent to Member States for their preparedness work. We regret the confusion it has caused.
• WHO has consistently assessed the impact of the current influenza pandemic as moderate, reminding the medical community, public, and media that the overwhelming majority of patients experience mild influenza-like illness and recover fully within a week, even without any form of medical treatment.
Influence from pharmaceutical industry
Key messages
• WHO works with a wide range of individuals to obtain the input needed for WHO to address public health issues. WHO has systems in place to safeguard against potential conflicts of interest by experts in its advisory groups.
• WHO requires all experts advising the organization to declare all professional and financial interests, including funding received from pharmaceutical companies or consultancies or other forms of professional involvement with pharmaceutical companies. This information is shared with other members of the advisory group and taken into account by WHO in determining whether the experts concerned should continue to provide advice to the organization.
• Allegations of undeclared conflicts of interest are taken very seriously by WHO, and investigated immediately.
Why WHO recommends vaccination
Key messages
• We need the best tools and best solutions to protect human life - and those tools include vaccines and antiviral drugs.
• We work with pharmaceutical companies because they are the ones who make vaccines. Vaccines are not made by the governments or by the public sectors, but by companies in the private sector. We work with these companies in the developed countries and also in a number of developing countries.
Emergency Committee
Key messages
• The Emergency Committee was the one that advised the Director-General to declare a pandemic, although the final decision was hers.
• To date, the names of these members have been withheld to reduce the possibility or any of them being directly pressured by any outside parties, since any actions or pronouncements taken by WHO under advisement by the Emergency Committee related to a public health emergency of international could have wide social, political and health related consequences.
Strategic Advisory Group of Experts (SAGE)
Key messages
• SAGE is a group of experts that advises WHO on all aspects of vaccines. In July 2009, SAGE held an emergency meeting to make recommendations related to pandemic vaccine, including which groups should be prioritized for immunization.
• This information is not secret: the names of members of SAGE and working groups of SAGE are published on the WHO web site, along with meeting reports and declarations of interest made by experts attending those meetings. http://www.who.int/immunization/sage/en/
Useful reference: WHO briefing note on use of advisory bodies http://www.who.int/csr/disease/swineflu/notes/briefing_20091203/en/index.html
Exaggerated pandemic? Key messages
• Early decisions are made in the midst of profound uncertainties. This is not an excuse but a fact. At the beginning of the pandemic, not knowing if it was a severe or mild disease, WHO had to take actions and make recommendations.
• WHO has consistently assessed the impact of the current influenza pandemic as moderate, reminding the medical community, public, and media that the overwhelming majority of patients experience mild influenza-like illness and recover fully within a week, even without any form of medical treatment.
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