It’s almost a year to the day that the World Health Organization (WHO) declared that the planet was in the throes of an influenza ‘pandemic’. The advice was delivered by Dr Margaret Chan, the director general of the WHO. Her announcement triggered large-scale ‘panic-buying’ of flu vaccines and anti-viral drugs such as oseltamivir (Tamiflu) and zanamivir (Relenza). According to the investment bank J P Morgan, the pharmaceutical companies did very nicely out of this ‘health scare’, profiting to the tune of $7 billion from the sale of vaccines alone.

In reality, though, the ‘pandemic’ turned out to be nothing of the sort. Estimates of cases and fatalities turned out to be wildly overblown. Apparently, many countries now have warehouses full of vaccines and drugs that they’re trying to offload, either back to the drug companies they bought them from or to other countries.

Of course, all this overreaction and unnecessary expense may have been down to nothing more than misguided and over-cautious recommendations made by those at the WHO and those who advise it. However, there has been reports that the supposedly impartial advice from the WHO regarding the flu pandemic was, at least in part, the result of influence from the pharmaceutical industry. The WHO has previously dismissed such allegations as ‘conspiracy theories’. Conspiracy theories can be just that – theories. But sometimes, they can turn out to be facts too.

This has come to a head today, on the publication in the British Medical Journal of a report and accompanying editorial [1,2] which focus on this issue. The report alone is voluminous, but here is a paragraph extracted from it that neatly sums up the issues:

‘A joint investigation by the BMJ and the Bureau of Investigative Journalism has uncovered evidence that raises 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. Was it appropriate for WHO to take advice from experts who had declarable financial and research ties with pharmaceutical companies producing antivirals and influenza vaccines? Why was key WHO guidance authored by an influenza expert who had received payment for other work from Roche, manufacturers of oseltamivir, and GlaxoSmithKline, manufacturers of zanamivir? And why does the composition of the emergency committee from which Chan sought guidance remain a secret known only to those within WHO? We are left wondering whether major public health organisations are able to effectively manage the conflicts of interest that are inherent in medical science.’

Often when I’m lecturing I am aware I am often saying things that go against ‘received wisdom’. Once presented with the scientific facts, some people feel quite outraged that they may have been misled in a way that may well have actually jeopardised their health (e.g. the eating of a margarine rather than butter or an emphasis on the low-fat, high-carb diet). Occasionally (though not commonly) someone will ask why our Governments or health agencies would want to mislead us.

It’s a perfectly reasonable question. My answer is that sometimes people are wanting to give us good advice but are just ignorant of the facts. See here for what I believe to be an example of this. The campaigning surgeon involved here may well believe that saturated fat causes heart disease. On the other hand, I have difficulty believing that all the scientists within the company who put him up (Unilever) are so blind to the truth.

Unilever has, as it happens, appeared to enjoy a quite-cosy relationship with the Food Standards Agency here in the UK. For example the now-disbanded FSA Advisory Committee on Research was chaired by someone who received funding from Unilever, and a member of the committee also happened to be a full-time employee of Unilever. The last chairman of the FSA (Dame Deirdre Hutton) it turns out also had a substantial shareholding in a major food company. Guess which one? No, go on, guess.

Only this week, two academics quit an FSA steering group over the FSA’s support of GM crops. One, director of the organisation Genewatch, “left in protest at the agency’s links with the agrochemical business, claiming that its so-called debates were nothing more than ‘a public relations exercise on behalf of GM companies’”. The other has accused the FSA of a ‘failure of institutional integrity’. You can read more about this fiasco here.

Does this mean we should reject out of hand what our Governments and health agencies tell us. No. But when the advice does not fit the facts, it’s worth bearing in mind that industry has the capacity to exert influence at the highest level. It also, it appears, has the capacity to put profit before public health.

References:

1. Cohen D, et al. WHO and the pandemic flu “conspiracies”. BMJ 2010;340:c2912

2. Godlee F. Conflicts of interest and pandemic flu. BMJ 2010;340:c2947