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Swine flu

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Report condemns swine flu experts' ties to big pharma

Trio of scientists who urged stockpiling had previously been paid,
says report

Randeep Ramesh, social affairs editor

Thu 3 Jun 2010 19.34 EDT

378 56

Scientists who drew up the key World Health Organisation guidelines advising governments to
stockpile drugs in the event of a flu pandemic had previously been paid by drug companies
which stood to profit, according to a report out today.

An investigation by the British Medical Journal and the Bureau of Investigative Journalism,
the not-for-profit reporting unit, shows that WHO guidance issued in 2004 was authored by
three scientists who had previously received payment for other work from Roche, which
makes Tamiflu, and GlaxoSmithKline (GSK), manufacturer of Relenza.

City analysts say that pharmaceutical companies banked more than $7bn (£4.8bn) as
governments stockpiled drugs. The issue of transparency has risen to the forefront of public
health debate after dramatic predictions last year about a swine flu pandemic did not come
true.
Some countries, notably Poland, declined to join the panic-buying of vaccines and antivirals
triggered when the WHO declared the swine flu outbreak a pandemic a year ago this week. The
UK, which warned that 65,000 could die as a result of the virus, spent an estimated £1bn
stockpiling drugs and vaccines; officials are now attempting to unpick expensive drug
contracts.

The cabinet office has launched an inquiry into the cost to the taxpayer of the panic-buying of
drugs.

Today, the Council of Europe, produces a damning report into how a lack of openness around
"decision making" has bedevilled planning for pandemics.

"The tentacles of drug company influence are in all levels in the decision-making process," said
Paul Flynn, the Labour MP who sits on the council's health committee. "It must be right that
the WHO is transparent because there has been distortion of priorities of public health
services all over Europe, waste of huge sums of public money and provocation of unjustified
fear."

Although the experts consulted made no secret of industry ties in other settings, declaring
them in research papers and at universities, the WHO itself did not publicly disclose any of
these in its seminal 2004 guidance. In its note, the WHO advised: "Countries that are
considering the use of antivirals as part of their pandemic response will need to stockpile in
advance."

Many nations would adopt this guidance, including Britain. In 2005, the government said it
had begun bulk-buying the drug Tamiflu, initially ordering 14.6m doses after bird flu killed 40
in Asia.

The specific guidance on antivirals was written by Professor Fred Hayden. He has confirmed in
an email that he was being paid by Roche for lectures and consultancy work at the time the
guidance was produced and published. He received payments from GSK for consultancy and
lecturing until 2002. He said "[declaration of interest] forms were filled out for the 2002
consultation".

The previous year Hayden was also one of the main authors of a Roche-sponsored study that
asserted what was to become a main Tamiflu selling point – its claim of a 60% reduction in flu
hospitalisations.

Dr Arnold Monto was the author of the WHO annex dealing with vaccine usage in pandemics.
Between 2000 and 2004, and at the time of writing the annex, Monto had openly declared
consultancy fees and research support from Roche and GSK. No conflict of interest statement
was included in the annex published by the WHO.

When asked if he had signed a declaration of interest form for WHO, Dr Monto said "conflict of
interest forms are requested before participation in any WHO meeting".

The third scientist, Professor Karl Nicholson, is credited with the WHO's influential work
Pandemic Influenza. According to declarations he made in the BMJ and Lancet in 2003, he had
received sponsorship from GSK and Roche.

Even though the previous year these declarations had been openly made, no conflict of
interest statement was included in the annex. Nicholson said he last had "financial relations"
with Roche in 2001.

When asked if he had signed a declaration of interest form for WHO, he replied: "The WHO
does require attendees of meetings, such as those held in 2002 and 2004, to complete
declarations of interest."

A WHO official told the BMJ it had to balance an individual's privacy with the robustness of
guidelines, which were subject to a wide external review process.

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Topics
 p
Swine flu
Pharmaceuticals industry / Drugs / Health policy / World Health Organization / Controversies / news

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