07 June 2010

BMJ and PACE on WHO COI


Two remarkable reports were released late last week on conflicts of interest among scientists advising the World Health Organization on response to influenza (the news story above discuss them). The reports criticize the WHO for its failure to adequately disclose and manage potential conflicts of interest among its expert advisors, calling into question the legitimacy and credibility of its policy guidance on influenza.

One report resulted from a joint investigation by BMJ (a medical journal) and The Bureau of Investigative Journalism. It concluded:
Key scientists advising the World Health Organization on planning for an influenza pandemic had done paid work for pharmaceutical firms that stood to gain from the guidance they were preparing. These conflicts of interest have never been publicly disclosed by WHO, and WHO has dismissed inquiries into its handling of the A/H1N1 pandemic as "conspiracy theories."
The BMJ website also has a 12 minute video on the investigation.

A second report was issued by a committee of the Parliamentary Assembly of the Council of Europe (here in PDF), and is scathing in its conclusions:
The Parliamentary Assembly is alarmed about the way in which the H1N1 influenza pandemic has been handled, not only by the World Health Organization (WHO), but also by the competent health authorities at the level of the European Union and at national level. It is particularly troubled by some of the consequences of decisions taken and advice given leading to distortion of priorities of public health services across Europe, waste of large sums of public money, and also unjustified scares and fears about health risks faced by the European public at large.
Fergus Walsh, medical correspondent for the BBC, summarizes some useful lessons of this experience:

Be open. Be transparent. That seems to be the key learning point for the WHO from this joint investigation.

It is common practice for academic experts to work closely with the pharmaceutical industry, such as getting funding for drug trials, or to be paid for attending meetings.

On all clinical papers authors must publicly declare any competing interests.

So it is surely advisable that the WHO follows the same policy with its advisors.

And there is surely no logic in refusing to name the members of the emergency committee which advised the WHO about the pandemic.

To fail to do so presents an own goal to critics and conspiracy theorists.

I hope that the InterAcademy Council Review of the IPCC is paying close attention, as the IPCC has similar problems with a lack of disclosure and potential conflicts of interest.