WHO Undertakes Independent Review Of Its Pandemic Flu Efforts

The World Health Organization’s handling of the recent pandemic influenza outbreak will be examined by an independent panel of experts beginning in April. Meanwhile, new reports from the WHO are available on influenza and on intellectual property and innovation.

The review board will have its first meeting from 12-14 April, with the names of the “about 29” panel members expected to be released shortly beforehand, said Keiji Fukuda, the special advisor on pandemic influenza to WHO Director General Margaret Chan, at a press conference 29 March. It will be open to observers from member states, UN agencies and accredited non-governmental observers, but not to the public or the press, said Fukuda, though he added WHO would “try to work with the media.”

The main goals of the review are to examine how the WHO responded to the recent pandemic situation and how well the world is prepared for future health crisis. The review falls under a planned examination of the WHO’s legally-binding international health regulations, which were designed to guide WHO members in case of a global health emergency. The spring 2009 outbreak of so-called swine flu, the H1N1 virus, was the first test of this system, Fukuda said.

The panel is meant to draw up its own plan for reviewing WHO’s activities, said Fukuda, meaning the question of whether or not they will review several critical issues not yet answerable. These issues include the accusation of possibly exaggerating the swine flu outbreak, and the WHO’s as-yet unfinished work to create a virus and related benefit-sharing mechanism.

But on the matter of delivering vaccines to countries that need them, Fukuda said this is a “very big topic [and] I don’t see how they could not address it.” A representative of Mexico, where swine flu originated, said at the WHO Executive Board meeting in January that it had not received enough vaccines; assuring such access is an area of continuing concern for many developing country members of WHO.

New Reports from WHO

Meanwhile, the WHO’s report on ongoing attempts to create a pandemic influenza preparedness framework for the sharing of viruses and vaccines and other benefits was released online 25 March. It no longer appears to be available from the WHO website, but can be accessed here [pdf].

There are several other new reports posted on the WHO site recently, as part of the lead-up to the 17-21 May World Health Assembly.

An intergovernmental process tasked with drafting pandemic preparedness framework was still at a standstill over several issues involving intellectual property rights and legally-binding benefit sharing provisions at its last mandated meeting in May 2009 (IPW, WHO, 18 May 2009).

At the 2009 World Health Assembly, the director general was given responsibility for completing outstanding elements of the framework, but at an informal consultation with member states in October it became clear that she would not be able to bridge the group’s differences (IPW, WHO, 22 October 2009).

The report is intended to brief the 2010 World Health Assembly on progress made since last year’s WHA. But it is hoped that even more progress can be achieved by a new intergovernmental process – created in January to help push through agreement on remaining areas of discord – that is meeting immediately prior to the Assembly.

The report said that there were a few areas of convergence achieved during the year: first, that on a Standard Material Transfer Agreement (SMTA) “stepwise approach” concerning all relevant entities receiving biological materials, with a “streamlined” agreement for members of the WHO Global Influenza Surveillance Network.

One area of disagreement during the intergovernmental process was in who would be bound by the SMTA.

There was general agreement that a list of benefits should be expanded, but there is continuing disagreement on whether those benefits should be shared voluntarily or if sharing them is mandatory.

Parts of the framework that have reached consensus call for viruses and benefits to be shared on an equal footing – and virus-sharing is not seen as optional. Developing countries and civil society groups are worried that a voluntary benefit-sharing arrangement will lead to uncertain availability of vaccines in developing countries and therefore to increased vulnerability to a pandemic virus.

The report says that Chan suggested a middle ground: requiring all vaccine manufacturers to contribute to the system but allowing them to choose what they want to contribute.

On IP rights, there are still “wide divergences” between member states, says the report. This seems an understatement, as some countries feel no IP rights should be sought by any member of the Global Influenza Surveillance Network and others argue precisely the opposite: that IP should not only be allowed but encouraged “as an important incentive for innovation.”

Public Health, Innovation, Intellectual Property

Also now online is the WHO secretariat report on the implementation of its global strategy and plan of action on public health, innovation and intellectual property. The global strategy, adopted in 2008, tasks different stakeholders with carrying out a variety of actions to encourage research and development, especially on neglected diseases. This document [pdf] reports the progress WHO has made on areas in which it was named the key stakeholder responsible for action.

Intellectual property matters are being addressed in cooperation with the World Intellectual Property Organization, and primarily involve “capacity building and training,” said the report.

It also mentions a European Union-supported partnership with the UN Conference on Trade and Development and the International Centre for Trade and Sustainable Development (ICTSD) which is examining the main obstacles to transfer of pharmaceutical technologies – including vaccines and diagnostics – to developing countries.

The secretariat is separately developing guidelines to support technology transfer, the report says, though it does not mention when those guidelines are meant to be ready.