WHO Director-General Margaret Chan on Monday responded to the first results of a probe into the agency’s response to the H1N1 (swine flu) pandemic, Agence France-Presse reports. While calling attention to where the external panel committee commended the agency’s actions, Chan also addressed the criticisms and recommendations issued in the draft report (3/28). Her comments came as the review committee held its “fourth and final public session” in Geneva to receive “feedback from countries and organizations on its preliminary report,” CIDRAP News reports (Schnirring, 3/28).

“For me, personally, as head of this agency, the assessment of the pandemic response needed to address two absolutely critical questions … [D]id WHO make the right call? Was this a real pandemic or not? … Second, were WHO decisions, advice, and actions shaped in any way by ties with the pharmaceutical industry?” Chan said during a meeting with the review committee, according to a transcript from the event. “The document exonerates WHO on both counts,” Chan said (3/28).

Chan did, however, acknowledge the agency’s shortcomings, as outlined in the draft report, Reuters writes. The report highlighted the “WHO’s lack of a consistent and measurable description for judging a pandemic’s severity which had created confusion” and said that “WHO bureaucracy had prevented a timely distribution of vaccines,” noting these as areas for improvement, according to the news service (Nebehay, 3/28).

In general, “WHO welcomes the preview document, its conclusions, and its recommendations” and “will do our utmost to implement them,” Chan said, according to the transcript. “But let me be very frank. Some of your recommendations will be far easier to implement than others, as has been mentioned by some Member States,” she said.

“In general, changes in policies, practices, and priorities that fall entirely within the purview of WHO and its governing bodies are comparatively easy to implement, though the amount of time needed for full implementation will vary, as will resource needs,” she continued. “More difficult to address are weaknesses in the pandemic response that lie outside the direct authority and beyond the direct influence of WHO. …These are weaknesses that arise from larger systemic difficulties. In other words, from the way this world and its international systems work,” Chan said, pointing to the committee’s critique of the time it took for the WHO to “achieve timely distribution” of vaccines donated for developing countries (3/28). WHO “made every effort to ensure that the vaccine, donated by rich nations and drug makers, swiftly reached vulnerable people in developing countries, [Chan] said,” according to Reuters (3/28).

“Negotiating swine flu vaccine to redistribute to poor countries was cumbersome, said [Institute of Medicine President] Harvey Fineberg,” who chaired the committee, CBC News reports (3/28). While wealthy countries were able to access the H1N1 vaccine, “WHO’s efforts to obtain millions of shots for poor countries were ‘very problematic'” he added, according to the Associated Press (3/28).  

“The hurdles that slowed us down arise from the lack of harmonisation of registration for medicines and vaccines, issues of liability that are part of company policies and the simple fact that no country is willing to give up its sovereign right to authorise the marketing of a medical product,” Chan told the group, according to Reuters. “In my view, no amount of advance planning is going to change this reality or alter the way the systems work,” she said. In total, the agency “coordinated the distribution of 78 million doses of vaccines to 77 eligible countries including Bangladesh, Cuba, North Korea and Zimbabwe, its figures show,” the news service adds (3/28).

The review committee will hold two days of closed-door sessions to discuss the points addressed in the public sessions, as well as written feedback the group has received since releasing the draft report (3/28). The review committee is scheduled to release its final report in the weeks ahead of the WHO Assembly, which is scheduled for May 16-24, Reuters adds (3/28).

CIDRAP News features a link to an audio recording of Fineberg’s comments made during the press conference at the meeting (Schnirring, 3/28).