Who is watching WHO?


On 23 October 2014, the World Health Organization convened a high-level emergency meeting to look at the many complex policy issues surrounding access to Ebola vaccines. The WHO talked about ways to ensure the fair distribution and financing of these vaccines, as well as plans for the different phases of clinical trials to be performed and partnerships for expediting clinical trials, and proposals for getting all development partners moving in tandem at the same accelerated pace.

Hmmm. That’s a lot of talk. And a lot of bureaucracy. Feeling reassured?

Let’s look at a real life casestudy of the WHO in response to a pandemic.

Avian flu

In January 2009, the H5N1 strain of avian flu was detected in chickens smuggled in from China in the northern province of Lang Son, Vietnam — just two weeks before the Tet holiday when poultry consumption is at its highest. A young girl’s death in a nearby province was confirmed as a result of the same strain just days before. Despite the local authorities spreading tons of sterilizers along the border, Vietnam reported bird flu outbreaks in the Thanh Hoa and Thai Nguyen provinces. In Hanoi, food inspectors discovered the widespread use of counterfeit quality stamps for poultry to disguise that the chicken was from China.

In the suburbs of Beijing a middle-aged woman died that same week in January, while in Egypt, also in the same week, a 21-month-old child was hospitalized from the same strain – just 35 days after a 16-year-old girl succumbed to the H5N1.

In many poor areas of the world there are too few laboratories to identify avian flu in poultry and identification of the disease can only be made if the destination country is sophisticated enough to operate a checking procedure. Who knows how many potentially lethal journeys are made as infected birds are unknowingly transported across borders? In addition, poor countries cannot compensate farmers so there is no incentive for them to come forward and alert the world to the fact that their flock is infected.

This creates a problem: the WHO doesn’t know the facts.

According to the World Health Organization, there have been 697 human cases of bird flu worldwide since 2003 and 393 of these cases have died. But these statistics are all post-mortem and may not include the deaths in remote areas where lab facilities and autopsies are unavailable.

Back in August 2005, WHO sent all countries a document, “Responding to the avian influenza pandemic threat”, outlining recommended strategic actions for responding to the avian influenza pandemic threat. (In WHO-speak, recommended actions aim to strengthen national preparedness, reduce opportunities for a pandemic virus to emerge, improve the early warning system, delay initial international spread, and accelerate vaccine development.) In this document WHO stated that the pandemic had met all the prerequisites for the start of a pandemic apart from human-to-human transmission. It stated that each new human case gives the virus an opportunity to evolve towards a fully transmissible pandemic strain.

It also posed the question: Is the world adequately prepared?

The answer, they say, is: No.

It goes on:

…the world is ill prepared to defend itself during a pandemic. WHO has urged all countries to develop preparedness plans, but only around 40 have done so. WHO has further urged countries with adequate resources to stockpile antiviral drugs nationally for use at the start of a pandemic. Around 30 countries are purchasing large quantities of these drugs, but the manufacturer has no capacity to fill these orders immediately. On present trends, most developing countries will have no access to vaccines and antiviral drugs throughout the duration of a pandemic.

The avian flu story worsens as according to a 2009 University of Colorado at Boulder study the resistance of the avian flu virus to a major class of antiviral drugs is increasing. The H5N1 strain is evolving a resistance to a group of antiviral drugs known as adamantanes, one of two classes of antiviral drugs used to prevent and treat flu symptoms. The rise of resistance to adamantanes appears to be linked to Chinese farmers who are adding the drugs to chicken feed as a flu preventative, a fact reported in a 2008 publication by researchers from China Agricultural University.

Despite the world’s blind faith in the WHO to ride to our rescue, it isn’t going to happen. There is no early warning system in place, vaccines are untested and not widely available, and there are inadequate amounts of vaccines (if they work) and antiviral drugs.