Affiliations: Domus Medica, Utrecht, The Netherlands | Department of Pharmaceutics, Faculty of Science, Utrecht University, Utrecht, The Netherlands
Note: [] Address for correspondence: D. Bijl, MD, Editor in Chief, Geneesmiddelenbulletin (Dutch Drug Bulletin), Redactie Geneesmiddelenbulletin, Domus Medica, Postbus 2190, 3500 GD Utrecht, The Netherlands. Tel.: +30 2823360; E-mail: dick.bijl@hetnet.nl
Abstract: The first reports of the New Influenza A (H1N1) spoke of a markedly increased morbidity and mortality. Later it turned out that this flu was a very mild flu. Gradually the role of the WHO was questioned. The definition of a pandemic flu had been changed and there rose doubts about the independency of the experts advising the WHO. It showed that some of these experts had a conflict of interest with the pharmaceutical industry, especially with those producing vaccines and neuraminidase inhibitors. As of june 2010 the WHO declared the outbreak to be a pandemic. This provided the momentum to produce vaccines. At the outbreak of the pandemic in the northern hemisphere, there was sufficient evidence that the pandemic would not be so serious, that a single vaccination was sufficient, that there were strong doubts about the efficacy of oseltamivir and that the drug, although rarely, could have serious side effects. With the stockpiling of neuraminidase inhibitors and with the recommendation of the vaccination political decisions were involved. These decisions should be driven and supported by independent scientific advisory bodies with no room for even the semblance of conflicts of interest. Stronger measures to limit the impact of experts with conflicts of interest on the development of, among others, guidelines are necessary.
Keywords: New Influenza A (H1N1), swine flu, pandemic, seasonal influenza, neuraminidase inhibitors, oseltamivir, zanamivir, pandemic influenza vaccines
