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WHO response to concerns in Serbia over its actions during the influenza A (H1N1) 2009 pandemic

01-11-2011

In January 2010, WHO’s Executive Board welcomed the Director-General’s proposal to initiate a review of the experience gained in the global response to the influenza A (H1N1) 2009 pandemic. Under the provisions of the International Health Regulations 2005 (IHR), a binding agreement between WHO's 194 Member States, a review committee of external experts was established to assess (as one of its three objectives) the ongoing global response to the H1N1pandemic (including the role of WHO).

The IHR Review Committee’s final report was published in May 2011 following more than one year of plenary meetings hearing testimony from a wide range of people and deliberative sessions. Testimonies were presented by individuals representing States Parties, National IHR Focal Points, intergovernmental organizations, nongovernmental organizations, United Nations agencies, industry, health professionals, experts, members of the media, chairs of relevant committees and the WHO Secretariat. The plenary meetings were open to the media.

The committee’s key conclusion, relating to the role of WHO during the influenza A (H1N1) 2009 pandemic, was that: “WHO performed well in many ways during the pandemic, confronted systemic difficulties and demonstrated some shortcomings. The Committee found no evidence of malfeasance.”

The report also addressed WHO’s links with private industry, including the pharmaceutical industry; specifically, paragraph 35 of the report reads:

“As far as the Review Committee can determine, no critic of WHO has produced any direct evidence of commercial influence on decision-making. In its interviews with staff and advisory committee members, including the Strategic Advisory Group of Experts and the Emergency Committee, and with representatives of industry, and through its review of internal and external documents, the Review Committee found no evidence of attempted or actual influence by commercial interests on advice given to or decisions made by WHO. In the Committee’s view, the inference by some critics that invisible commercial influences must account for WHO’s actions ignores the power of the core public-health ethos to prevent disease and save lives.”

The public health actions taken by WHO during the pandemic were based on precautionary principles in the face of incomplete and often-conflicting information that was available in April and May of 2009. There were many signs in the early days from Mexico that the disease was severe. Since influenza vaccines are safe and effective for all population groups, countries purchased vaccine to protect their populations. Subsequent studies have shown no difference in safety between adjuvanted and un-adjuvanted vaccines. If a new pandemic were to happen, WHO would conduct the same public health actions as in 2009.

The IHR Review Committee also concluded that influenza A (H1N1) 2009 satisfied the definition of a pandemic based on the extent of spread. The definition of a pandemic had no criterion of severity and was not changed in 2009 to eliminate such a criterion. The report was endorsed by WHO’s Member States at the sixty-fourth World Health Assembly in May 2011.

The Ministry of Health of Serbia collaborates closely with WHO/Europe in the areas of influenza surveillance and vaccination. Serbia reports to the WHO/Europe Regional influenza surveillance platform EuroFlu.

Vaccination recommendations for 2011-2012 influenza season 

Seasonal influenza vaccination is a safe and effective measure which can benefit all age groups, but is especially important for people at higher risk of serious influenza complications, and for people who care for high risk individuals. In healthy adults, influenza vaccine can prevent 70% to 90% of influenza-specific illness, and in the elderly, the vaccine reduces severe illnesses and complications by up to 60% and deaths by up to 80%. Specific population groups may be targeted for vaccination depending on the objectives of the national vaccination programme, access to vaccine, and the ability to implement vaccination campaigns in the targeted groups.

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