Experts advise WHO, 'pandemic yet to peak'

Pandemic yet to peak?

The director-general of the World Health Organisation has today said that it is too early to declare that the peak of the global swine flu pandemic is over. WHO chief Margaret Chan has decided that it was "appropriate not to make any changes in the current pandemic phases right now".

The decision comes a day after the WHO's emergency committee of experts recommended against the UN health agency declaring that the peak of the pandemic is over. A committee of experts had warned that the pandemic of H1N1 flu is yet to peak, advising that it would be premature to suggest otherwise.

The warning came despite recent reports speculating that WHO's ties with the pharmaceutical industry meant the threat of H1N1 had been exaggerated.

Last June, the World Health Organization (WHO) declared the new virus had caused the first influenza in more than 40 years, after it spread around the world from Mexico and the US in less than six weeks. Since then, however, the impact of the influenza pandemic has failed to reach the levels expected by experts.

But according to reports from yesterday, the expert committee has now advised WHO that it would be too soon to suggest that all parts of the world have experienced peak transmission of the H1N1 virus - adding that additional time and information was needed to provide expert advice on the "status of the pandemic."

The ruling by the committee, which was addressed in an email from WHO spokesman Gregory Hartl, is of particular significance as it comes from a committee comprised of 15 experts which makes confidential recommendations to WHO director-general Dr. Margaret Chan.

From here, Chan is then required to inform the health ministries of WHO's 192 member states and the Vatican of her decision.

WHO has already confirmed the virus has killed 16,000 people, though stresses that this is a gross underestimate as patients often go undiagnosed or untested. In fact, according to WHO, it may take a year or two after the pandemic is over before the truth can really be established about the death toll.

Vested interests

Ultimately though the message coming out of WHO's camp seems to be a complex one. The mixed messages, which have been highlighted by the fact that - as a direct result of the H1N1 pandemic and the resulting demand for vaccines - the pharmaceutical industry has seen a massive rise in profits, have also been maintained by the so-called "unpredictability" of the influenza.

According to Dr. Nancy Cox of the U.S. Centers for Disease Control and Prevention (CDC) and a member of WHO's emergency committee, the group has long been struggling to make sure it gets the issue across correctly. "It is very, very difficult to get the wording exactly right," Cox said in a telephone interview yesterday. "We expect the 2009 H1N1 virus to be around for a long time. It is a complex kind of message."

As such, analysts are anticipating that WHO and other public health agencies will be keen to make clear that the influenza has a ferocious and uncertain future.

Race for vaccines

What's more, doubts remain over the reliability of vaccines, largely associated to the fact that drug makers rushed to get vaccines to market as the pandemic spread. In fact, following the outbreak last June the pharmaceutical industry's biggest players literally raced to develop new vaccines, with drug makers GlaxoSmithKiline (GSK) and Roche leading the way - but, as the pandemic appeared to be less severe than anticipated, nations who purchased the vaccines are now being left with a surplus of the drugs.

Switzerland, Spain and Britain, for instance, are now considering giving away or selling the millions of doses that they have received or have on order, while the US - which so far has only distributed 160 million of the 251 million doses it purchased to doctors, hospitals and other healthcare providers - is yet to make a decision on whether it will have an overflow and what it will do with any surplus.

Dr. Keiji Fukuda, WHO's flu expert, formally announced WHO's final decision earlier today, and the outlook appears pretty clear. Last week, Fukuda aready told reporters that younger people - especially those with chronic medical conditions - and pregnant women continue to be at a higher risk of infection and viral pneumonia from the H1N1 virus. In addition the WHO has cautioned that the H1N1 virus could still mutate or mix with the more deadly bird flu virus, which remains endemic in poultry in many Asian countries.

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