Fire in the hole: Wolfgang Wodarg and WHO

The Reveres have written many posts about the World Health Organization in five years. Some just reported on their activities, others, as seemed appropriate, were critical or praised them. WHO operates in a difficult landscape under rules of engagement not well suited to fighting an enemy that recognizes neither national borders nor national sovereignties and one might question this intergovernmental agency's relevance given those constraints. But we have always bridled at accusations WHO acted unethically or incompetently, neither of which is true. WHO does a difficult job with just a fraction of the budget of many national agencies and mostly ithem well. Nasty and mean spirited accusations now being hurled by ignorant and self-aggrandizing members like the head of health of the Council of Europe, Wolfgang Wodarg, who charges WHO with pimping for the drug cartel, are so stupid one wonders why anyone would take him seriously. But apparently some wearers of tin foil hats take him seriously enough that WHO felt it necessary to issue a statement defending its honor:

Additional allegations that WHO created a 'fake' pandemic to bring economic benefit to industry are scientifically wrong and historically incorrect.
  • Lab analyses showed that this influenza virus was genetically and antigenically very different from other influenza viruses circulating among people
  • Epidemiological information provided by Mexico, the US and Canada demonstrated person-to-person transmission.
  • Clinical information, especially from Mexico, indicated this virus also could cause severe disease and death. At the time, those reports did not indicate a pandemic situation, but taken together sent a very strong warning to WHO and other public health authorities to be ready for one.
  • As the pandemic evolved, clinicians identified a very severe form of primary viral pneumonia, which was rapidly progressive and frequently fatal, that is not part of the disease pattern seen during seasonal influenza. While these cases were relatively rare, they imposed a heavy burden on intensive care units.
  • Geographical spread was exceptionally rapid.
  • On 29 April 2009, WHO reported lab confirmed cases in 9 countries.
  • About 6 weeks later, on 11 June, WHO reported cases in 74 countries and territories in more than two WHO regions. It is this global spread which led WHO to call for increasing phases and finally, to announce that a pandemic was underway.
  • By 1 July, infections had been confirmed in 120 countries and territories.
  • The world is going through a real pandemic. The description of it as a fake is wrong and irresponsible. We welcome any legitimate review process that can improve our work. (WHO statement)

Just so. The influenza pandemic appeared in a form that surprised everyone and like just about everyone WHO managed some things well and some things less well. That's the nature of major disease outbreaks and with influenza, one of the most unpredictable diseases of all, nothing is assured. Planning for the worst is the only responsible course of action. But all of this is well known.

WHO is handicapped in many ways, not the least being it must obey certain standards of public and diplomatic decorum. We don't have those constraints so we are free to say what's really on our mind about this and here it is:

Wolfgang Wodarg is a flaming asshole.

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Well said.

It seems to me that at this point, the World Health Organization would want to encourage a proactive disclosure of senior management's personal relations with pharmaceutical companies.

Personal relations including: recieving direct renumeration as part time employees of a pharmaceutical companiy while employed by the WHO; spouses and other familly members employed; direct investments; accepting rewards such as dinners and trips etc.

There isnt necessarily a problem with some of these economic relationships, if the individual removes him/herself from decision making regarding the company in question.

...Given 'Oil for Food' with Iraq and other misdemeanors through the years with the United Nations and subordinate agencies, you would think that this would be the #1 issue for incoming 'ethical' WHO leaders at all levels.

Does the World Health Organization have a publicized code of ethics?

If they don't, it says everthing that needs to be said about ethics and integrity.

SARS survivor: This freelance journalist doesn't know the subject area and given what's been written by the tinfoil hat types and those who make a living exploiting public cynicism about the world in general this piece is not surprising. Wodarg may call himself an epidemiologist but my search didn't discover any epi studies he had ever done. He is a publicity hound and he is getting publicity.

Tom: I think when you raised this last time you got a response from Jody about WHO's Conflict of Interest policies and the statement I linked to has further information. But Codes of Ethics are not the real issue. It is a given that people at WHO, CDC and anywhere else are supposed to act ethically. That means very little. The real question is what happened, what was reasonable and plausible, were they unduly influenced by Big Pharma. My view is they were influenced by some of their powerful member states, which is, after all, how the organization operates, and that influence wasn't beneficial to good public health, but that's the system and everyone knows it. Big Pharma was just hanging around like vultures to see if they could pick up some of the carrion from this pandemic and since WHO and CDC and everyone else needed them to make the vaccine it was necessary to work with them and even cater to them. That's not even close to collusion or worse.

"It is a given that people at WHO, CDC and anywhere else are supposed to act ethically."

I'm not sure I would completely agree with this statement.

I think it would be reasonable to assume the outcome of removing speed limits from roads...and I also think it reasonable to assume the outcome of intention without regulation in respect to codes of ethics.

I really don't think the relationships between regulators, researchers and pharmaceutical companies will ever be solved...

...but I do believe that those whose taxes pay the wages of the World Health Organization deserve to know the truth... and that only occurs with independent oversight and full and proactive disclosure of potential conflicts of interest.

Here is the report of the hearing of the Council of Europe's Committee on Social, Health and Family Affairs on Wodarg's allegations (http://www.cidrap.umn.edu/cidrap/content/influenza/swineflu/news/jan261…), and here is a synthesis (http://assembly.coe.int/ASP/NewsManager/EMB_NewsManagerView.asp?ID=5209…) and finally here'e the video of the hearing (mms://coenews.coe.int/vod/20100126_05_e.wmv).
What struck me were the allegations made by Dr. Ulrich Keil, allegedly a former member of "WHO Collaborating Center for Epidemiology and Prevention of Cardiovascular and Other Chronic Disease at Germany's University of Munster", who accused WHO of hiding the fact that H1N1 was in fact an already well known virus.
And no, Wodarg is no epidemiologist, and reading his websites he appears to have some problems with basic logic too.
Keep up the good work, always enjoying reading your posts

silphion: Thanks for the links. Keil's comments are either willfully misleading or incredibly ignorant of influenza epidemiology. H1N1 is a subtype and of course various strains of this subtype have been known for decades (in fact since we knew flu was a virus, the 1930s; it's not just the subtype that is at issue since both seasonal flu and 1918 flu are H1N1). This is a strain of H1N1 that is novel (the genetic analysis demonstrates that) and the epidemiology proves it by its age distribution. As for comparing deaths from seasonal flu and tabulated deaths in Germany, it sounds like he doesn't care that these numbers are apples and oranges since they are estimated in entirely different ways.

The Kink in the Pandemic Flu Response Plan: making the vaccines. At issue, the first step, once multiple isolates are isolated and identified. "Flu vaccines are usually grown in fertilized chicken eggs. The virus is injected into an egg. It is allowed to multiply in the embryo for several days. Then the egg is opened and the virus is harvested. After being purified and inactivated, it is used to make vaccine."

BUT,

1. There was MORE than 1 isolate in circulation: there were actually two separately circulating strains with different combination of genes.

2. Poultry do NOT show symptoms when infected with relatively high doses of either 2009 S-OIV or the reconstructed 1918 pandemic influenza viruses.

Ooops.

So the virus didn't readily grow well in chicken eggs and this delayed large-scale vaccine production for months. The question is why did it take investigators several years to test avian response to the reconstructed 1918 strain? The result might have given vaccine makers a heads up that vaccine production to an avian-swine-human reassortant might be harder than anticipated.

The Plan was to trot out sufficient vaccine to inoculate most of the susceptible population - children and adults. They delay meant that those of us who should have been vaccinated, weren't before the second wave swept through the region.

Another major issue was the total lack of public health agency coordination in doling out the delayed vaccine and enacting public protection measure (distancing, etc) in a timely manner, especially in the US. This despite millions being spent and years of planning for just such an pandemic event. Public controls were successful in other countries, like Japan. They were nearly absent in others, like the UK, where most adults and children didn't even bother to wash hands to control virus spread.

Another surprise was that the much feared Fall Wave was not nearly as broadly lethal nor protracted as expected, based on case reports from the First (Spring) Wave in the Americas and Northern Europe and later in Asia. It caused severe complications in select patients, but was relatively mild in most patients. The second wave peaked and waned relatively more abruptly than anticipated, too.

Another surprise was the relatively limited acquisition of antiviral drug resistance, despite the widespread mutations in the seasonal flu of just one year earlier.

Dr Chan, Director General of WHO, maintains that "we were exceptionally lucky and dodged a bullet'.

She is correct, but WHO and CDC don't realize just how close we came, why the pandemic arose in 2009 with early lethality in many healthy adults and children, why it appeared simultaneously in Mexico and the US, and why the second wave petered out rather quickly, despite coincidental timing with seasonal holidays a situation that normally amplifies infectious outbreaks.

It had very little to do with delayed public vaccination.

The real story behind the 2009 Pandemic remains to be told.

Dr. Chan is also correct on one last point: we are not out of the woods yet.

About the following:

"My view is they were influenced by some of their powerful member states, which is, after all, how the organization operates, and that influence wasn't beneficial to good public health, but that's the system and everyone knows it. Big Pharma was just hanging around like vultures to see if they could pick up some of the carrion from this pandemic and since WHO and CDC and everyone else needed them to make the vaccine it was necessary to work with them and even cater to them. That's not even close to collusion or worse."

1) How and to what extent were they influenced by member states?

2) "but that's the system and everyone knows it." And therefore, making a mistake would be justified?

3) "it was necessary to work with them and even cater to them." What kind of catering was done exactly? And what were the consequences of this catering?

4) "That's not even close to collusion or worse." If catering to them in any way, without disclosure of the WHO management's personal relations with the pharmaceutical industry, is not collusion, then what would be collusion?

> Wolfgang Wodarg is a flaming asshole.

sorry, but that puts you a bit towards the same category.
Attack the argument, not the arguer.

WHO made it enough clear that their declaring of a pandemic had nothing to do with virulence.
Despite Chan's "..including virulence..." after the protest from Japan and Britain. Then they had a 1-2 week
"preparing period" before the pandemic was declared
(phase 6)

However, you may ask, how useful the pandemic phases are then for preparation
guidelines and pandemic plans ?
So, WHO should IMO issue other,separated guidelines which also consider virulence.

Alex: Here is where WHO fits in the international system:
http://scienceblogs.com/effectmeasure/2009/08/world_health_organization…

We discussed here several times how the UK, China and Japan influenced the delay in calling the pandemic and added to confusion. Use the WHO category on the sidebar. The main point is that the international system requires that WHO be influenced by their member states. That was why I question their relevance for this problem.

The catering is a consequence of the fact that the world is entirely dependent on them. We have argument over many years this is bad, that there should be regional vaccine institutes (look at the ""vaccine" category on the sidebar to find some of the many posts) that don't depend on the market system.

There were no secret arrangements. Everyone could see what was happening and the relationship of the WHO to the vaccine industry has been going on in the open for 50 years through the surveillance system.

passerby: Our view is not the problem was the vaccine -- the progeny of the H1N1 vaccine have been grown in eggs since the beginning of flu viral culture in the 1930s; PR8 H1N1 is the routine lab flu virus -- but failure of national gov'ts to strengthen their public health and social service infrastructures. Growing the virus in eggs is old technology but the drug industry never bothered to put the new technologies through the regulatory process because it wasn't profitable so we were stuck (in the US) with eggs.

anon: The single line you object to comes at the end of a post full of arguments against Wodarg's absurd accusations. More to the point, we have been posting on this for 5 years, as you know so it isn't as if we don't have arguments aplenty.

There was no secret about the definition of a pandemic. It did not include virulence. It only included it when powerful member nations objected. Your point about the usefulness of the guides is well taken and goes to our observation that their relevance for this is questionable, given the nature of the international system.

Jupe: Writing a grant so haven't had a chance to read it. Will take a look as soon as I can.

> anon: The single line you object to comes at the end of a post full of arguments against
> Wodarg's absurd accusations.

not just that line. Spare me to do further quotes. What about your headlines ?

> More to the point, we have been posting on this for 5 years, as you know so it isn't as if we
> don't have arguments aplenty.

same holds for Siegel,Fumento,Tenpenny,...

> There was no secret about the definition of a pandemic. It did not include virulence.

yes. Even a non-virulent pandemic is important with longterm effects since it may replace old strains
and/or reassort with them. (why didn't you use that as an argument ?)

> It only included it when powerful member nations objected. Your point about the
> usefulness of the guides is well taken and goes to our observation that their relevance
> for this is questionable, given the nature of the international system.

IMO the real critics should be addressed to PCAST who spoke of 30000-90000 deaths in August
when evidence from the NY-city wave, from Mexico and incoming data from Australia,NZ
already suggested a lower CFR.

I don't understand how was this allowed to get so far. Wodarg has absolutely no proof for his claims.

anon: We don't know what the CFR is/was yet. That will await some analysis and may take years. I don't know what point you are making about Siegel and Fumento.

We're never going to know the "true" CFR, here. The waters have been muddied by common testing procedures that -- unavoidably -- introduced huge numbers of false negatives. Along with that, we have (to date) been "cushioned" by the advent of very efficacious anti-virals, and state-of-the-art ICU's. We may be in store for an emerging third wave, with this virus (the second wave, in the US at least, has clearly bottomed-out, now); if this is the case, it is almost certain that the third wave will not be ushered in by a "pure" iteration of the strain that served as the "seed virus" for the first two waves; that strain has largely been subdued by a combination of initial infections and vaccinations that have conferred a robust herd immunity on the general population, effectively reducing the number of possible host prospects to the point where that strain is essentially no longer viable. It has managed, in the course of the last year, to nearly eliminate the reservoir of potential hosts. That's to be expected, of course. The successor progeny that can probably deal with this environment most successfully will likely be one that can take advantage of the successes of its very infectious predecessor, while at the same time avoiding such a close identification with it that the current version of pandemic vaccine can effectively contend with it. The "third wave" virus will have to be one that has managed to mutate away from the current vaccine, if it is to be successful (we'll know that when large numbers of previously infected people, or those who have been vaccinated, begin to be infected). I think there's a strong possibility that a strain of that potential is now out there. And I would also think that we will know if this is actually the case within the next several weeks. The pandemic has either run aground, or we will witness the next iteration in the near term, as I see it. YMMV.

This is what I would suggest, at this point: Watch Mexico; Southern Mexico (and the Southern US, where the second wave began to radiate outward from) is still very much the canary in the coal mine, here, in my opinion.

Revere,

thanks for all the information. Is there anything that can be done to create regional vaccine institutes, independent of Big Pharma?

Alex: I have heard scuttlebutt that there are discussions of regional vaccine institutes now, although I don't know any details or even it it's true or if it is, how far it has gone. Two US states, Massachusetts and Michigan, used to make vaccines but that stopped in the Reagan years. It's not unprecedented and the world is topsy turvy so who knows what will emerge from this period of transition.

Just for the record:
Wolfgang Wodarg has been Chairman of a Health Subcommittee of the Council of Europe Parliament Assembly (PACE) only up to 2004.
In addition, he has not been re-elected by his German voters (there is still hope about common sense of citizens all over the world...) and lost his post as Member of PACE recently.
In fact, this week, with all the fuss over the WHO questioning, he is not technically a member of PACE, and only attends the hearing sessions "by invitation".
And yes, he had not prove anything.
Farewell, Wolfgang.

By Antoni Trilla (not verified) on 30 Jan 2010 #permalink

Revere the WHO is an organization that is political in nature at the least and lately, in the max. I really dont like closed door decisions being made. Thats where this one went south back a couple of years ago when Pharma, Auntie Margaret and the rest of the boys and girls all went behind the medical iron curtain to make decisions about an H5N1 pandemic that never showed. Why? It was a world issue and OMG transparency there is just like the Obama adminstration. Back door deals, bunker'd and hunker'd we are going to ram this down your throat because we cant say ram it up your ass on TV. Was there a big chance of H5N1 breaking? Sure, but H1N1 took its place and thats where everything you say above becomes very credible. But we still have this problem and that is that the whores are sleeping with the whores.

My mom who was in both politics and PR for 50 years would have first said silence the crowd and they didnt. Was there a pandemic looming? You betcha ! There were two of course, a pandemic of bullshit that consumed the world more quickly than the bug itself, and the question mark bug. Which version? Which strain? But everyone kept making seasonal vax too now didnt they? They wanted the world to fund their R&D and then...they would sell us questionable vaccines using our money.

There was no question that there COULD have been a major problem and frankly it was a pretty big one when H1N1 turned up, H5N1 turned out and the WHO spent one shitload of money and we got what? Richer Pharma... and we spent how much money on a vax and a questionable vax at that. It was 1976 all over again..at 40 million vax's there were about the same number of reactions....And Pharma people got richer. They would have ither way but to have a pandemic was a money maker for the ailing Pharma industry. There really werent any negotiations on this at all. They made several countries responsible for adverse reactions and not the manufacturers. Yep, the US was responsible if anything happened. France and a couple of others too. Mega-bucks with a backstop. We pay for the liabilities, we pay for the free vax, then we get sued after the fact. Nice .

So how did we get here? There was that thing with Baxter and he wrong stuff being sent to the Czechs... How messy and unprofessional and how infectious? How many cases like that do we not know about? Hey its a little yellowish liquid and there are varying degrees of yellow and danger with them. Dont worry about BSL labs, we have Baxter.

Wolfie does make some valid points that no one wants or will answer. Time for doctors to be doctors at WHO and get the hell out of bed with Pharma. But they cant. Its like cancer treatment. Those guys dont make money off of anything but the drugs they are making.or in the case of the WHO, the control of world health. Probably didnt hear about their latest funding scheme have you? Too many positions of authority hold seats of power at drug manufacturers- WHO =Pharma.

Kind of like ADD medication. Who comes up with the criteria for use of medication? Pharma. W.H.O. comes up with the criteria for the declaration and production of vaccines? Who comes up with the fix? Pharma.

Way too cozy. But who is a bigger asshole?

People that kicked out several hundred billions of dollars of world taxes and saying that it was good for the people or the WHO that pissed off the next biggest asshole on the planet Supari? It gave her the out to say we were making bioweps? It was like giving a star in the East to Jerry Falwell. She had a valid point but only in the media.

The first chunk of money was stolen in Indonesia big time and she admitted it. It built great little dacha's up in Phuket Thailand, but then she wanted more-extortion in fact. She wanted to be in on the gravy train but in a world that was looking at how money was spent at the time, well memories are short. You excoriated Rumsfeld, lets excoriate the WHO too and its because when that curtain got drawn, Ed Hammond who I disagreed with personally about most things was excluded along with the entire media...It gave rise to the conspiracy and its not a theory. Its a fact because the curtain WAS drawn by WHO.

There ARE a lot of unanswered questions and only because of their actions, not Wolfies. Let them properly answer the questions posed and everything will ease up and make Wolfie the asshole you say he is. Until then Wolfie is right and only because of his position, not because of his message. Let them disprove it by points, not by some press release. You are right about what you have posted, but he isnt wrong because you say he is. Pandemic is here but its very mild and I havent seen them spend 750 billion dollars on seasonal flu....Yet.

Sorry for the length...The BS is deep and you have use a long shovel to get it out.

By M. Randolph Kruger (not verified) on 31 Jan 2010 #permalink

@Revere: The faster they can get those regional vaccine institutes going, the faster the anti-vaccers lose the "It's a huge conspiracy by the government" argument and possibly other retarded arguments.

@Kruger: I'd like to see some references for all of this. Without them, the post is just another rant. I hope that by "the whores are sleeping with the whores.", you're not trying to challenge Wodarg's recently acquired position as flaming asshole, as Revere put it.

On a separate note, it's always fun to look at anti-vax websites. Infowars, which is not just an anti-vax website but also the epicenter of Quantum Conspiracy Theory development, always makes me laugh. They claim that Orwell's 1984 came 25 years late (2009) in the form of H1N1 vaccination, mandated by governments and the WHO and that it will be similar to eugenics programs in the 1920s. Big Brother is vaccinating you.

Alex...Please to refer to the posts here from two and three years ago. They are there. But to cut to the chase...Ed Hammond of the Sunshine Project ended up at the conference and was like a stealth weapon. Ed and I hardly ever agreed on anything but the one goddamn thing that we did was that everything should be out in the open. They went into "executive session" on more than one occasion talking about H5N1. Executive committees, you know the ones we pay all of our tax money so we can send it to corrupt corporations like the WHO, or a Pelosi/Reid two step insurance company buy-off we are seeing now.

Ed was excluded from some of the meetings but he was able to slip in, get info and it was incredible stuff. It had all of the stench of a cover-up and well, now unless you have someone in there you can come up with all sorts of things.

Conspiracy-The thing about conspiracies that are properly done is that they are properly done. Never can quite get to the end of them. Too well insulated. We are in a pandemic now, there is no question of it. The true question is whether people were or are making serious money off of it.

Alex-Do go back into the archives and bring yourself up to speed on this. 750 billion goes in and jack shit comes out from the vax program. Really the whole way on the edge of not being worth crap. Wodang's assertions may be a bit off base but not totally. A LOT of people got rich I can definitely say that for sure. We end up with regional vax institutes? Hardly, it would take years to get them going. Frankly they are dangerous as hell and are terrorist targets.

By M. Randolph Kruger (not verified) on 31 Jan 2010 #permalink

@Kruger: Which posts from 2-3 years ago exactly? Can you give a link?

I know nothing about Ed Hammond but don't have time now to look that up. Sorry. I'll check later.

Now, about the following:

"corrupt corporations like the WHO"
>>The influence Big Pharma has on WHO should be looked at. Revere says that those at the WHO were very competent and did the best they could with what they had. I tend to be more skeptical. But calling them corrupt is a gross exaggeration. And besides, the WHO is not even a corporation.

"The true question is whether people were or are making serious money off of it."
>>That was already addressed by Revere in the reply above. "Big Pharma was just hanging around like vultures to see if they could pick up some of the carrion from this pandemic and since WHO and CDC and everyone else needed them to make the vaccine it was necessary to work with them and even cater to them."

"750 billion goes in and jack shit comes out from the vax program. Really the whole way on the edge of not being worth crap."
>>Not sure how much goes into it but a lot has come out of it. The eradication of smallpox is one of the greatest successes of vaccination.

"Wodang's assertions may be a bit off base but not totally."
>>Yes, totally. I don't have time to write a full answer to this but Wodarg seems to have gone full metal jacket on the WHO, for no serious reason. Wodarg was a very controversial figure even before attacking the WHO. Read up on him.

"A LOT of people got rich I can definitely say that for sure."
>>Which proves nothing. A lot of people got rich from selling portable computers in the 70-80s. That doesn't make it a conspiracy against the public. And besides, if you want to use the conspiratorial tone, you should say that a few got rich from this. A LOT getting rich from something sounds like a collective project, not a conspiracy.

"We end up with regional vax institutes? Hardly, it would take years to get them going."
>>But they would be much better than having Big Pharma with their fat fingers on the buttons. I don't see why you're against reg vax institutes if you're against people making money off vaccinations.

"Frankly they are dangerous as hell and are terrorist targets."
>>They're not dangerous, they're just vax institutes. And Middle East terrorists usually direct their attacks towards large phallic symbols, such as the WTC. It has something to do with how easy it is to fly a plane into a tall building, as opposed to flying it into a small clinic. And I'm not sure what message they would send by attacking a vax institute: "We have struck deep into the heart of infidel medicine"?