The Pandemic That Isn't

Posted June 29, 2009

Cases of H1N1 swine flu continue to appear—especially in the Southern Hemisphere. Australia, for example, saw a quadrupling of cases in a week earlier this month. But that is hardly a surprise: Flu virus is known to be transmitted more efficiently in cold temperatures, and so a winter hike in infections there is to be expected.

It must have surprised officials at the World Health Organizatifon (WHO), however, because on June 11 after a high-level meeting to consider the new data from the Antipodes, they boosted the pandemic alert to the highest level, Phase 6, meaning that a pandemic is under way – the first time in 41 years that WHO has declared a pandemic. But they must be suffering from collective amnesia for that period, because ordinary seasonal flu, which sweeps the world annually – and which is invariably far more lethal than the mildly virulent H1N1 swine flu – certainly meets their definition of a pandemic: widespread geographical spread. A June 11 New York Times headline said it all, “To Flu Experts, ‘Pandemic’ Confirms the Obvious.”

Something else has been obvious: From the beginning of the H1N1 swine flu outbreak, the WHO’s decisions and pronouncements have been far from reassuring. Most flu and public health experts consider the WHO to have been overly alarmist, and that their decision during the week of April 27 to raise the pandemic flu threat to the penultimate level, Phase 5, “Pandemic Imminent,” far outpaced the data that had accumulated and was unwarranted.

Even worse was their official declaration that a pandemic was under way, which illustrates that WHO’s fundamental paradigm is flawed: A warning system based solely on how widely a virus has spread but that does not consider the nature and severity of the illness it causes is prone to false positives; it would classify as "pandemics" not only seasonal flu but also the frequent but largely inconsequential outbreaks of virus-caused colds and gastroenteritis, for example. (the WHO has never offered any explanation for why these obvious examples don’t meet their criteria.)

False alarms make the “pandemic under way” designation almost meaningless and diminishes its usefulness. And that, in turn, has important consequences: As Jack Fisher, a professor of surgery at the University of California, San Diego, School of Medicine, observed, “Keep ‘crying wolf,’ and the WHO can expect lower than customary compliance with flu vaccine advisories next fall.” Not only next fall, but when in future we encounter a genuinely dangerous new pathogen, such as a strain of H5N1 avian flu (which in its present form boasts a mortality rate more than 100 fold higher than the H1N1 swine flu) that is easily transmissible between humans. Whether the threat is tsunamis, hurricanes, forest fires or an infectious disease, it becomes increasingly difficult to get the public to respond to urgent warnings when they’ve become jaded by repeated false alarms.

The U.N.’s false alarms also have more immediate, negative effects. The managing director of Australia’s Tourism Export Council , Matthew Hingerty, said this week that the country could lose 15,000 tourists during the next two months. He noted that secondary schools in Japan have already cancelled planned trips. Hingerty also expressed concern about another disincentive to travel spawned by the WHO’s declaration of a pandemic – namely, the prospect that visitors to Australia may be quarantined when they return to their own countries.

I have had the misfortune to work with U.N. officials for many years, most recently at the meetings of the task force on biotechnology-derived foods of the Codex Alimentarius Commission, the creature of the U.N.’s WHO and Food and Agriculture Organization (FAO) that sets international food standards. The group established standards that were unscientific and excessively stringent, ensuring that new, innovative foods will be so expensive to develop that they will remain largely unavailable to the poorest of the poor, who need them most. During a meeting of the task force, Jorgen Schlundt, the director of the WHO department concerned with food safety, zoonoses [diseases that spread from animals to humans] and food-borne diseases, repeatedly exhorted the group to add ethical concerns about biotech foods to the regulatory barriers that already impede their adoption. He was more like a witless Monty Python character than an official entrusted with serious international responsibilities – including issues pertaining to swine flu, avian flu, West Nile Virus and SARS.

But the U.N.’s influence is no laughing matter. Its involvement in international public health policy is just one manifestation of the organization’s hegemonic designs: The U.N. has become the regulator-wannabe for all manner of products and human activities, from desertification and biodiversity to the regulation of chemicals, uses of the ocean, and new genetic varieties of plants. The U.N.’s regulatory policies, requirements and standards regularly defy scientific consensus and common sense: U.N. agencies’ virtual ban on DDT for mosquito control and their stultifying regulation of agricultural biotechnology are lamentable examples. The result is a more precarious, more dangerous and less resilient world.

Henry I. Miller, a physician, molecular biologist, and former flu researcher, is a fellow at Stanford University’s Hoover Institution.He headed the FDA’s Office of Biotechnology from 1989 to 1993.