Flynn's team stopped short of saying that WHO had bungled the pandemic, but did conclude that some of WHO's actions led to the "waste of large sums of public money, and also unjustified scares and fears about health risks faced by the European public at large."
Infectious disease specialists contacted by ABC News/MedPage Today agreed that the lack of disclosure was troubling, but there was little criticism of the WHO's decision declare the worldwide H1N1 outbreak a pandemic, nor were there many knocks about WHO's handling of the pandemic.
"I do find these investigations troubling, when the only way WHO could be exonerated is if there had been tens of millions dead," said John Barry, a distinguished scholar at Tulane University and author of The Great Influenza. "And then we'd have investigations about how ineffective they were."
"While I agree WHO should have disclosed any relationship between advisors and industry," he continued, "based on what WHO actually did, I find it absurd to accuse them of having been influenced by the drug industry. Antivirals, though hardly a magic bullet, are the only drug option. And a recommendation to stockpile them was the only option."
John Bartlett, MD, founding director of the Center for Civilian Biodefense Strategies at Johns Hopkins, echoed those sentiments. That conflicts of interest are prevalent among influenza experts "is not at all surprising to me since the people in medicine who know most about flu are often conflicted because they also are advisors to pharma and often do the big trials that are funded by pharma."
Bartlett said he was not an authority on influenza, but added, "The colleagues I know who do this work often/usually have these connections, but that is usually good for better pharma and good for better WHO advice."
Addressing concerns that the pandemic was declared to profit pharmaceutical companies, Barry said that "if anything WHO was slow to make that call. And if you know anything about the history of the influenza virus, again it had no option. 1918 saw a very mild spring wave, quite comparable to what we experienced in 2009. It turned virulent months later."
"This is a classic case of 20-20 hindsight, with some witch hunting thrown in," Barry said.
Dr. John Treanor, a vaccine expert at the University of Rochester Medical Center, in Rochester, N.Y., agreed that WHO's preparations were justified.
"I think even the authors [of the BMJ report] would have to agree that there really was no choice here but to prepare for a pandemic," he said. "If there had been a severe pandemic and there had been no preparations, the outcome (and the outcry) would have been far worse."
World Health Organization and H1N1 Flu
Although some of the WHO's advisors received compensation from manufacturers of the same antivirals and vaccines recommended for use during the H1N1 pandemic, Treanor noted that there are few options available for combating influenza.
"You can tweak the plans — how much antivirals, what kinds, where is the vaccine coming from, who should be vaccinated first, should you close schools, etc. — but the basic elements are going to be the same," he said. "So I don't see the argument here as whether WHO made the right recommendation at the time, regardless of who was advising them — they clearly did."