According to the University of Rochester's Treanor, the important issue to consider is not whether WHO made the right decisions about the H1N1 pandemic — because he believes they made the right recommendations at the time — but "the much more tricky and generic question about how to appropriately separate the interests of the pharmaceutical industry from the interests of public health, while at the same time being able to take advantage of existing expertise on the issues, the bulk of which resides in individuals with some kind of ties to industry."
"In our current system of healthcare," Treanor said, "the responsibility for demonstrating that these interventions are safe and effective lies with the manufacturer. Hence, individuals with the greatest experience and insight into these interventions will almost always either be employees of industry or individuals paid by industry to conduct studies."
However, according to Philip Alcabes, associate professor of epidemiology at City University of New York Hunter College, investigations should go far beyond the question of whether potential links to drug companies went unpublicized.
"Even when nobody is directly in the pay of a corporation, policy decisions are too-often made by members of the Big Public Health party," said Alcabes. "H1N1 flu was a great example."
When evaluating advice from a panel of experts, Treanor said it's important to consider the fact that researcher's will always view the products they do work on in a positive light, even if they weren't paid by industry.
"After all," Treanor said, "it's much more fun to be involved in the development of an effective product than one that doesn't work."
Finally, Dr. Donald A. Henderson, who served for three years as Director of the Office of Public Health Emergency Preparedness in the Bush administration and who is perhaps best known for his role in leading the effort to eradicate smallpox, brings the perspective of long experience to analysis of WHO's handling of H1N1.
Henderson, who is now a professor of medicine and public health at the University of Pittsburgh, agreed that too much antivirals were stockpiled and too many vaccines produced, and when that happens the body politic demands "someone or some organization must be blamed -- in this case, WHO has been named, and its policy of using experts who may not have disclosed possible relationships with relevant pharmaceutical companies. However, WHO is not an authoritarian and all-knowledgeable body as witness the fact that a number of different countries (e.g. USA, U.K., Sweden, Canada and a number of others) convened their own expert committees and reached different conclusions as to how much vaccine and antiviral products they would buy and policies for their use.
"So, why is WHO singled out? Each national body and expert group is more comfortable ascribing mistakes in strategy or policy to someone else. WHO is a handy whipping post. I would characterize this focus on WHO as a 'cheap shot.'"