One Year Later: Assessing the H1N1 Pandemic Response
The process of reviewing the world’s reaction to the 2009 H1N1 (swine flu) pandemic is officially underway.
The World Health Organization (WHO) has announced an assessment of global response to the pandemic and to identify lessons for the future. The Review Committee, made up of 29 members who are experts in scientific fields or with practical experience in public health, both in developing and developed countries, will also be examining the functioning of the International Health Regulations (IHR).
None of the Review Committee members are WHO staff, nor do they receive funding from WHO for their contributions to the review process. See a complete list of committee members here.
The IHR is an international agreement binding on 194 states parties across the globe, including all member states of WHO, with the purpose of helping the international community prevent and respond to acute public health risks that have the potential to threaten people worldwide. 2009’s H1N1 pandemic is the first international public health emergency to occur since its implementation in 2007.
According to WHO, the review will focus on:
- Assessing the functionality of the IHR;
- assessing the ongoing global response to the H1N1 pandemic, including the role of WHO; and
- identifying lessons for strengthening preparedness and response for future public health emergencies.
In her opening remarks at the first meeting of the Review Committee in Geneva, Dr. Margaret Chan, Director-General of WHO, had this to say.
“This has been the most closely watched and carefully scrutinized pandemic in history. This gives us a vast body of scientific, clinical, and epidemiological data to assess. Moreover, the pandemic’s spread was rapidly global. To date, laboratory confirmed cases of H1N1 pandemic influenza have been officially reported from 213 countries and overseas territories or communities. This gives us a vast and varied experience to assess.”
It was one year ago this month when we heard about the first death from H1N1 in Mexico. It went on to become a global pandemic, killing 17,770 people to date.
Whether the pandemic was mild or not seems to be in the eye of the beholder. There is no question that it was, and is, deadly, especially for the very young, those with underlying health conditions, and to pregnant women. The severity of cases, and the number of deaths varied from country to country, as did availability of the vaccine.
The vaccine itself continues to be a source of great controversy, with anti-government, anti-pharmaceutical sentiment running deep, especially in the United States and Europe. What began as a clamoring for creation of and access to the vaccine soon fizzled out, leaving a large supply of unused H1N1 vaccines. For those charged with protecting the public health, it became a “damned if you do, damned if you don’t” situation. It was either too little or too much.
An AFP article reports that WHO influenza chief Keiji Fukuda told the Review Committee that the internet had a disruptive impact on handling of the pandemic by fanning speculation and rumors, even while being an effective tool for bringing news and information to people around the world. The internet, as always, is a conduit for both useful and confusing information. Using the media to disseminate critical health information is something that certainly must be addressed and improved.
As of this writing, the Centers for Disease Control reports that flu activity in the U.S. is low nationally; however some southeastern states continue to report regional activity, and most flu cases are H1N1. Internationally, H1N1 is still circulating, including in the southern hemisphere, which is about to enter its flu season. Activity is highest in parts of southeast Asia, western Africa, and the tropical regions of the Americas.
It will take a year or two after the pandemic is declared officially over before final death rates and the effectiveness of vaccines can be measured. The review panel’s final report on the handling of the pandemic is due by January 2011.
The Associated Press is reporting that the head of the Review Committee said that some members of the panel would inevitably be biased because of their close links to WHO or national governments. At least ten panelists flown in by WHO are past or current advisers to the organization. Twenty four members of the panel are government employees. Harvey Fineberg, president of the Institute of Medicine in Washington, said the 29-member panel will try to expose conflicts of interest and recusing members from specific discussions.
Related Reading: Care2 Swine Flu Project
Photo: U.S. Centers for Disease Control and Prevention