WHO, Swine Flu and Vested Interests - A Bitter Pill to Swallow

WHO, Swine Flu and Vested Interests - A Bitter Pill to Swallow

Was it smart action by governments that kept swine flu (H1N1) in check last year? Or was it more that fears about the disease were grossly (and deliberately) exaggerated to begin with and swine flu never was the killer disease it was made out to be?

As India commences clinical trials of the first H1N1 vaccine, even as many countries are getting rid of their vaccine stockpile, the answer to those questions is no longer academic. Why?

Because documents acquired under the Danish ‘Freedom of Information Act,’ suggest the World Health Organisation (WHO) might have had a vested interest in terming the outbreak of the disease a global pandemic. Not only did a member of the WHO board receive substantial funding for his research centre from vaccine manufacturer, GSK, six other members of the WHO board on vaccines were also found to have financial ties with vaccine companies.

The question is did those links play any part in WHO declaring the disease a pandemic? Yes, says Wolfgang Wodarg, head of health at the Council of Europe. It led governments to activate ‘sleeping contracts’ entered into with vaccine companies during the earlier scare over avian flu for millions of doses of vaccine resulting in huge profits for pharma companies.

The final word is not in. But there was clearly a huge conflict of interest. In the past, too, we’ve seen how tobacco companies successfully stymied all attempts to link smoking to lung cancer by funding research studies that faithfully trotted out results that backed their position.

Closer home, conflicts of interest in the medical profession have led the Indian Medical Council to revise its 2002 regulations regarding professional conduct and ethics of doctors. While doctors can work for research projects funded by industry it enjoins them to ensure their right to publish research results in the greater interest of society by inserting a suitable clause in the agreement to do such research.

Conflicts of interest are not unique to medicine. We’ve seen such conflicts in the context of accounting majors (Enron and Arthur Andersen), rating agencies, journalists and even in politics where increasingly politicians are businessmen in their own right (think Italy’s Berlusconi, Thailand’s Thaksin Shinawatra, US’Dick Cheney, some of our own ministers and many African leaders). But to the extent the public is aware there is a potential conflict of interest that in itself acts as a check on more egregious forms of such conflict.

Unfortunately, the same cannot be said about subtler conflicts of interest in the domain of economics and finance that influence policy making. Yet such links are more insidious and can do far more damage. Take the recent financial crisis that was driven in many ways by Big Finance with vested interest in encouraging a proliferation of worthless products.

Or the still unanswered question whether the then US Treasury Secretary Hank Paulson’s ties with Goldman Sachs had anything to do with his decision not to bail out Lehman Brothers, Goldman Sachs’ arch rival; a decision that plunged the world into the worst post-war crisis.

In the Indian context we’ve seen the same conflict in the context of foreign investment banks and consultancies urging the government to open up faster, dismantle capital controls, issue sovereign bonds etc regardless of the macro consequences or the macro economic environment. Presumably with an eye on the commissions to be earned from the mandates they would win. But the conflict of interest is often not obvious to the lay public. Hence the danger!

Lord Robert Skidelsky of Warwick University puts it best. Speaking at the Bharat Ram lecture at FICCI, earlier this month he said, ‘In economics much more than in physics, the research agenda and structure or power within the profession reflects the structure of power outside it... Who finances the institutions from whom ideas spring? Who finances the dissemination of ideas — media, think tanks? What are the incentives facing producers, disseminators and popularisers of ideas even in a society where discussion is free?’

As research institutions and other players involved in the dissemination of ideas become increasingly dependent on outside, rather than taxpayer funding, and get more and more profit-oriented, those are troublesome questions; with no easy answers.

To quote Skidelsky once again, changes in facts do not directly give rise to new theories. It is how those facts are interpreted and who controls the interpretation of those facts that is crucial. In the circumstances the only safeguards are greater transparency and more tolerance for the voices of dissent.

The hidden hand (The Economic Times, 24 January 2010)