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Resolution 1749 (2010) Final version
Handling of the H1N1 pandemic: more transparency needed
1. The Parliamentary Assembly is alarmed
about the way in which the H1N1 influenza pandemic has been handled,
not only by the World Health Organization (WHO), but also by the
competent health authorities both at the level of the European Union
and at national level. It is particularly troubled by some of the
consequences of decisions taken and advice given leading to the
distortion of priorities of public health services across Europe,
the waste of large sums of public money and unjustified fears about
health risks faced by the European public at large.
2. The Assembly notes that grave shortcomings have been identified
regarding the transparency of decision-making processes relating
to the pandemic which have generated concerns about the possible influence
of the pharmaceutical industry on some of the major decisions relating
to the pandemic. The Assembly fears that this lack of transparency
and accountability will result in a drop in confidence in the advice given
by major public health institutions. This may prove disastrous in
the case of a next disease of pandemic scope, which may turn out
to be much more severe than the H1N1 influenza.
3. The Assembly recalls its previous work on good governance
in the public health sector in Council of Europe member states,
in particular Recommendations 1725
(2005) on Europe and bird flu – preventive measures in
the health field and 1787
(2007) on the precautionary principle and responsible
risk management. In Recommendation 1908 (2010) on lobbying in a democratic
society (European code of conduct on lobbying), the Assembly noted
that unregulated or secret lobbying may be a danger and undermine
democratic principles and good governance.
4. On a positive note, the Assembly welcomes the review and evaluation
processes regarding the handling of the H1N1 crisis recently launched,
or about to be launched, by WHO, European institutions dealing with health
issues and a number of national governments and parliaments. The
Assembly urges all parties concerned to continue and reinforce dialogue
between public health institutions at all levels and to hold more regular
exchanges on good governance in the health sector in the future.
5. Notwithstanding the willingness of WHO and the European health
institutions concerned to enter into dialogue and conduct a review
of the handling of the pandemic, the Assembly seriously regrets
that they have not been willing to share some essential information,
in particular to publish the names and declarations of interest
of the members of the Emergency Committee of WHO and relevant European
advisory bodies directly involved in recommendations concerning
the handling of the pandemic. Furthermore, the Assembly regrets that
WHO has not moved swiftly to revise or re-evaluate its position
on the pandemic and the real health risks involved, despite the
overwhelming evidence that the seriousness of the pandemic was vastly
overestimated by WHO at the outset. In addition, the Assembly regrets
the highly defensive stance taken by WHO, whether in terms of being
unwilling to accept that a change in the definition of a pandemic
was made, or an unwillingness to revise its prognosis on the pandemic.
6. In the light of the widespread concerns raised over the handling
of the H1N1 pandemic, the Assembly calls on public health authorities
at international, European and national level – and notably WHO
– to address in a transparent manner the criticisms and disquiet
raised in the course of the H1N1 pandemic, by:
6.1. reviewing the terms of reference
of their general governance bodies and special advisory bodies wherever
appropriate with a view to ensuring the utmost transparency and
the highest level of democratic accountability regarding public
health decisions;
6.2. agreeing in a transparent manner on a common set of definitions
and descriptions concerning influenza pandemics, involving a cross
section of expertise, in order to generate a coherent worldwide understanding
of such events;
6.3. revising and updating existing guidelines on working with
the private sector or preparing such guidelines where they are lacking,
in order to ensure that:
6.3.1. a wide range of expertise
and opinions is taken into account, including contrary views of individual
experts and opinions of non-governmental organisations;
6.3.2. declarations of interest of experts involved are made
public without exception;
6.3.3. collaborating external organisations are obliged to indicate
their links with key opinion leaders or other experts likely to
be subject to the risk of conflicts of interest;
6.3.4. all persons subject to conflicts of interest are excluded
from sensitive decision-making processes;
6.4. improving communication strategies related to public health
matters by taking into account the current social context marked
by a high level of access to new technologies and by closely collaborating with
the media in order to avoid sensationalism and scaremongering in
the public health domain;
6.5. preparing and refining the ground for the proper use of
the precautionary principle in health matters in the future, including
through the preparation of fully transparent communication strategies
and accompanying education and training measures;
6.6. sharing the results of H1N1 influenza pandemic review
processes in the most transparent and comprehensive manner possible
amongst all stakeholders concerned, including WHO, the European institutions
(the European Union and the Council of Europe), national governments
and parliaments, non-governmental organisations and the European
public as a whole, in order to learn from this experience, to ensure
that responsibility is taken for any errors made, and to re-establish
confidence in public health decisions and advice.
7. The Assembly furthermore invites WHO, and, where appropriate,
the European health institutions concerned, to engage in more regular
European exchanges on the issue of good governance in the health sector
by:
7.1. participating in more regular
debates on topics related to good governance in the health sector within
the Parliamentary Assembly;
7.2. actively contributing to the intergovernmental work undertaken
at Council of Europe level on good governance in the public health
sector.
8. The Assembly also calls on member states to:
8.1. make use of their means of democratic
control through the internal governance systems of WHO and European
institutions, with a view to ensuring that this resolution is properly
implemented;
8.2. launch critical review processes at national level if
they have not yet done so;
8.3. develop systems of safeguards against undue influence
by vested interests if they have not yet done so;
8.4. ensure stable funding for WHO;
8.5. consider establishing a public fund to support independent
research, trials and expert advice, possibly financed by an obligatory
contribution from the pharmaceutical industry;
8.6. ensure that the private sector does not gain undue profit
from public health scares and that it is not allowed to absolve
itself of liabilities with a view to privatising profits whilst
sharing the risks. In order to avoid this, member states should
be ready to develop and implement clear national guidelines for dealing
with the private sector and to co-operate with one another in negotiations
with international corporations whenever necessary.
9. The Assembly invites national parliaments to support national
policies aimed at the improvement of governance systems in the public
health sector and ensure that they are involved in relevant national
review and policy-making processes in order to guarantee the highest
democratic accountability possible.
10. Finally, the Assembly invites the pharmaceutical industry,
including corporations and associations, to revise their own rules
and functioning regarding co-operation with the public sector in
order to ensure the highest degree of transparency and corporate
social responsibility when it comes to major public health matters.