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Wow.  It has been more than two months since my last blog entry.  that must mean that H1N1v, or swine flu, is gone, right? 

No. It means I am incredibly busy these days, and have not had much to say about pandemics nor about infectious disease.  Well, that is not entirely true.  For example, dengue fever has established a beachhold in Key West, Florida, where a Navy person recently was confirmed to have contracted dengue from within Key West's city walls. 

Also, and as most of us surmised, swine flu is still worming its way through the developing world.  India seems to be under the gun with outbreaks of H1N1v, and I am not sure what the genetic makeup of this new virus might be. 

Additionally, recent reports regarding testing of the H1N1 vaccine on mice and subsequent attempts at infection with 1918 Spanish flu are encouraging.  It appears that there is some conferred immunity from the 1918 pandemic virus with the H1N1 swine flu vaccine.  This is important, because if you recall from reading this Blog, the 1977 recurrence of H1N1 was believed to be the result of a Soviet lab accident.  So this pandemic may have been serendipitous in that it is helping immunize the planet against another Spanish Flu. 

Anyway, the article that prompted me to write this blog actually deals with the WHO analysis of itself.  The WHO has been the subject of much scrutiny as the result of what has been to date, a very mild pandemic.  Some are inferring that Big Pharma actually orchestrated this pandemic in order to make a lot of money on vaccine and antivirals.

Believe me, Big Pharma has more and bigger things to make money on than vaccines.  Anyone who really believes Big Pharma would drop everything it was doing to go and make vaccine just does not understand how drug companies make their money today.  Druf companies see vaccine production as a necessary evil; a component of what they do, but not nearly as profitable as making and selling drugs dealing with everything from erectile dysfunction to hair loss.  

In fact, accusing drug makers of profiting unnecessarily from vaccine production may actually cause drug makers to forego vaccine production in the future.  Now some, including those misguided but WRONG individuals who think vaccines cause autism, might rejoice in that thought.  But the simple truth is that drug companies see vaccine production as an important public health duty.  And accusing them of orchestrating an overly aggressive response to a flu pandemic is placing blame in the wrong place.

Is there a right place to place blame?  In my opinion, no.  There is no blame.  The WHO acted correctly.  Now there are protocol adjustments to make, and my previous blogs have covered the principal problems, dealing with severity.  The WHO needs to adopt the US "Saffir-Simpson" standard for pandemic severity.  I am sure that concept will get an airing and eventual adoption. 

But the absolute best news I gleaned from today's article about the WHO oversight committee deals with the committee itself.  First, the AP story of today: 

2 experts resign from WHO swine flu review panel

(AP) – 1 hour ago

GENEVA — The World Health Organization said Tuesday that two members of an expert panel reviewing the global body's response to the swine flu outbreak have resigned over concerns about perceived conflict of interest.

John MacKenzie and Tony Evans stepped down because their close association with the UN health organization during the outbreak could be seen as conflicting with the panel's ability to remain independent, WHO said.

"Both have been closely engaged in deliberations at WHO which our committee is charged to review," said panel chairman Harvey Fineberg. "They each concluded it would be better to avoid the position as reviewer of their own earlier actions."

Mackenzie, a professor of tropical infectious diseases at Curtin University in Australia, and Evans, medical chief of the Montreal-based International Civil Aviation Organization, were on the emergency committee that advised WHO's Director-General Margaret Chan before she declared swine flu a pandemic.

WHO convened the panel in April to conduct a "credible and independent review" of how it and national authorities handled the outbreak. Concerns were raised at the time that several panel members were trusted WHO advisers and government employees who could end up whitewashing any failures.

The review panel will present a final report next year.

Harvey Fineberg is Dr. Harvey Fineberg, head of the Institute of Medicine in Washington, DC.  He also is the former head of the Harvard school of public health, and former Harvard provost.  But to flubies, Harvey is best-known as the co-author of the seminal study of the 1976 swine flu debacle, along with the late historian Richard Neustadt.  Harvey is also a pen pal of mine, and I engage him occasionally as a sounding board for ideas that, depending on his thoughts, eventually appear here as blogs.

Harvey may be the most-qualified person in the world to assess the WHO's handling of the 2009-10 swine flu pandemic.  His 1976 study should be required reading for anyone who is interested in public policy when it comes to public health and infectious disease policy.  I am equally certain his committee's analysis of the WHO's conduct during this latest pandemic will also be compelling reading.