Vaccination instead of information

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The vaccination campaign during the 2009 Mexican flu epidemic was a run-away train nobody dared jump off. The World Health Organisation used spurious arguments to set the train in motion, at least, that is the conclusion Dutch investigative journalist Daan de Wit draws in his recently published book Dossier Mexicaanse Griep, which will be officially presented on Thursday.

Mexicans wearing surgical masks and closed public places; those were the first images of the Mexican flu epidemic - which was still called swine flu at the time - to be sent around the world in February 2009. Three months later the World Health Organisation declared a pandemic.  A global epidemic which could potentially claim the lives of hundreds of thousands of people. The WHO decided to launch a mass vaccination campaign against the H1N1 virus.

Conflict of interest
Dutch journalist Daan de Wit investigated the authorities' choice in favour of vaccination instead of information, and the interests that motivated that choice. Mr De Wit describes in detail how during the summer of 2009,  the northern hemisphere was in a position to predict the consequences of the flu epidemic by studying the situation in the wintry southern hemisphere, where health ministries reported that the Mexican flu caused relatively mild symptoms. There was still time to choose a different strategy, but strong ties between the WHO and the pharmaceutical industry prevented that.

“And then you see the influence of the pharmaceutical industry on the emergency committee created to fight the Mexican flu. Eighteen months later, it became clear that one third of the committee members had ties to the industry. More than half the experts on the Scientific Advisory Group for Emergencies (SAGE), an influential group advising the WHO on vaccination, had ties to the pharmaceuticals. Every time, in all kinds of fields, there is that connection.”

‘Inevitable ties’
Virologist Ab Osterhaus of the Erasmus University Medical Centre in Rotterdam, which played a prominent role in the Netherlands during the pandemic, said this type of criticism was dangerous, even though he understood what gave rise to it. Mr Osterhaus, who himself has ties to the pharmaceutical industry, argues that these ties are inevitable.

“It is vital that the WHO should receive sound advice. We as scientists need to be closely involved. Governments no longer produce drugs and vaccines, the pharmaceutical industry does. So it has to work closely together with the science community in public-private partnerships.”

However Mr Osterhaus would not say whether he believed these partnerships were sufficiently transparent. He said a currently ongoing evaluation will have to pass judgment on the issue. The Dutch virologist said he himself had always been very open about his ties to the industry. Mr Osterhaus rejected the notion that H1N1 was just a mild flu. He argues that the southern United States and Latin America did face serious problems. “I still support the measures taken by WHO at the time.”

‘Never took a step back’
And yet investigative journalist De Wit says the conflict of interest was key. He argues that the definition of what constitutes a pandemic was relaxed as the result of pressure from vaccine-producing companies, clearing the way for the eventual vaccination campaign. No one ever took a step back to see whether the campaign - which involved an experimental vaccine - was really necessary.

"There were people who sought more information on the vaccines and its ingredients, but they were systematically opposed by the Dutch government, even though it has a sworn duty to inform its citizens so they can decide for themselves whether they should get vaccinated. This was a vaccination campaign instead of an information campaign"

Ab Osterhaus calls Daan de Wit’s allegations regarding the relaxation of definitions absurd. “This was a global infectious disease. You just cannot wait and see whether the virus is dangerous. You need to vaccinate.” The virologist adds that five studies proved the safety of the additives.

European solidarity
According to Mr Osterhaus, the lesson to be learned is that the distribution of vaccines must change.

“I am greatly concerned about the issue. We need to ensure that it’s not just six or seven countries in Western Europe which have adequate supplies, but that they must be distributed in European solidarity, and that’s not even mentioning the rest of the world. It never happened, even though the issue was discussed before the pandemic broke out.”

Investigative journalist Daan de Wit is taking things a step further. He is hoping his book will lead to a parliamentary inquiry, which will leave no stone unturned.