Chan hits back at WHO critics

The head of the World Health Organisation hit back at critics who have accused it of over-reaction to the swine flu crisis, warning it may comeback “with a vengeance” in the months ahead.

In her first extensive media interview since alerting the world to a possible flu epidemic 9 days ago, Margaret Chan, the agency’s director-general, told the Financial Times that the end of the flu season in the northern hemisphere meant an initial outbreak could be milder but then a second wave more lethal, as happened in 1918.

New information from Mexico indicated the affect of the flu could be less than at first believed. José Angel Cordova, health minister said the flu virus epidemic had passed its peak and was waning. “The evolution of the epidemic is now in its phase of decline,” he said.

The Mexican government, which had already scaled back its first count of 176 deaths, said 19 of the suspected 100 deaths from the H1N1 virus had been confirmed.

But Ms Chan warned that an apparent decline in mortality rates outside and within Mexico didn't intend the pandemic was ending.

“We hope the virus fizzles out, because if it doesn’t we are heading for a big outbreak.” But she said: “I’m not anticipating the pandemic will amplify, but if I miss it and we don’t prepare, I fail. I’d rather over-prepare than not prepare.”

She emphasized that a likely increase to the agency’s maximum “level 6” pandemic alert didn't needfully mean “every country and all humans will be affected” with many more deaths.

Instead “it is a sign to public health agencies to take suitable steps” such as intensified disease surveillance.

Ms Chan admitted frustration with slow release of information on the threat posed by the virus. But she defended Mexico as very co-operative but overwhelmed by extending treatment and limiting the spread of infection as well as analyzing cases. She added: “The data is starting to roll in.”

“These countries are so overwhelmed. Other countries may anticipate a lot of information now. But people need to allow time for the epidemiology, laboratory and clinical data. ”

She repeated the WHO’s perspective based on “the evidence and science available to us” that travel limitations were counterproductive. Although countries had the right under international health regulations to take different measures, they would need to justify them publicly.

But she supported recent decisions such as that of Hong Kong and New Zealand to quarantine travellers arriving with suspected flu.

Ms Chan called on pharmaceutical companies to increase their contributions, praising their efforts so far but asking for fresh donations and for larger numbers of drugs and vaccines at lower costs to help care for and protect the poor.

She had released most of the WHO’s stockpile of the antiviral medicine Tamiflu provided by Roche, its manufacturer, which had already agreed to provide more and to propose lower costs.

She suggested new methods to encourage generic companies to develop inexpensive variations of Tamiflu to expand capacity.