Keiji Fukuda, the WHO’s top influenza expert, on Monday said the organization did not effectively communicate the uncertainties of the H1N1 (swine flu) virus, which led to confusion worldwide, Reuters reports. “The reality is there is a huge amount of uncertainty (in a pandemic),” Fukuda said during an address to 29 external experts tapped to review the WHO’s response to H1N1. “I think we did not convey the uncertainty. That was interpreted by many as a non-transparent process,” Fukuda said (Nebehay, 4/12).

Fukuda acknowledged the six-phase system the WHO uses to assess a pandemic, which is based on “the geographic spread of a virus but not its severity” heightened public confusion, the Daily Mail reports. “Confusion about phases and level of severity remains a very vexing issue,” Fukuda said (4/13).

“The WHO probe was set up following accusations that the agency-led international reaction to A(H1N1) influenza, including a pandemic declaration last June, was overblown and may have been tainted by commercial interests,” Agence France-Presse reports. “Panel members and officials said that sporadic outbreaks of more lethal bird flu had boosted pandemic preparations, including stronger International Health Regulations enforced in 2007 and the stockpiling of anti-viral drugs before swine flu appeared,” AFP writes.

Experts say “the 60 percent death rate for H5N1 bird flu had also raised expectations about the severity of a new pandemic virus.” Such expectations, in turn, led to public skepticism when H1N1 “turned out to be far less lethal even though the WHO had declared a pandemic,” AFP writes. The news service notes that leaders discussed the need “for a reassessment of the flu alert phases and severity criteria, and the need for consistent and clear communications.”

“It wasn’t that mild when you see the number of deaths in the young, but the customer expected it to be much more severe,” said Australian infectious diseases expert John Mackenzie, who AFP writes “has been closely involved in determining the response to the swine flu pandemic.”

Delegates from India and Kenya at the meeting “urged the panel to consider obstacles for poor countries’ access to medicines and vaccines, noting that rich countries had priority on pandemic orders because of their wealth,” the news service writes (Capella, 4/12). To date, 31 poorer countries including Afghanistan, Cuba, Kenya and Myanmar have received limited supplies of vaccine donated by drug companies and Western countries, via the WHO,” Reuters writes.

H1N1 has killed 17,770 people in 213 countries, since April 2009, according to the WHO, Reuters adds (4/12).

“Populations around the world have very high expectations for immediate information,” Fukuda said, Canwest News Service/Montreal Gazette reports. “In many ways it is unforgiving out there” (Fitzpatrick, 4/13).