New Business February 4, 2010, 5:00PM EST

Swine Flu: The Pandemic That Wasn't

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Next time, consumer outreach needs to start earlier and be more aggressive, perhaps including TV ads, says Mary Anne McCaffree, an Oklahoma City pediatrician and AMA board member. "The bottom line is, we came, we saw, but I'm not sure we conquered," McCaffree says.

Some miscues came from the WHO. It initially assumed each patient would need two shots to get protection. One dose proved adequate for adults, which meant that most European countries had enough vaccine on hand to immunize all their residents. But because of confusion and public apathy, those countries ended up protecting no more than 10% of their populations.

As for vaccine makers, Morgan Stanley analysts initially predicted the three largest—Novartis (NVS), Sanofi-Aventis (SNY), and GlaxoSmithKline (GSK)—would sell a combined $5.3 billion of vaccine during the six months ending Mar. 31. In a December report, they said actual sales may be as much as 15% lower. France has cut back its orders to Novartis and Sanofi. And on Jan. 26, Novartis' vaccine chief, Andrin Oswald, said 2010 sales of H1N1 vaccine would be less than half of the $1 billion the shot generated in 2009.

Even with infection rates dropping, many flu experts are concerned about some facets of swine flu. While mortality is low, children make up many of the victims. And even though next year's seasonal flu vaccine will likely include protection against swine flu, virulent new strains could emerge.

As scientists puzzle over epidemiological questions, the WHO has been accused of unnecessarily fanning public fears. One critic is Wolfgang Wodarg, a doctor and former German parliamentarian who is on the Council of Europe, an organization in Strasbourg, France, that promotes human rights. During a Jan. 26 council meeting, Wodarg accused the WHO of fabricating a pandemic that led to little more than revenues for the pharmaceutical industry. It was, he said through a translator, "dangerous nonsense."

The WHO's Dr. Keiji Fukuda, who also spoke at the hearing, defended the agency's response. Flu policies and responses recommended by WHO "were not improperly influenced by the pharmaceutical industry," he said in a statement. But, he added, "there is much to learn about how the world can improve its handling of such events."

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We're Not Ready

Are the surveillance systems the U.S. government uses to track diseases adequate to protect the public during a pandemic? Not exactly, conclude researchers from the RAND Corporation in an article in the journal Disaster Medicine and Public Health Preparedness. The authors examined six systems for disease monitoring and found shortcomings. In one case, for example, there was a three-month lag from when a safety issue affecting a flu vaccine was reported and when it was investigated. "Were a potential safety signal to be detected with the use of pandemic vaccine, several months would be far too long to provide the needed information to health officials or to reassure the public," the authors write.

To read the full paper, go to http://bx.businessweek.com/swine-flu/reference

Weintraub is a senior writer for BusinessWeek's Science & Technology department. Gerlin is a reporter for Bloomberg News. Doherty is a reporter for Bloomberg News. Serfino is a reporter for Bloomberg News.