The World Health Organization (WHO) has come under fire after an internal email surfaced showing that a pharmaceutical lobbying group had access to a confidential draft report on the financing of drug research and development. WHO officials have defended the integrity of its decision process, but critics say that a clear industry bias has tainted the agency's commitment to the developing world.

“I find this incredibly disturbing,” says Tido von Schoen-Angerer, director of the campaign for access to essential medicines at Médecins Sans Frontières (Doctors Without Borders) in Geneva. “It's a clear indication that [big pharma] had room to influence the report.”

The WHO established an expert working group in November 2008 to assess nearly 100 proposed ways to encourage research and access to medicines for diseases affecting the developing world. Last year, the 24-member panel met several times in person, held two web-based public hearings and prepared a report that the group planned to present at the World Health Assembly in Geneva in May.

Confidential parts of that report, however, seem to have fallen into the hands of the International Federation of Pharmaceutical Manufacturers & Associations (IFPMA), a Geneva-based lobbying group that represents top drug makers including Pfizer, Novartis and GlaxoSmithKline. A dossier posted in December on Wikileaks, a website that anonymously publishes sensitive information, included the draft report, a comparative analysis of the submitted proposals and three internal IFPMA documents.

“We received this document confidentially and we would kindly advise you to not share it outside of our industry network,” an undisclosed sender wrote to the IFPMA's public health advocacy committee in an email dated 1 December 2009. The email goes on to call the report “in line with most of the industry positions,” before noting that the IFPMA will keep monitoring the WHO's progress “should any input be requested from friendly [working group] members.”

For many critics, this suggests that the foul play runs deeper than just a sneak peak of private documents. With public policy groups voicing dismay that they were kept away from the negotiating table, industry may have had an undue and undisclosed role in quashing promising proposals that would challenge its business model. “The leaked email gives the impression the IFPMA had a firm hand on the process,” says Sophie Bloemen, European projects officer for Health Action International, an Amsterdam-based policy advocacy group.

“This committee that was created was a step backwards,” adds James Love, director of Knowledge Ecology International, a Washington, DC–based group pushing for intellectual property reform. He says that the working group was, by design, too supportive of big business. “It was old school; it was status quo; it was antichange.” Bloemen agrees, saying that there was no transparency in how the experts were selected for the group.

WHO dunnit: Ill-gotten report mars health agency Credit: Yann Forget

But working group member and report coordinator Mary Moran, a health policy expert at the George Institute for International Health in Sydney defends the credibility of the report. She maintains that she was not personally pressured by the IFPMA, that none of the other expert panelists voiced unexpectedly pro-industry views during their meetings and that a range of stakeholders were consulted during the preparation of the report. One working group member, who asked to remain anonymous, speculates that the IFPMA email was a self-serving attempt to make the lobbying group seem more impressive to its associated member companies. IFPMA officials declined to comment for this story.

Following the leak, the working group released its now finalized report on 15 January. It endorses 11 ways to increase investment, better allocate funds and lower the costs of innovation for diseases common in the developing world. These include a new consumer tax on consumer goods, cash prizes and the harmonization of regulatory pathways. It also includes a tax on pharmaceutical companies that had been included in the leaked draft report but not in a public summary of the group's work released in late December.

WHO officials say they are now investigating who was behind the leak. A WHO spokeswoman says that although disciplinary action will be taken against any internal staff who acted as moles, there are likely to be few options for recourse if the leaks came from independent working group members.

Regardless of IFPMA's actual role, the damage to the credibility of the working group and its report has already been done. Without the controversy, WHO member states would probably have rubber stamped the report's recommendations when it gets tabled in May, says Moran. But now, “I'm not sure that will happen anywhere near as quickly, or perhaps not even happen at all.”