As outbreaks of H1N1 pandemic influenza continue to erupt in parts of the world and the possibility that a third wave later this winter or next could involve a potentially more virulent strain, the World Health Organization (WHO) and global public health authorities are having to fend off  “absurd” charges that the pandemic was manufactured for the economic benefit of the pharmaceutical industry.

Some European officials, led by Dr. Wolfgang Wodarg, a German physician and politician who chairs the Council of Europe's health committee, have alleged that pharmaceutical companies deliberately conspired with scientists with financial interests in the businesses to exaggerate concerns about the pandemic in order to scare governments into buying unnecessary stockpiles of vaccines – vaccines every public health official HSToday.us interviewed said were responsible for thwarting what could have been a far more serious pandemic had the vaccines not been available.

“Inestimable lives have been saved because of the vaccines,” one top official said, downplaying the naysayers as being “out of touch with reality … even science.”

"We don't know how much these efforts have helped to mitigate the overall effect of the pandemic, but we firmly believe that these efforts should not be discounted,” said Dr. Keiji Fukuda, WHO’s top pandemic expert.

Indeed. As HSToday.us has reported, the pandemic so far has been rendered mild compared to earlier pandemics because of the years of work governments put into preparing for a potentially much more deadly H5N1 avian influenza pandemic, coupled to the global initiatives to vaccinate the populations who are most at risk to H1N1 infection and the application of antivirals in cases involving H1N1-stricken persons who haven't been vaccinated.

"There are reasons why the H1N1 pandemic hasn’t been as severe as some might have perceived it would be given our early concerns about it,” a senior government public health official told HSToday.us.

Authorities said the vast numbers of people who got vaccinated and continue to do so have helped to reduce the spread of the H1N1 flu virus, which has lessened the growth and impact of the pandemic.

“It’s not rocket science,” a clearly angered senior government public health official told HSToday.us. He said the pandemic “undoubtedly” would have been far worse “had we not so quickly worked to get vaccines and to warn peoples around the world about the necessity of getting vaccinated. This could have gone down in a very bad way; it could have been a much more deadly pandemic. These clowns who are saying the pandemic is fake or is a conspiracy are completely out of touch with reality and science … they’re wingnuts, pure and simple – they need to be vaccinated with a reality shot, or something!”

"I believe we would all rather see a moderate pandemic with ample supplies of vaccine than a severe pandemic with inadequate vaccine," said WHO Director-General Margaret Chan.

In Australia, where experts are warning that another wave of H1N1 is possible, a study concluded that Australia's public health system failed to prevent the H1N1 pandemic there last year, emphasizing that had the pandemic consisted of a much more virulent virus, there would have been mass casualties and a collapse of the nation’s health care system.

Nevertheless, the Council of Europe, an organization of 47 nations, said last week that the charges pushed by Wodarg will be on the agenda when its Parliamentary Assembly meets in Strasbourg, France later this month. The Assembly's Social Affairs Committee has asked for a debate, called "False Pandemics: A Threat to Health," according to a statement by the panel.

“What’s a threat to health are the idiots pushing this notion that this pandemic was manufactured solely so that vaccine manufacturers would get these big contracts in response,” said an official who spoke on condition of anonymity because of the politically sensitive nature of his job.

In response to the allegations by Wodarg and his supporters, WHO rejected the allegations that it over-hyped a “fake” A/H1N1 pandemic. WHO officials emphatically stressed that they have not overplayed the risks of H1N1, which HSToday.us has regularly been reporting on.

"The world is going through a real pandemic. The description of it as fake is both wrong and irresponsible," said Dr. Keiji Fukuda, WHO’s top pandemic expert, stressing WHO "has not underplayed or overplayed the risks of the pandemic."

"WHO has reached out to all parties who could help to reduce the harms of the pandemic. We did take very great care to make sure that its advice received and not unduly influenced by commercial or non-public health interests," Fukuda said.

And the pandemic is not over, yet, authorities stressed. A third wave of H1N1 infections is still possible.

"Pandemic infections are occurring in many countries but overall the pattern is decreasing," said Fukuda, who warned  that a new wave of infections could strike the northern hemisphere in late winter or early spring. “We simply do not know."

“And we’d be derelict if we hadn’t prepared for this possibility,” said a top government public health official, who noted that H1N1 could still mutate into a more virulent virus, “or, God forbid, reassort with the H5N1 [flu] virus resulting in a completely new strain the lethality of which we have no way of knowing what it might be like … We have to be prepared.”

Dr. Gregory Poland, director of the Mayo Clinic's Vaccine Research Group, told CIDRAP News that the claims of Wodarg and his supporters are "preposterous … The idea that pharmaceutical companies made official agencies squander their resources is ludicrous. Vaccine stockpiles are like insurance policies. You're talking about the health and welfare of entire nations."

"Authorities are obligated to prepare for the worst and hope for the best," Poland said, adding that Wodarg's position "impl[ies] a profound lack of insight into public health emergency planning.”

“And science,” added one of the senior government pandemic preparedness officials told HSToday.us.

Poland agreed that that would take one small mutation in the virus to cause it to create a more virulent pandemic.

Dr. David Salisbury, director of Britain’s immunization program, told the Guardian that it’s because of the possibility of a third wave of H1N1 infections or a more lethal pandemic because of a mutated H1N1 virus that the government must maintain a stockpile of vaccinations. "If there were a UK resurgence during 2010, we would look very foolish if we had disposed of a valuable stockpile," he said.

Michael Osterholm, a noted infectious disease expert and director of the University of Minnesota's Center for Infectious Disease Research and Policy, publisher of CIDRAP News, said all the talk about collusion between governments and vaccine makers to profit from a “fake” pandemic is “absolutely irresponsible and plain nonsense.”

"Unfortunately, it's very easy to make charges like this, which not only undermine the overall ability to respond in the future, but also give the public the sense that public health intentionally exaggerates these potential situations for resources," Osterholm said, adding, "I worry that if these companies end up taking a major economic hit or are brought before a court of public opinion that they'd have every reason to be reluctant in the future to put resources forward for a pandemic vaccine.”

Osterholm stressed that "we've not written the final obit on this pandemic yet. I think many of these officials [who are criticizing the response now] would be questioned if we had a severe third wave. I guarantee that if we have a severe third wave, there won't be a drop of vaccine left."

And it’s because there is a surplus that governments and public health authorities are breathing a sigh of relief.

“We’ll have this surplus stockpile in place if a third wave of H1N1 hits,” one of the officials said who talked to HSToday.us.

Presently, H1N1 continues to be active in North Africa, South Asia and parts of Europe, according to WHO. Nepal and Sri Lanka also are still experiencing widespread transmission.

"Pandemic H1N1 2009 virus continues to be the predominant circulating influenza virus in the European region with only sporadic detections of seasonal influenza viruses," WHO said.