May 18, 2009 (CIDRAP News) – As the World Health Organization (WHO) convened its annual meeting today, several countries urged the agency to use caution in weighing whether to declare a full-scale pandemic, despite signs that the novel H1N1 influenza virus is now spreading in Japan.WHO Director-General Dr. Margaret Chan seemed to signal that she was listening to the suggestions that the agency go slow on raising its pandemic alert from the current phase 5 to phase 6, according to the text of her address at the World Health Assembly (WHA) in Geneva.”I have listened very carefully to your concerns this morning,” Chan said. “As the chief technical officer of this organization, I will follow your instructions carefully, particularly concerning criteria for a move to phase 6, in discharging my duties and responsibilities to member states.”With the novel H1N1 virus spreading widely in the United States and Mexico, the current pandemic alert level is phase 5, meaning community outbreaks are occurring in more than one country in one WHO region.But cases in Japan jumped from 4 to 129 over the weekend, signaling possible community spread in a second region. In the current WHO system, that would mean it’s time to declare phase 6, a full-scale pandemic.”We remain in phase 5 today,” Chan said in her address. “The virus may have given us a grace period, but we do not know how long this grace period will last. No one can say whether this is just the calm before the storm.”WHO officials last week emphasized that the pandemic alert phases are based on how widely a virus is spreading, not on how severe the illness is or how great the possible impact on society.Officials worry about sowing panicAt today’s opening WHA session, China, Britain, Japan and other countries urged the WHO to be cautious about declaring a pandemic, expressing concern that the move could lead to panic and confusion, the Associated Press (AP) reported.British Health Minister Alan Johnson was the leading voice for caution, according to the AP. He warned that moving to phase 6 could unnecessarily trigger costly and risky actions such as switching from production of seasonal flu vaccine to pandemic vaccine, even though the virus so far seems mild.Johnson asserted that a pandemic declaration should in part reflect the severity of the disease, not just its geographic extent, the AP reported. “It’s very important that that’s reflected in your ability as to whether to move from 5 to 6,” he said. “So I would like to propose that you have more flexibility in that rather than follow a mechanistic process.”Johnson was backed by New Zealand, Switzerland, and the head of the Pan American Health Organization, according to an Agence France-Presse (AFP) report.According to a Reuters report, Chan replied to Johnson, “You are requesting me before we move to phase 6 to put in place other factors to consider. I take on board your request to me but I would like to get guidance and advice from other member states on how we move forward.”Mexico, which has had the most deaths from the new virus, was also among the countries urging the WHO to move slowly, according to the AP report.”People don’t understand what [phase] 4, 5, or 6 means,” Mexican Health Minister Jose Angel Cordova said. “They think that when you go to a higher level things are worse.”AFP reported that the WHO advised vaccine manufacturers that making seasonal flu vaccine should still be their priority. “We are taking double insurance. I want to make sure countries get sufficient supplies of seasonal influenza vaccine,” the story quoted Chan as saying.Protecting developing countriesBesides promising to consider the concerns expressed by Johnson and others, Chan in her prepared speech urged WHO members to do all they can to protect developing countries from “once again, bearing the brunt of a global contagion.”She observed that most of the severe and fatal infections, other than in Mexico, are hitting people with chronic health problems and added that the burden of chronic diseases has shifted recently from rich countries to poorer ones. “”Today, around 85% of the burden of chronic disease is concentrated in low- and middle-income countries,” she said. “The implications are obvious. The developing world has, by far, the largest pool of people at heightened risk for severe and fatal H1N1 infections.”She said the WHO hopes to offer advice on protecting people in vulnerable groups: “Ideally, we will have sufficient knowledge soon to advise countries on high-risk groups and recommend that efforts and resources be targeted to these groups.”Chan also noted that diarrhea has occurred in about 25% of H1N1 cases, an unusual feature for influenza. If the virus is shed in fecal matter, that would mean trouble for places with poor sanitation, such as urban shantytowns, she said.In other comments, Chan expressed concern about the chance of the new virus mixing with seasonal flu strains or H5N1 avian flu to spawn still other new strains.Noting that the novel H1N1 virus has reached the southern hemisphere, she said, “We have every reason to be concerned about interactions of the new H1N1 virus with other viruses that are currently circulating in humans.”See also: Chan’s address to the WHAMay 18 WHO news release about the opening of the WHA
Sally Bridgeland, the former chief executive of the BP Pension Trustees, is joining the UK team of Dutch governance and outsourcing advisers Avida International in October in the role of senior adviser.The firm said Bridgeland, who left the £19bn (€24bn) UK corporate pension fund at the beginning of April, would “support Avida in shaping its services to expand its footprint in the UK pension fund market”.Commenting on why she had decided to take on the role at Avida, Bridgeland said: “I’ve been impressed by the investment governance expertise Avida can bring to bear and look forward to working with them.”She said the UK institutional investment market was set for big changes as it continued to mature. “There is a lot we can learn from how the Dutch have tackled the associated challenges,” she added.Bridgeland joined BP Pension Trustees in 2007 after working at Aon Hewitt and its predecessor Bacon & Woodrow for 20 years.She has non-executive roles at EDHEC, FTSE and the Worshipful Company of Actuaries. After she left the BP scheme, she said that it had been time to move on, and that she was going to talk to people in the pensions industry to see what the options were.Avida’s UK managing director Bart Heenk said the firm was delighted someone of Bridgeland’s calibre was joining the team.He said she would bring a lot of pension governance experience with her, allowing Avida to take on more projects and helping pension funds improve their operational efficiency.
But under the new plan, investment risk in the disbursement phase is to be lower than in the savings phase, and the traditional insurance currently managed by the Swedish Pension Agency (Pensionsmyndigheten) is to constitute the default’s payment option.AP7 said it agreed with proposals that an overall goal should be formulated for the whole of the default alternative, and that the investment rules should be broadened.But given that an overall goal was needed, the pension fund went on to say it was “counterproductive and surprising” that the plan involved breaking the default option into two separate products with two different principals.“This will lead to fragmentation that complicates the holistic approach and long-term view that an effective default solution needs,” AP7 said.“This will lead to fragmentation that complicates the holistic approach and long-term view that an effective default solution needs”AP7On top of this, the fund said, deciding to abandon a functioning product for an alternative where neither the parts nor the whole had been worked through entailed unmotivated risk-taking.“Risk-taking between the savings and the payment phase must be balanced and the total risk-taking needs to be adjusted to the system’s overall goal of clearly exceeding the development of the income index,” AP7 said.Splitting up the different management phases risked leading to sub-optimal decision making with insufficient regard for the whole, it said.“The consequence will then be that future pensions will be lower and that pension savers will be exposed to unnecessary risks through an abrupt transition from the savings phase to the payment phase,” the fund said.Meanwhile, the Swedish Pensions Agency, which currently manages the premium pension system’s funds platform as well as running the traditional insurance payout phase of the default alternative, said in its response to the consultation that it approved of the plan to let AP7 invest in alternatives for the first time – although the proportion of these assets suggested was too high.But it did not agree with having an overall target for the default option in the premium pension system, because in practice, it said, there would be two state default products with different purposes and designs.“We, therefore, propose two different goals that are adapted to the purpose of the saving and disbursement phase, which provides better conditions for control and follow-up,” the authority said.In other feedback, the pensions agency also said it was positive about the idea of transferring default option savers to traditional insurance automatically before disbursement.However, funds which were switched in this way should then be transferrable back to unit-linked insurance, it said.“Otherwise, the proposal entails unreasonable lock-in for pension savers,” the pensions agency said.To read the digital edition of IPE’s latest magazine click here. The largest of Sweden’s national pension funds has warned against a key element of the transformational plan to modernise its role as the default option in the premium pension system.In its response to the consultation on a proposal to reform the default provision in the first pillar system of individual accounts, AP7 said the idea of splitting the product into separate savings and payout phases risked losing sight of the whole – and ultimately reducing pensions.The memorandum “Förvalsalternativet inom premiepensionen” was published in February, and is based on a government-commissioned proposal drawn up by pensions expert Mats Langensjö.As things stand, the SEK670bn (€63.4bn) pension fund’s balanced Såfa pension product – automatically allotted to people making no active provider choice in the defined benefit premium pension – can continue from savings to payout phase.