The Pharmaceutical Journal
Vol 278 No 7451 p546
12 May 2007

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WHO criticised for being too reliant on expert opinion

The World Health Organization has been criticised for being too reliant on expert opinion when it formulates policy. The criticism coincides with an initiative it has launched to improve data sharing among researchers, health care professionals and the public.

Writing in the online version of The Lancet (9 May 2007), Andrew Oxman, of the Norwegian Knowledge Centre for the Health Services, Oslo, and John Lavis, of the Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, Canada, call on the WHO to make more use of systematic reviews of relevant research when developing its policies and recommendations

The two researchers interviewed WHO department directors (or their delegates) to find out how WHO recommendations are developed. They also reviewed a sample of WHO reports containing recommendations. “Expert committees or meetings of experts were almost always convened when developing recommendations whereas only a few directors mentioned having commissioned systematic reviews to inform the work of these expert groups,” the researchers say. This approach to developing recommendations goes against WHO’s own guidelines for developing recommendations, they add.

In response, Tikki Pang, of the WHO’s department of research policy and co-operation, and Suzanne Hill, of its medicines policy and standards unit, concede that WHO practices might be less than optimal. They note that a guidelines review committee, to provide support to WHO departments developing recommendations, has been proposed and that continuing education in guidelines development should be offered to WHO staff. “Basing guidelines on explicit and transparent consideration of the best evidence is crucial to WHO’s international credibility, standing and reputation,” they say.

The concerns over the WHO’s approach to policy development were raised at the same time as the WHO launched an initiative to improve data sharing. Its Clinical Trial Search Portal will act, the WHO says, as an entry point into high quality clinical trial registers with global search functions.

“The Clinical Trial Search Portal is a collaborative international initiative led by WHO that facilitates the identification of all clinical trials, regardless of whether or not they have been published,” explained Tim Evans, assistant director general, information evidence and research, WHO. “The portal represents an enormous step towards greater access, transparency and accountability of health research globally,” he added.