# 3236
The debate over whether to declare this outbreak of H1N1 to be a pandemic continues between member nations of WHO gathered in Geneva this week, with political and economic considerations apparently taking precedence over established (and presumably science based) criteria.
Declan Butler of Nature editorializes for us on this debate (follow the link to read it in its entirety).
When is a pandemic not a pandemic?
Arguments about the pandemic status of swine flu are a distraction from tackling the outbreak, warns Declan Butler.
As the influenza A (H1N1) swine flu virus fans out across the globe, there can be little doubt that we are already in the early stages of a flu pandemic. Nonetheless, there is considerable resistance to calling it a pandemic.
On 29 April, the World Health Organization (WHO) moved its assessment of the pandemic threat to phase 5 on its six-point scale, indicating that the new virus had caused "sustained community level outbreaks in two or more countries in one WHO region".
And that is where the threat level has sat ever since — one point short of official global pandemic status. The current definition of phase 6 requires that there are "sustained community level outbreaks in at least one other country in a different WHO region". That criterion will almost certainly be met sooner or later.
Yet this week Margaret Chan, director-general of the WHO, came under pressure from member states — including the United Kingdom and Japan — to move the goalposts to delay or prevent a move to phase 6, by redefining it to include an assessment of the severity of the disease, and not only its geographical spread.
Adding that requirement of severity may sound like common sense. But it is not, because the severity of a pandemic is unpredictable. The flu might fizzle out; or it could go away for months only to come back with a vengeance, creating as much devastation as the 1918 flu outbreak, which caused an estimated 50 to 100 million deaths worldwide.
