United Nations health officials claim in a new report they need nearly $1.5 billion to prevent the swine flu epidemic from spiraling into a global catastrophe.
But for a virus from which most people recover without ever being treated, not all experts are convinced swine flu merits such attention — and some critics even suspect the U.N. is using the pandemic as a convenient way to raise money.
On the sidelines of the U.N. General Assembly, World Health Organization chief Margaret Chan was meeting Thursday with other top officials to discuss the swine flu funding appeal, which was authored by WHO and two other U.N. agencies.
Experts said the global community should closely track how the swine flu money gets spent.
"When $1.5 billion is pledged, it's a reasonable question to ask about the details behind it," said Orin Levine, an associate professor at Johns Hopkins Bloomberg School of Public Health. "We should be very careful to watch where the money goes."
WHO spokesman Gregory Hartl denied WHO was using the H1N1 swine flu virus as a pretext for fundraising and said the appeal was a necessary response to the global health emergency.
"If we don't try to fund H1N1, we would be remiss in our public health responsibility to the world," he said.
In the U.N. funding appeal, the agency says nearly 80 percent of the requested money would be used to buy antivirals and vaccines. The rest would go mostly to "strengthening country readiness."
Influenza viruses like swine flu are unpredictable. Since the H1N1 virus first emerged in spring, experts have worried it might mutate into a more lethal form.
So far, those fears haven't panned out. Experiments at the U.S. Centers for Disease Control and Prevention showed swine flu lacks certain traits to help it easily morph into a more dangerous version.
Hartl said even if the virus doesn't turn deadlier, the agency expects to see a spike in cases that might crush health systems in poor countries. "There are a lot of signs that we need to take this seriously," he said.
3,500 have died so far
Globally, WHO estimates more than 3,500 people have died of swine flu — far fewer than those killed by diarrhea, pneumonia, or road accidents. That leads some experts to contend that WHO's prediction the virus could lead to "civil disruption" in poor countries may be overblown.
A sum of $1.5 billion is a lot to ask for considering swine flu is unlikely to be one of the world's top killers, said Christopher Murray, director of the Institute for Health Metrics and Evaluation at the University of Washington.
"Given that the world spends about $22 billion on all global health problems, is it really wise to spend $1.5 billion only on swine flu?"
Some experts said WHO's funding appeal went beyond the boundaries of its mandate.
"I am concerned WHO's communications is corrupted by the fact they push the buttons in the public's brains that will raise the most funds," said William Aldis, a retired senior WHO official who worked on the bird flu crisis.
"That is incompatible with what the organization should be doing: serving the public with technically correct factual information, pure and simple."
Others accused WHO of sacrificing science for dollars.
"WHO is peddling an alarmist, unscientific agenda to raise funds," said Philip Stevens, a director at International Policy Network, a London-based think tank. "The U.N. is operating on pure conjecture that we will face anarchy and chaos in the developing world should the virus mutate," he said.
HIN1 overshadowing other pressing problems?
In countries where health systems are too weak to effectively mass distribute antivirals and vaccines, some experts questioned WHO's spending plan, particularly since most of the money will benefit the drug industry.
"If we want to reduce the mortality that will be caused by the H1N1 pandemic, we cannot rely only on the vaccine," said Dr. Christophe Fournier of Medecins Sans Frontieres.
Aldis warned that in countries with few resources, giving people a swine flu shot might come at the expense of a vaccine for measles or diptheria.
Some experts said the U.N.'s billion-dollar swine flu appeal could overshadow other pressing health problems.
"I would prioritize other areas like maternal and child health, where the need is urgent and huge," Murray said.