Will Tamiflu recommendations change this winter?BMJ 2014; 349 doi: https://doi.org/10.1136/bmj.g6742 (Published 27 November 2014) Cite this as: BMJ 2014;349:g6742
All rapid responses
We are surprised by a statement the World Health Organization reportedly made to The BMJ. According to the article, "Nahoko Shindo, who leads the influenza and respiratory disease team at WHO … said the organisation did not currently recommend pandemic stockpiling of oseltamivir [Tamiflu] and had no guidelines for seasonal influenza."
Do the governments around the world which reportedly spent billions of dollars stockpiling the drug know this? A few weeks ago, England’s Chief Medical Officer Sally Davies told a UK Parliamentary Accounts Committee examining the UK’s Tamiflu stockpiling decision, "It is interesting that our advisers support this decision [to stockpile], as does the American CDC and the WHO." 
Somebody needs to alert the CMO that the WHO has apparently changed its mind.
In 2005, the WHO eagerly accepted the donation of 3 million courses of Tamiflu into a stockpile it would control. But if WHO does not recommend stockpiling, has it got rid of its stockpile? Throughout the last decade, WHO encouraged member countries to use antivirals in "interpandemic periods." The rationale was contained in its “Global Agenda on Influenza,” which stated: "wide scale use of antivirals and vaccines during a pandemic will depend on familiarity with their effective application during the interpandemic period. The increasing use of these modalities will expand capacity and mitigate the morbidity and mortality of annual influenza epidemics." 
If the WHO no longer in fact recommends stockpiling Tamiflu, it should provide a public explanation of why. As authors of a Cochrane review that found a the evidence demonstrating any important public health benefits to be lacking—and raised questions about the drug’s risks —and have pointed out the fact that the WHO has yet to perform an independent analysis of the clinical trial data , we think WHO needs to make its position on stockpiling clear.
 Global agenda on influenza--adopted version. Part I. Wkly Epidemiol Rec. 2002 May 31;77(22):179–82.
 Jefferson T, Jones MA, Doshi P, Del Mar CB, Hama R, Thompson MJ, et al. Neuraminidase inhibitors for preventing and treating influenza in healthy adults and children. Cochrane Database Syst Rev. 2014 Apr 10;4:CD008965.
Competing interests: TJ and PD were co-recipients of a UK National Institute for Health Research grant (HTA – 10/80/01 Update and amalgamation of two Cochrane Reviews: neuraminidase inhibitors for preventing and treating influenza in healthy adults and children—http://www.nets.nihr.ac.uk/projects/hta/108001). In addition: PD received €1500 from the European Respiratory Society in support of his travel to the society’s September 2012 annual congress in Vienna, where he gave an invited talk on oseltamivir. PD is also an associate editor at The BMJ. TJ receives royalties from his books published by Blackwells and Il Pensiero Scientifico Editore, Rome. TJ is occasionally interviewed by market research companies for anonymous interviews about Phase 1 or 2 pharmaceutical products. In 2011-2013, TJ acted as an expert witness in a litigation case related to oseltamivir phosphate; Tamiflu [Roche] and in a labour case on influenza vaccines in healthcare workers in Canada. In 1997-99 TJ acted as consultant for Roche, in 2001-2 for GSK, and in 2003 for Sanofi-Synthelabo for pleconaril (an anti-rhinoviral, which did not get approval from the Food and Drug Administration). TJ was a consultant for IMS Health in 2013, and in 2014 was retained as a scientific adviser to a legal team acting on the drug Tamiflu (oseltamivir, Roche).