Who's In Charge? Leadership during Epidemics, Bioterror Attacks, and Other Public Health Crises by Laura H. Kahn

Author:Laura H. Kahn [Kahn, Laura H.]
Language: eng
Format: epub
ISBN: 9780275994853
Publisher: ABC-CLIO
Published: 2020-04-12T00:00:00+00:00

VIEWS OF THE CRISIS

One of the leaders involved with the BSE crisis was Dr. Keith Meldrum, chief veterinary officer (CVO) of England, Scotland, and Wales from 1988 to 1997. When he was the CVO, he also represented the United Kingdom at the World Organization for Animal Health (OIE) and served on the Standing Veterinary Committee of the European Union (EU). Here is his reflection on his time as CVO:

BSE was a massive animal health challenge with incredible complexity. It was a totally new disease with a lot of uncertainty surrounding it. Before I became CVO, I had been involved with the recycling of animal proteins and the use of animal feeds. Nobody ever suggested that scrapie might affect cattle.

My primary responsibility as CVO was to advise ministers. I was also responsible for executive decisions such as confirming the existence of an outbreak and for all sorts of negotiations in Brussels and elsewhere. By law, the CVO is responsible for the confirmation of the existence of a notifiable disease. The minister was responsible for the strategic decisions such as banning MBM for use in feed for ruminants. The minister would make such decisions based on advice from the CVO and from others such as advisory committees. The minister had to make the ultimate decision because he was answerable to the House of Commons and would have to defend it. Ministers invariably would accept the CVO’s advice. I had no problems working with them. It is important to note that they wouldn’t just take my advice, but they would also take advice from people in advisory committees.

BSE was an unknown disease, and very little was known about CJD. There were only 30 to 50 or so cases of CJD per year in the UK before vCJD was diagnosed in 1996. Very few people had seen it. After Southwood [the Southwood committee], there was the SEAC [Spongiform Encephalopathy Advisory Committee]. It was helpful to have a standing advisory committee. As CVO, I would review the opinions of these committees.

However, there is a danger in being surrounded by all sorts of advisory committees, and it is important to know how the members of the advisory committees are appointed. You must look at their recommendations carefully. Is the advice based on scientific evidence or on opinion?

For example, Sir John Pattison,58 who was the chair of the SEAC committee, went public and said that there could be half a million cases of vCJD. It was a massive overestimate—a pure figure off the wall. It was totally unhelpful and frightened people to death. There was no scientific evidence to support that statement.

Many of the decisions that were made during the BSE crisis were inspirational. They were sound then, and they haven’t been changed in any significant way since. For example, the SBO ban of 1989 is still in place even though members of the opposition party in Parliament criticized it. They didn’t change it when they took over following the general election in 1997. The decision to ban MBM was based on sound epidemiological science done by John Wilesmith.

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