Coutinho's role has led to a dispute between Coutinho and Osterhaus. Coutinho describes himself as an expert who is independent of the institutional setting and always does what he believes in. Osterhaus, however, depicts Coutinho as a governmental expert, since he falls under direct responsibility of the health minister. Osterhaus recounts how he has seen Coutinho change over the years, becoming less outspoken, and says that his political accountability has contributed to this (Osterhaus 29 July 2008). Although Coutinho clearly experiences the political pressures, he says it has not changed him; he is not the governmental representative Osterhaus claims he is. He is less outspoken, since there is no need for him to act otherwise (Coutinho 13 May 2008) .