By: Alanna Shaikh, MPH on November 15, 2009 Afghanistan’s first death from swine flu was reported on October 18. Since then, at least ten more people have died in Kabul, the LA Times reports. The news gets worse; the Afghanistan ministry of health has estimated that swine flu could infect up to 22% of the country’s population. That’s 6.6 million people, of which 330,000 are likely to develop severe complications. That’s more than Afghanistan’s struggling health system can handle. There are only 50,000 doses of anti-viral medicine available in Afghanistan. At present, there are no vaccine stocks. The World Health Organization has promised swine flu vaccine to the Afghan Ministry of Health, but none has yet arrived. Mortality rates from swine flu, even with complications, have been low in the U.S. and Europe. In Mexico, however, they were much higher. Conditions in Afghanistan – crowded, impoverished, and malnourished — are far more like those in Mexico than the wealthy world. Afghanistan could well be looking at a mortality rate of 6-7 percent, like Mexico’s. So far, the Afghan government is focusing on awareness and isolation to reduce the threat of swine flu. There are radio and television campaigns encouraging people to stay at home if they’re showing swine flu symptoms and to avoid shaking hands and embracing. Schools, universities, and public restrooms have been closed down, as have sports clubs and wedding halls. Reducing and eliminating crowds is a good first step to preventing the spread of swine flu. It was a big part of what helped Mexico slow the pandemic. However, it’s not anywhere near enough. Afghanistan is going to need vaccine and anti-virals as weapons in the fight against swine flu. And even if they get those, the health system may not be strong enough to wield them successfully.