About three hours ago the World Health Organization declared that the H1N1 Flu is now a global pandemic. And in so doing, the world is now at the beginning stages of the first global flu pandemic in 41 years.

What does this mean? First, if like me you live in a developed country, don’t panic. There have been about 30,000 confirmed cases of H1N1 in 74 (mostly developed) countries resulting and 141 deaths. And while each of these deaths is tragic, this is not considered all that deadly. (Regular influenza is much worse.) Also, about two thirds of those who have succumbed to H1N1 have had other underlying medical conditions. Second, the WHO does not recommend any travel restrictions. I’m still planning on attending that wedding in Puerto Vallarta in October.

Still, there are some reasons to be concerned. So far, the virus has popped in places with decent health infrastructures. It has not – and this is only a matter of time – hit the developing world.  And this, says WHO director Margaret Chan “is of gravest concern.”

We do not know how this virus will behave under conditions typically found in the developing world. To date, the vast majority of cases have been detected and investigated in comparatively well-off countries.

Let me underscore two of many reasons for this concern. First, more than 99% of maternal deaths, which are a marker of poor quality care during pregnancy and childbirth, occurs in the developing world.

Second, around 85% of the burden of chronic diseases is concentrated in low- and middle-income countries.

Although the pandemic appears to have moderate severity in comparatively well-off countries, it is prudent to anticipate a bleaker picture as the virus spreads to areas with limited resources, poor health care, and a high prevalence of underlying medical problems.

Bottom line: brace yourself, global south.

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