Pan Flu Disproportionately Targets the Poor

According to a recent Lancet article by Christopher Murray et al. (see citation below), the vast majority of those affected by the next pandemic influenza will be people living in resource poor settings. Murray and his colleagues used information from the previous 1918 pandemic influenza and made appropriate adjustments for the current (2004) situation to construct a mortality model for the next pandemic. The model suggests that 96% of estimated deaths will take place in the developing world. The death toll is predicted to be 31 times higher in some developing settings when compared to developed settings. The model suggests that nearly half of the difference in projected mortality was due to differences in income.

During the next pandemic, morbidity and mortality will most likely be mediated through factors such as medical infrastructure, nutritional status, the presence of other diseases, and other poverty-related factors. While it is uncertain how the next pandemic influenza will play out, it is certain that its effects will disproportionately target poor and vulnerable groups. As Neil Ferguson suggests, more work needs to be done to explore the means by which poverty affected mortality in the 1918 pandemic so we can prevent and mitigate mortality in these populations during the next pandemic influenza.

Murray, CJL et al. (2006). Estimation of potential global pandemic influenza mortality on the basis of vital registry data from the 1918-1920 pandemic: a quantitative analysis. The Lancet 368: 2211-2218.