Pandemic influenza: imminent threat, preparedness and the divided globe.

With generic consensus on certainty of an impending influenza pandemic, concerns are mounting about its devastating global impact. Preparedness and preventive approaches adopted by the nation states are polarised between resource rich and resource challenged countries. India has, rightly, taken a middle path. It seems that the non-pharmaceutical interventions would be the only preventive modality available in large parts of world. Production of any pandemic vaccine would take a minimum of 6 months after isolation of novel virus, and antivirals may not be available where they are required most. Efforts to create a universal pool of resources and stockpiles of antivirals, antibiotics and vaccines for use in first affected countries need to be strengthened with urgency.