In the Developing World, Swine Flu Elicits Shrugs, Not Panic

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Mahesh Kumar / AP

Outside a swine flu emergency ward set up at a government hospital in Hyderabad, India.

If the fast spread of swine flu suggests the world is small, the global response to the epidemic reminds us that in many ways it's still light years apart. Swine flu has been making headlines in the Western world, but in places like India and Africa, where "pandemic" is just another part of the daily vocabulary, no one has so much as stifled a sneeze.

In Africa, malaria kills more than 3,000 children a day; in South Africa, HIV/AIDS has taken 2.8 million people and infected 5.3 million more. Every day in India, 1,000 people succumb to tuberculosis. Those are just the big diseases. According to the United Nations, a recent cholera outbreak killed nearly 4,000 Zimbabweans and infected 80,000, while in India diarrheal diseases kill an estimated 600,000 children under 5 every year. (Read "Top 5 Swine Flu Don'ts")

So, when the World Health Organization (WHO) announced that deaths in Mexico from the H1N1 swine flu leapt to 16, you can see why the news didn't make the front page in Africa or India. (The two suspected cases of swine flu in South Africa turned out to be false, and only one case has been confirmed in Asia, in Hong Kong.) Any concern in these regions has so far centered on sports: specifically, whether any new travel restrictions will affect the Confederations Cup, the international eight-team soccer tournament due to be played in South Africa in June, or the Indian Premier League, a new cricket tournament featuring players from around the world, now being played also in South Africa.

Still, the WHO has urged all governments to prepare for an imminent pandemic. "The biggest question is, 'How severe will a pandemic be?'" Dr. Margaret Chan, the WHO director-general, said in Switzerland. So politicians have to make like they're doing something. Gabon and Ghana have banned the import of pork, even though the flu virus cannot be contracted through eating dead pig. Kenya, South Africa, Zambia and Zimbabwe say they are checking arriving passengers at borders and airports and have response plans of varying sophistication should an outbreak occur. In some places, they've gone much further: Authorities in Egypt, which was affected by bird flu last year, have begun slaughtering the country's entire unfortunate pig population of more than 300,000. (A Brief History of Flu Pandemics.)

But given that many public health systems in Africa do not have the skills, equipment or resources to protect their citizens even against the lethal health crises they battle every day, the truth is that the threat of another disease — even a pandemic flu — tends to elicit shrugs in this sickness-struck continent. If asked what preparations they are making for the possibility of swine flu's arrival, most African governments opt for the same kind of wordy non-statement issued by African Union chairman Jean Ping on Thursday: "We hope to establish a continental plan for prevention, and if necessary a mechanism to fight this outbreak that has not yet affected Africa."

See a photoessay of the swine flu hitting Mexico

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