WHO warns of impact on poor countries of large-scale swine flu outbreak

The World Health Organisation is distributing part of its stockpile of 3.5m anti-viral drugs to southern Africa and other vulnerable regions after warning about the risk of a health infrastructure ill-equipped to deal with a large-scale outbreak of swine flu, coupled with the onset of winter.

Keiji Fukuda, the WHO assistant director-general for health security, yesterday said the organisation had begun "distributing anti-flu drugs to countries most in need, as well as to Mexico".

The WHO declined to say which countries were receiving the medicines but Fukuda said people in the southern hemisphere, where winter was on its way, were of particular concern. Previously the WHO said richer countries should act immediately to help the developing world prepare for a flu pandemic.

South Africa's health minister, Barbara Hogan, said the region's health ministers were working with the WHO. "We have set up a technical task team and they are, through the WHO, accessing additional supplies for the whole region."

Referring to a recent cholera crisis, she said South Africa had experience of dealing with outbreaks. "We've activated all those response teams at the weekend ... we've been through this before."

South Africa is on alert after reporting the first two suspected cases of swine flu on the continent, although those people were found not to be infected. Thermal imaging systems are being installed at Johannesburg's international airport to detect passengers arriving with fevers.

Questions have been raised about whether southern African states are equipped to handle such a crisis, in part because of the critical shortage of health workers. Gregory Pappas, a Nairobi-based pandemics expert, told a conference in Addis Ababa - held to discuss swine flu - that if a pandemic did hit it could be a disaster. "This region cannot even handle cholera. An outbreak of a pandemic flu would be catastrophic."

Hospitals in parts of Zimbabwe and Mozambique are barely functioning, and hospitals in areas of rural South Africa are poorly equipped and staffed.

Health officials have said that the lack of adequate medical facilities, surveillance programmes, drugs and personnel, would hamper screening, diagnosis and treatment. They fear the disease could spread quickly in the densely populated townships and squatter camps.

Poor nutrition and diseases such as Aids, TB and malaria, could also lead to higher-than-normal rates of mortality.

South Africa is the only African country to have filed a national contingency plan with the WHO. Pretoria has offered help to poorer neighbouring countries, such as Namibia and Zimbabwe, where one economist said there was "zero preparedness" to deal with a swine flu pandemic.

In east Africa, health officials from seven governments have met in Ethiopia. The health ministry for Kenya said that it had adequate stocks of the anti-viral drug Tamiflu and had reactivated a surveillance plan established to check for avian flu. Uganda has recommended that its citizens avoid travelling to north America, Britain and Spain.