Anticipation and response: pandemic influenza in Malawi, 2009

Sambala, Evanson Z.; Manderson, Lenore

In interviews, participants explained that the planned risk scenarios and general preparedness were based on H5N1/avian influenza, raising questions of the uncertainty of interventions largely targeting human influenza. Proper assessment of the pandemic risk is needed in any context to alert decision-makers to issues related to timely response and guidance on public health policy on influenza. Due to the lack of country funds for the PRPI, policymakers fully endorsed and adopted the WHO universal guidelines on pandemic influenza, without taking into account the local context. We argue that it is not possible to simply apply a graded series of responses to emerging pandemic viruses; this requires the Pandemic Severity Index (PSI) to be calibrated to the case fatality ratio to determine actions ranging from limited to stringent measures [24] .