"In all likelihood, people in these countries won't be able to obtain supplies of pandemic vaccines or they will get them too late" he says.

"Many health officials have placed their hopes on stockpiles of antiviral agents, but resistance to the most widely stockpiled agent, Tamiflu, in seasonal flu outbreaks, has prompted concerns that similar resistance could develop in any pandemic virus.

"It's estimated that countries that do not produce influenza vaccines will only have enough antivirals to treat one per cent of their combined populations.

"At a scientific meeting in 2008 we heard that all of the people who developed bird flu in Indonesia, and did not receive antiviral treatment, died. This observation is terrifying. If this particular virus were to develop efficient human-to-human transmission we could see a global population collapse.

"Swine flu has only recently emerged so we have had less time to study its effects. But any influenza pandemic is cause for great concern regardless of what strain it is."

International influenza expert and journal editor Dr Alan Hampson says that it is essential that the focus on swine flu doesn't distract health professionals from the risk still posed by bird flu, which is continuing to rise, particularly in Egypt.

"Wouldn't it be a terrible irony if bird flu suddenly achieved the ability to transmit readily in humans, possibly aided by widespread infection of swine flu and that fact that most of our resources are focussing on that" he says.

Dr Hampson, who has worked extensively with the World Health Organization and is an influenza advisor to the Australian Government, says that the WHO recommended that all countries should develop pandemic preparedness plans.

"However, web-based evidence suggests that only 45 countries have produced plans so far and these tend to be the more developed countries, who may be less vulnerable" he says.

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