H1NDone

Almost eighteen months after it spread out of the rural state of Veracruz in Mexico and gripped North America’s largest metropolis, the H1N1 “swine flu” pandemic is over and done. That’s the ruling of World Health Organization. As it turns out, H1N1 was a rather benign strand of influenza, but it struck at an unexpected time of the year, stoking widespread hysteria. In its announcement yesterday, the WHO also ruled out the possibility that H1N1 could cause future outbreaks.

More than 18,000 people died worldwide from H1N1. After killing many in Mexico, and halting life in Mexico City for a week, the influenza strand spread through the Americas. South of the equator the impact of the virus was less noxious. However, this was not the case in Argentina, probably because of inept federal-to-state public health coordination.

The rapid spread of H1N1 was, by fall 2009, followed by cries of overreaction. 300 million people received vaccination for H1N1 worldwide, and in most rich countries there was a glut of flu shots. However, there was a stark disparity between access to vaccinations in rich countries versus access for the poor.

In an interesting aside, the British medical journal Lancet recently concluded that governments receiving foreign health aid tended to invest fewer of their own resources in health-related activities.

Sighs of relief should beware complaisance. The global health community is raising red flags about NDM-1, a “superbug” resistant to even the most powerful pharmaceutical remedies. So far, it has only appeared in a few patients in Britain and India. But it is extraordinarily pernicious. And India and Britain are ripe transmission hubs because of booming medical tourism industries.