Planning is an evolving activity that reflects a 'map' rather than a 'destination', and our findings provide a snapshot of the plans accessible in late 2007. The scope and content of the plans will change over time, as seen in two countries that adjusted their plans after simulation exercises, Exercise Cumpston in Australia [70] and Winter Willow in the UK [71] . Interestingly, the former identified specific weaknesses in the involvement of the primary health care sector and made recommendations to better integrate primary health care providers into planning at the national and jurisdictional levels [70] . National and sub-national pandemic plans may be intended to provide a strategic focus and not to elaborate on operational activities; it is possible the latter may have been addressed, but were not accessible at the time of our study.