Implications of our study for primary health care in developing countries: Endemic and epidemic infectious diseases inflict high levels of morbidity and mortality in developing countries because of a combination of poor living conditions, effects of multiple concurrent illnesses particularly in children, fragile national health systems, overburdened and overstressed health workers, and negative work environments [73] . Although our study targeted general practice in developed countries, the conceptual framework we developed (Table 1) can be used by primary health care services in developing countries to deconstruct the multidimensional challenges posed by pandemic influenza. Identifying possible solutions and apportioning responsibilities across components of the health system is more complex. Operational guidelines have been developed for the detection and rapid containment of a potentially pandemic strain of influenza to the epicentre of the outbreak [74] , for example, if this were to occur in a South East Asian country. However, because of the immense global implications of such an event, this intensive strategy will need to be supported by extraordinary resources from the global community, an action not sustainable once the pandemic strain spreads beyond the initial epicentre.