Last April, the same week that the World Health Organization (WHO) declared a public health emergency due to influenza A(H1N1), Cuban government and public health authorities met to chart a course for prevention and management of the flu that by year’s end had become pandemic, spreading to some 200 countries.

 Like disaster response, epidemic-containment strategies depend largely on the situation before catastrophe: the resources and infrastructure at hand, readiness planning already in place, general population health, and social determinants like education and culture. Epidemic response must also take into account the unpredictability of the disease’s biological agent—in this case, a novel virus whose lethality and mutation probability were unknown.