Introduction While rare, infl uenza pandemics are a regular feature of human existence. In the last century alone the world’s population was subjected to three such events in 1918, 1957 and 1968, respectively. In April 2009, the World Health Organization (WHO) declared that another infl uenza pandemic was underway following the spread of a novel H1N1 virus strain. Fortunately, the fi rst pandemic of the twenty-fi rst century was shown to be comparatively mild and short-lived; but refl ecting the conventional response of governments to such threats, the event nonetheless resulted in billions of dollars being spent on procuring vaccines and antiviral medications. These acquisitions were based on advice from the WHO, which has been at the core of international pandemic infl uenza governance arrangements for over 60 years. Since 2007 however, several Asian leaders – a number of whose populations are considered at greatest risk from the H5N1 avian infl uenza virus – have openly challenged the existing regime on the basis that it favours those countries that can afford to procure vaccines, namely Western developed states.1 This questioning, and Indonesia’s actions in withholding infl uenza virus samples, has contested the legitimacy of existing pandemic infl uenza governance structures.