We at the global humanitarian organization Save the Children agree that controversy over lab-created H5N1 avian influenza virus should not detract from the larger concern of global preparedness for a flu pandemic (Nature 482, 131; 2012).

In a pandemic flu situation, when all countries and responding organizations are stricken, we think it is unrealistic to hope that the most resource-poor communities around the world will receive adequate supplies of vaccine, antivirals or antibiotics. We believe in preparing now so that community leaders, and the organizations working with them, can mitigate the effects of a severe wave of flu in the absence of substantial outside resources.

As the World Health Organization has noted, non-pharmaceutical interventions such as quarantine are crucial for an effective response, and may sometimes be the only means of delaying the spread of flu. Yet most national plans lack practical operational considerations (see go.nature.com/mi9sr3).

Detailed authoritative guidance on reducing flu transmission at household and community levels, and on the home-based care of flu patients, in low-resource settings is the most important, and needs to be published. Support should also be provided to governments in developing countries to adapt this guidance for their settings.

We believe that such efforts should be an urgent priority, and are concerned about this apparent gap in the most basic level of pandemic preparedness.