Public health researchers in New Zealand say the Pacific is particularly vulnerable to an influenza pandemic.
Dr Nick Wilson and several colleagues, writing in the international journal, Emerging Infectious Diseases, say a future pandemic is likely, if not inevitable.
Dr Wilson says donor countries need to provide assistance to help the island countries prepare and improve their medical resources.
He says an additional factor for the Pacific is the growing burden posed by the incidence of chronic diseases.
"Which means there's an increased risk that influenza will actually kill people that get infected. For example people with diabetes or heart disease are at an increased risk of hospitalisation and death during influenza epidemics."