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There are multiple reasons. Some of those are:

Disadvantaged countries usually have contaminated water supplies and hygiene is always an issue. This makes it much more likely that the virus will be passed from person to person without hand washing and without cleaning of surfaces in public places.

In addition, the public is likely malnourished which makes recovery from the flu slower and the immune system weaker and less able to fight infections.

IF schools are available, the students are usually over crowded and more likely to pass communicable diseases to each other. Schools often have no available water or supplies for hygiene.

Doctors are few and far between, so there are usually no vaccinations and/or no education to help the people understand why vaccines are important, no medicines to prevent or treat the flu and complications get to critical stages before they are able to be addressed by health care professionals, IF that is available at all to these poverty stricken populations. The people are also more likely to have underlying diseases and health problems that make complications of the flu more likely. The HIV/AIDS epidemic is rampant in many of the stricken countries which puts all of those in great peril if they get infections since HIV/AIDS means there is ineffective immune function.

These are only a few of the problems of health maintenance and infectious disease in 3rd World Nations.

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Q: Why does the study on swine flu say poorer countries would be affected the most by the pandemic?
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