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A nurse fills needles with flu vaccine at a clinic in Victoria.

Aboriginal leaders are bracing for a dark season on reserves if - as health authorities fear - the H1N1 virus's spread outpaces vaccine production at the height of the flu this autumn.

Many remote reserves were shorted vital flu-fighting supplies such as masks, antivirals and hand sanitizers during the mild spring phase of the disease. A shortage of vaccines during the harsher fall flu season could presage a much larger catastrophe.

Candidates for national chief in the coming Assembly of First Nations election urged the federal government Tuesday not to place aboriginals at the bottom of the queue to receive critical swine flu vaccines, or to take their time delivering life-saving drugs to reserves.

"When a vaccine is created, remote communities should be one of the top priorities in getting the vaccine, because they're obviously more susceptible. It's certainly a fear that it won't happen," said John Beaucage, the grand council chief for Ontario's Anishinabek Nation. "It's certainly a fear that major urban centres will get it first and there will be huge vaccination programs in the urban centres and poor people in the remote communities will be the very, very last to get it, but maybe the first to get the disease."

Asked about assurances the federal government could provide native communities regarding flu vaccines, Health Canada said it couldn't respond Tuesday night.

The issues around H1N1 and its impact on reserves will likely be raised at the July 22 leadership convention in Calgary.

Mr. Beaucage said the federal government and native communities need to look at ways to improve the health of those on reserves. "Much of the work that's done at Health Canada and various other areas seems to be more looking at the bottom dollar than it is at health outcomes," he said.

The virus appears to have hit aboriginal communities harder. In Manitoba, the infection rate among aboriginals is 135 per 100,000, according to the Assembly of Manitoba Chiefs. That compares to about 20 per 100,000 for the Canadian population as a whole.

AFN candidate Perry Bellegarde from Saskatchewan noted yesterday that if the federal government doesn't work to get medical resources much more quickly to these communities, "there's going to be an epidemic right across the North."

Another candidate, Regional Chief Shawn Atleo of the B.C. Assembly of First Nations, said the "woefully inadequate supports" for aboriginal communities during the swine flu outbreak in the spring speaks volumes about the federal government's handling of other health issues on reserves, including clean drinking water.

Some communities have their own pandemic-response plans, but AFN candidates said that there are not enough resources to implement those plans.

Mr. Atleo fears that the number of H1N1 victims in aboriginal communities will grow over the fall flu season, given the housing conditions and the lack of clean water in some areas. "I fear that we'll see an overrepresentation of swine flu infection if we don't respond with very serious measures to make sure that not only is medication readily available, but that the full health supports are in place," he said.

"I see that this is going to escalate. And who's it going to hit hardest? It's the impoverished. This is not the time to turn your back on the poorest."

AFN candidate Chief Terry Nelson of Manitoba's Roseau River Anishinabe First Nation echoed the sentiment. "In the 1918 flu, the communities that were hardest hit were first nations communities. This will occur again."

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