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Rich nations and drug manufacturers must help ensure that all populations, including the poor, have equal access to swine flu vaccinations, says Tadataka Yamada of the Bill and Melinda Gates Foundation.

Yamada and his colleagues have developed a set of principles to "guide the global allocation of pandemic vaccine".

These include using tiered pricing and boosting donations to make vaccines more accessible to developing countries, and providing resources and technical assistance to bolster mechanisms for distributing vaccines. Yamada says that using adjuvants to enhance the action of vaccines could also reduce the dose needed by up to 75 per cent, and he calls on drug regulators to speed up the approval process.

Drug manufacturers must not commit all their capacity to countries that can pay the most, or reserve supplies for their own countries, says Yamada. All nations deserve equal access to vaccines, regardless of their ability to pay for them. In return, the manufacturers should be protected against liability for potential adverse reactions to their vaccines, he adds.

Link to full article in The New England Journal of Medicine