MSF Calls for Specialized HIV/AIDS Treatment for Children, Urges WHO, UNICEF To Address Problem
Children with HIV/AIDS in developing countries are "needlessly" dying because of "ignorance" and a lack of suitable pediatric medications, the international medical aid organization Medecins Sans Frontieres said in a statement on Tuesday, the AP/Yahoo! News reports (Klapper, AP/Yahoo! News, 11/2). The announcement came one day before the opening of a three-day conference MSF is hosting with UNICEF and the World Health Organization that will address improving treatment for the approximately 2.5 million children worldwide living with HIV/AIDS (Nebehay, Reuters, 11/2). According to Siobhan Crowley, an AIDS expert with WHO, the conference also will "propose more aggressive steps" to increase the availability and access to effective and affordable drugs for children, according to the AP/Yahoo! News (AP/Yahoo! News, 11/2). In the statement, MSF called upon the pharmaceutical industry to develop easy-to-use, fixed-dose combination antiretroviral drugs modified for use by infants and children (Reuters, 11/2). Although necessary medications are increasingly available to HIV-positive adults in developing countries, most drugs are not produced in dosages and combinations appropriate for children, according to MSF. Therefore, most doctors must create appropriate dosages for children by "opening the pills themselves, then measuring the contents and resealing the capsules," the AP/Yahoo! News reports. "I do what most doctors are doing," Dr. Koen Frederix, a pediatrician practicing in Lyotho, Malawi, said, adding, "I try to show caregivers, such as grandparents, how to crush and break adult tablets, hoping that the children will get the doses they need. It is easy to overdose or underdose children" (AP/Yahoo! News, 11/2). When specialized treatments, such as syrups, are available for children, they typically cost $1,300 annually -- more than six times the $200 annual cost to treat adults, the Financial Times reports (Williams, Financial Times, 11/3).
Lack of 'Commercial Interest'
According to Daniel Berman, AIDS coordinator for MSF's Access to Essential Medicines program, there is a lack of "commercial interest" among pharmaceutical companies to develop less-expensive, fixed-dose antiretrovirals for children because the number of HIV-positive infants in wealthy nations is declining, according to AFP/Yahoo! News. In addition, developing countries do not have the resources to purchase drugs developed for children, Berman said. "To really make an impact, international organizations and national programs will need to work proactively with governments and drug companies to overcome the lack of commercial interest in AIDS drugs for children," he said (AFP/Yahoo! News, 11/2). However, the lack of effective drugs for children also has received "insufficient attention" from such organizations as UNICEF and WHO, Berman said, adding that UNICEF has "let down children to date because they have not challenged this reality" (AP/Yahoo! News, 11/2). Berman said that WHO and UNICEF "should sound the alarm," adding, "This week, the experts will meet to identify the gaps. But to really make an impact, international organizations and national programs will need to work proactively with governments and drug companies to overcome the lack of commercial interest in AIDS drugs for children" (MSF release, 11/2).
The MSF statement also said that because infants younger than 18 months are not being accurately diagnosed as HIV-positive because of inadequate testing facilities, treatment often is prohibited by national laws that restrict the use of certain medications without a "definitive diagnosis," according to the AP/Yahoo! News. In addition, some health care workers -- who often are "unconvinced" that HIV-positive children can be treated properly -- do not give them "adequate attention," the AP/Yahoo! News reports. "It has just never been done. We need to recognize that children are treatable," Frederix said (AP/Yahoo! News. 11/2).