Children with AIDS are dying needlessly because of a
lack of suitable and adapted medicines, according to Médecins Sans Frontières (MSF),
the medical humanitarian organisation. A day before the opening of a paediatric AIDS
summit organised by the World Health Organisation and UNICEF in Geneva, MSF
highlights experience that shows treating children with HIV/AIDS is much more
expensive and difficult than treating adults.

Simplified ways to treat HIV/AIDS in adults have become available to patients in
developing countries within the past year. Most adult patients in developing
countries now take either a triple fixed-dose combination treatment - one pill twice
a day - or one double combination plus a third drug.

But neither the triple nor double combinations are available in dosages for
children. When childhood doses are available, they come at a premium. It can cost
over six times more to treat a child than to treat an adult - US,300 versus US0
per year (for a 14-kg patient taking three different syrups).

"Since companies do not make easy-to-use triple drug combinations for children, I do
what most doctors are doing: 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," said Dr Koen Frederix, a paediatrician working for MSF in Malawi. "Small
children can't swallow tablets so they have to use different syrups in different
quantities, which complicates treatment."

There is only a weak global market in paediatric AIDS drug formulations: in wealthy
countries relatively few children are being born with HIV, while developing
countries are often simply too poor. Consequently, drug companies have little
interest in developing or marketing paediatric formulations adapted to poor
countries, such as fixed-dose combinations or breakable or chewable tablets.

The only hope on the horizon is that some companies may choose to develop fixed-dose
combinations or adapted formulations for children. Some ongoing studies are looking
at once-daily tablets for children. However, without the lure of a lucrative market,
companies are not allocating enough resources to make quick progress. [Source: CRIN]

[Source: Médecins Sans Frontières. To read the article in full, go to:
www.msf.org/content/page.cfm?articleid=C918F074-3067-4CDC-B29BCD2500E8BBF9]