E-DRUG: MSF: Lack of AIDS Drugs for Children a Matter of Life and Death
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[sorry, delayed delivery to E-drug; posted 2 Nov; WB]
Medecins Sans Frontieres / Campaign for Access to Essential Medicines
Lack of AIDS Drugs for Children: A Matter of Life and Death
Press Conference: 11.30am CET, Tuesday November 2, Library, Salle de Press
2, Palais des Nations.
Geneva, November 2nd 2004: Children with AIDS are dying needlessly because
of a lack of suitable and adapted medicines, according to Midecins Sans
Frontihres, the medical humanitarian organisation. A day before the opening
of a paediatric AIDS summit organised by the World Health Organization 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$1,300 versus US$200 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.
MSF urges the WHO, UNICEF and national governments to document the extent
of this crisis and to lead the charge to overcome the lack of a market for
AIDS drugs for children.
"As the UN's children's agency, UNICEF should sound the alarm," said Daniel
Berman, HIV/AIDS coordinator for MSF's Campaign for Access to Essential
Medicines. "This week the experts will meet to identify the gaps. But to
really make an impact, international organizations and national programmes
will need to work proactively with governments and drug companies to
overcome the lack of commercial interest in AIDS drugs for children."
MSF began treating children with ARVs in December 2000. By mid-2004, about
5% of MSF patients on antiretroviral treatment were children under 13. MSF
is committed to doing better for children but the efforts of our doctors
have been frustrated by the lack of proper tools.
MSF teams have created innovative tools to support health care providers in
prescribing ARVs and supporting adherence in children, such as health
diaries, treatment calendars, and fairy tales about "Devimmon", a witch
that is a metaphor for HIV, in an effort to help children understand and
adhere to treatment.
The estimated worldwide number of children with HIV/AIDS was over 2.5
million in 2003. In the same year, 700,000 children under the age of 15
were newly infected with HIV/AIDS, 88.6% of whom live in sub-Saharan
Africa. Approximately 50% of children with HIV/AIDS die before the age of
two.
For more information, please call Sean Healy on +4122 849 8401 or +4179 239
9271. Or visit our website at: www.accessmed-msf.org
Sean Healy
Information Officer
Campaign for Access to Essential Medicines
Midecins Sans Frontihres
Geneva, Switzerland
tel ++41-22-8498 401
fax ++41-22-8498 404
mobile tel ++41-79-239 9271
sean.healy@geneva.msf.org
www.accessmed-msf.org