E-DRUG: New analysis from the Access to Medicine Foundation
--------------------------------------------------------------
New analysis from the Access to Medicine Foundation on the HIV, malaria and TB epidemics and how to end their burden on children
Dear E-drug colleagues,
I'm emailing to inform you of the latest publication from the Access to
Medicine Foundation.
Our new series of articles stress the urgent need for new 'child-friendly' treatments for HIV, malaria and TB, as COVID-19 and drug resistance threaten to derail years of progress. Three articles, one for each disease, provide a bird's eye view of pharma industry engagement, mapping current paediatric pipelines and product gaps for children, while identifying five areas where action is needed to scale up progress.
Full series of articles:
https://accesstomedicinefoundation.org/publications/ending-the-burden-of-hiv-malaria-and-tb-in-children
As the COVID-19 pandemic deepens, it disrupts health systems bringing
prevention and treatments programmes to a halt. These disruptions are
predicted to lead to a spike in deaths from HIV, malaria and TB. Models
predict twice as many deaths from malaria in sub-Saharan Africa in 2020 as
in 2018; an additional 1.4 million TB deaths over the next five years
globally; and significant increases in new HIV infections in children,
ranging from 37% in Mozambique to 104% in Uganda. The pandemic also risks
accelerating the rate at which drug resistance is emerging.
HIV, malaria and TB pose the greatest risk to children, especially those
living in low- and middle-income countries. Termed the 'Big 3' for their
combined impact on human health, these infectious diseases have long been
the target of international collaboration and funding. As a result,
mother-to-child transmission of HIV has decreased by almost half in East
and Southern Africa since 2010, and malaria deaths have dropped by
approximately 30% since 2010. Nevertheless, they still account for over
half a million child deaths each year, mostly in children under the age of
five.
For many children, their HIV, malaria or TB medicine comes in hard pills or
bitter syrups that are difficult to swallow. Caregivers often resort to
breaking or crushing adult versions of medicine. This increases the risk of
children not getting enough of the active ingredient with each dose,
keeping them sicker for longer and exposing them to drug resistance. It
takes considerably longer for child-friendly medicines to reach the market
than adult versions. This is in part due to clinical and technical
challenges, but also because small and fragmented paediatric markets offer
little incentive for pharmaceutical companies to invest. Even once new
options are developed, children face long delays before gaining access.
The Access to Medicine Foundation has now published a birds-eye view of
pharmaceutical industry engagement with this issue. Its new series of
articles maps current paediatric pipelines and product gaps for children
with HIV, malaria and TB, underscoring the impact that these diseases have
on children and highlighting the challenges that threaten progress. The
articles identify nine case studies of real action from pharmaceutical
companies and organisations working towards the delivery of these
much-needed paediatric treatments.
The three articles each dive into the current situation for one of the
three diseases, setting out which new child-friendly treatments are needed
and specific actions for ensuring their availability.
HIV: DRUG RESISTANCE INCREASES NEED FOR NEW CHILD-FRIENDLY TREATMENTS
The article on HIV covers how the number of new paediatric HIV infections
has decreased significantly in recent years. While this is an extremely
positive trend, it also means that the market for child-friendly ARVs is
shrinking, making it less attractive for pharmaceutical companies to invest
in developing new ones. With one in two newly diagnosed children showing
resistance to commonly used ARVs, new treatments that are child-friendly
are needed to replace those that are no longer effective.
MALARIA: HIGH-QUALITY CHILD-FRIENDLY ANTIMALARIALS ARE NEEDED
The article on malaria highlights how, although children under five are
most vulnerable to malaria, the availability of child-friendly
antimalarials is limited. In the meantime, suboptimal treatments or even
substandard and falsified antimalarials medicines are prevalent, which
increases the threat of drug resistance. The development and delivery of
high-quality, optimal formulations for children are urgently required.
TB: NEW INCENTIVES AND PRIORITIES ARE NEEDED TO DIRECT FOCUS ON MDR-TB
In the article on TB, adherence issues are highlighted as a particular
challenge for children with multidrug-resistant TB (MDR-TB), as treatment
regimens can be long and gruelling. Yet poor adherence also drives drug
resistance. Sustained collaborative action between public and private
actors will be essential to ensure access to much-needed MDR-TB medicines
for children.
While each of the three epidemics pose unique challenges, common areas of
action have been identified as a basis for scaling up progress. The series
of articles published today makes clear that this a shared responsibility
between the pharmaceutical industry, regulators and governments.
Further comments or questions on the series can be directed to Deirdre Cogan,
Writer/Editor at
<dcogan@accesstomedicinefoundation.org>
Best wishes,
Victorine de Milliano
ABOUT THE ACCESS TO MEDICINE FOUNDATION
The Access to Medicine Foundation is an independent non-profit organisation
based in the Netherlands, which analyses how the world's largest
pharmaceutical companies are addressing access to medicine. Its mission is
to stimulate and guide pharmaceutical companies to do more for the people
who live in low- and middle-income countries. The Foundation defines the
actions pharmaceutical companies can and should be taking through a process
of stakeholder consensus building, gathering the views of independent
experts in global health, access to medicine and the industry. The
Foundation is funded by UK Aid, the Dutch Ministry of Foreign Affairs, the
Bill & Melinda Gates Foundation and the Dutch Ministry of Health, Welfare
and Sport.
Victorine de Milliano
Researcher
Access to Medicine Foundation
Amsterdam The Netherlands
Victorine de Milliano <vdemilliano@accesstomedicinefoundation.org>