E-DRUG: Paediatric AIDS is a neglected disease
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[Reuters wire first; AP wire next. Copied as fair use. WB]
MSF seeks life-extending drugs for AIDS children
By Stephanie Nebehay
GENEVA, Nov 2 (Reuters) - Medecins Sans Frontieres on Tuesday criticised
pharmaceutical companies for failing to offer suitable life-extending drugs
for children with HIV/AIDS in poor countries.
The aid group urged the pharmaceutical industry to develop easy-to-use,
fixed-dose combination drugs adapted to infants and children, saying these
would prolong their lives for many years.
Its appeal came a day before MSF, the U.N. Children's Fund (UNICEF) and
World Health Organisation (WHO) gather 60 experts at three-day talks to
look at improving treatment of roughly 2.5 million children worldwide who
carry the deadly virus.
Nearly 90 percent of them are in sub-Saharan Africa. Roughly one in two
children with HIV, most of whom caught the virus from their infected
mothers, dies before the age of two.
"Today there is simply no fixed-dose combinations for children. We think
kids with HIV are being written off," Daniel Berman, MSF's HIV/ AIDS
coordinator, told a news briefing.
In poor countries, health workers or grandparents caring for orphaned AIDS
children struggle with anti-retroviral drugs designed for adults, often
resulting in dangerous under- or over-dosing of children, according to MSF.
Treating a child -- typically with a haphazard concoction of messy syrups
and fractions of pills -- also costs some $1,500 per year -- five or six
times that for an adult, it says.
"We want to challenge the companies. It is unconscionable that companies
charge more for the pediatric formulations. This is unacceptable and it
needs to change," Berman said.
Siobhan Crowley, a WHO medical officer, said the problem was that there
was no economic incentive for drug companies to develop pediatric
formulations because the numbers of infected children were expected to fall
as programmes aimed at cutting mother-to-child transmission took effect.
"We can't let the status quo stay, children don't get access," she told
Reuters. "But there is no real long-term future in this particular segment
of the market."
The WHO, a United Nations agency, hoped that a consensus would emerge at
the experts' talks in Geneva on which compounds or products to develop for
children, she said.
Fernando Pascual, a MSF pharmacist, said the main reason for the high cost
of drugs for children and the lack of a market was that there were fewer
and fewer HIV children in the West.
"We are victims of our success in the sense that prevention is working very
well," he said.
Group: Kids HIV, AIDS Dying Needlessly
Tue Nov 2,12:59 PM ET
By BRADLEY S. KLAPPER, Associated Press Writer
GENEVA - Children with HIV (news - web sites) and AIDS (news - web sites)
are dying needlessly because of ignorance and a lack of suitable medicines,
and the U.N. must increase efforts to change the situation, the
international medical relief group Medecins Sans Frontieres said Tuesday.
HIV-positive adults in developing countries are increasingly able to obtain
necessary medication, but most dosage sizes and combinations are simply not
produced for children, said MSF, which is also known as Doctors Without
Borders (news - web sites).
Where medicines designed for children do exist, they can cost six times as
much as those for adults, the group said. Most doctors are forced to create
their own dosages for children by opening the pills themselves, then
measuring the contents and resealing the capsules.
"I do what most doctors are doing," Dr. Koen Frederix, a pediatrician based
in Lyotho, Malawi, said on the eve of a three-day U.N.-sponsored pediatric
AIDS summit in Geneva. "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."
There is little impetus for drug companies to develop cheaper fixed-dose
combinations for children because incidence of childhood AIDS is declining
in wealthy countries. But the problem has also received insufficient
attention from organizations such as the U.N. children's agency and the
World Health Organization (news - web sites), said Daniel Berman, AIDS
coordinator for an MSF campaign to improve access to essential medicines.
"UNICEF (news - web sites) has let down children to date, because they have
not challenged this reality," Berman said. "Four years ago, the common
perception was 'it is too expensive to deal with AIDS in Africa.' Since
then, it has gotten cheaper and easier to treat adults but today children
suffer from a similar situation."
The children's agency should play the main role in highlighting this
shortcoming, Berman said. "UNICEF has to make it a moral imperative to
treat children with HIV/AIDS," he added. "They changed reality with
immunization; why not with treatment?"
In addition, a lack of adequate testing facilities in developing countries
means babies under eighteen months cannot be properly diagnosed with the
HIV virus (news - web sites). While symptoms may give doctors a clear
indication a baby is HIV positive, treatment is often blocked by national
laws restricting the use of certain therapies without a definitive
diagnosis.
In other cases, medical workers in developing countries, unconvinced that
children can be treated, fail to give them adequate attention.
"It has just never been done," said Frederix. "We need to recognize that
children are treatable."
The AIDS summit will address the lack of pediatric AIDS medicines and
propose more aggressive steps to increase child access to affordable and
effective drugs, said Siobhan Crowley, an AIDS expert at WHO.
"We may need to subsidize and incentivize research and development, because
the market is not there," Crowley said. "We also have to find a way to get
these products to have reasonable prices."
UNICEF was not immediately available for comment.