MSF calls for greater focus on paediatric ARVs

Medecins Sans Frontieres (MSF) called on the international pharmaceutical industry this week to develop AIDS drugs suitable for children. "Children are not just small adults," Dr David Wilson, MSF coordinator in Thailand, told a press conference at the 15th International AIDS Conference in Bangkok. "There are specific issues in terms of treatment." The lack of paediatric formulations of antiretroviral (ARV) drugs meant that "children who need treatment have to drink great amounts of foul-tasting syrup or swallow large tablets, and that's only if they are even able to access treatment in the first place," said Wilson. Because preventing mother-to-child transmission of HIV had been successful in Western countries, fewer children were being born with the virus. "The resulting lack of a profitable market means that paediatric formulations are in short supply, despite the growing need for them in developing countries," MSF said in a press statement. The available paediatric ARVs are expensive, and there are no fixed-dose combinations (several drugs combined in one pill). Over 2.5 million children were estimated to be HIV-positive in 2003. Approximately 50 percent of children with HIV/AIDS die before the age of two, the statement noted. "The first challenge is to know if children are HIV-positive. Standard serological tests are not reliable in infants less than 18 months. In addition, monitoring CD4 [an indication of the strength of the immune system] is also difficult, since most of the commercially available CD4 machines are not adapted for use in young children," said MSF.