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HEALTH: Pharmaceutical Firms Neglecting Children with HIV/AIDS
By Moyiga Nduru
BANGKOK, Jul 14 (IPS) - More than 2.5 million children living with
HIV/AIDS have been neglected by pharmaceutical companies
that
mainly produce life-prolonging drugs, such as antiretroviral
drugs
(ARVs), for adults, says the leading humanitarian agency
Medecins Sans Frontieres (MSF).
HIV treatment for adults is slowly becoming easier, with
increasing
availability in developing countries of a three-drug cocktail in one
tablet.
But children who need treatment still have to drink large
amounts
of foul-tasting syrup or swallow large tablets '' that's if they can
actually access treatment at all,'' Dr David Wilson, the medical
coordinator of MSF, who is based in Thailand, told reporters.
ARVs are substances used to kill or inhibit the multiplication of
retroviruses such as HIV.
Wilson, who is attending the ongoing 15th International AIDS
Conference, in the Thai capital Bangkok, said: ''Children with HIV
are
generally not interesting for pharmaceutical companies, but
some
generic companies are developing more child-friendly ARV
treatments.''
''International agencies need to push this issue up the agenda
and governments will need to remove barriers to the use of
generic
products,'' he said at a press conference Tuesday.
Worldwide, the estimated number of children with HIV/AIDS
was
over 2.5 million in 2003, according to the Joint United Nations
Programme on HIV-AIDS (UNAIDS).
In the same year, 700,000 children under the age of 15 were
newly
infected with HIV/AIDS, 88.6 percent of whom live in sub-
Saharan
Africa.
''Efforts to prevent transmission of the virus from mother-to-
child
have been largely successful in industrialised countries
meaning
there are relatively few children being born with HIV,'' Wilson
said.
The resulting lack of a profitable market for children drugs in
developed countries means that these medicines are in short
supply despite the growing need for them.
As a result, children with HIV/AIDS are neglected, and doctors
treating them have very limited choices of drugs at their
disposal,
Wilson explained.
But pharmaceutical firms, attending the gathering, contacted by
IPS declined to respond to the MSF claims.
MSF, which is currently treating 13,000 children worldwide,
says it
began treating children with the ARVs in early 2002. However, in
March 2004 only 5 percent of MSF patients were children under
13.
''In South Africa, we started with 13 children last year. We hope
to
expand the treatment to the many children who need it,'' Nozia
Ntuli,
a nurse with MSF in South Africa, told IPS.
South Africa, where 10 percent of its population is living with
HIV/
AIDS, has around one million AIDS orphans, latest figures from
the
South African government say.
According to the MSF, most methods used to diagnose HIV are
not
reliable for children under 18 months.
Monitoring blood count, known as CD4, is also difficult, since
most
of the commercially available CD4 count machines are not
adaptable by the lack of proper tools.
The other challenge is the lack of paediatric formulations of
ARVs,
which makes determining and administering doses complex
and
burdensome. Currently, doses are determined according to
weight
or body surface, so doses must be adjusted as the child grows.
In developing countries, says MSF, there are no standardised
dosing schedules, and doctors and other health professionals
have
no simple guidelines for treatment of HIV in children.
In most cases, bad-tasting, difficult to measure syrups are
used
for children under 10 kilogrammes. For older children, a dosing
chart is used to calculate dose by weight.
MSF says syrups and oral solutions are not suitable for use in
older children because of the large volumes needed, but low
dosage tablets and capsules are not produced for most ARVs.
In
practice, this means that caregivers are forced to measure
syrups
and cut and crush adult formulations.
''This will not be possible for a grandmother, living in rural area
with four children, to handle,'' Fernando Pascual, a pharmacist,
with
MSF's 'Campaign for Access to Medicines', told the press
conference.
But others disagree.
They argue that people living in rural areas, especially in Africa,
have higher drugs compliant rate.
''I don't think grandparents have problems delivering drugs to
children living with HIV/AIDS. If you give them the right
information,
they will stick to it and deliver the drugs correctly,'' Ludfine
Anyango,
of Action Aid, an international charity, told IPS.
The other challenge facing AIDS campaigners is that drugs for
children come at a high price.
ARV treatment for children costs several times more than for
adults. While the cheapest fixed-dose drug for adults is available
for
about 200 U.S. dollars per patient for a year year.
The best price for the same drugs in paediatric formulations is
around 1,300 dollars (oral solutions and syrups), according to
MSF.
There are no paediatric fixed-dose combinations, it says.
For the other life-prolonging drug, known commonly as AZT,
the
adult yearly price is from 1,200 dollars but for paediatric
dosages,
the same regimen in power and syrup formulations costs from
2,846 dollars per person for a year, according to MSF.
In a bid to move into mass production, Dr. Omokhudu Idogho,
of
the Action Aid, who is based in Nigeria, urged African countries
to
formulate a policy whereby 30 percent of pharmaceutical
companies' budgets are set aside for producing drugs for
children.
''Apart from South Africa, most African countries do not have the
capacity for mass production. Therefore, we must move fast
because European and American pharmacies do not feel the
pressure to produce the drugs for us,'' he told IPS. ''If we donít
produce them fast enough, then we're going to lose more lives.''
Meanwhile about 50 protestors forced Hank McKinnel, the
chairman of U.S. pharmaceutical giant Pfizer, to abandon his
speech at a session on ARVs at the conference. The protestors
accused Pfizer of creating barriers to patients' access to low-
cost
ARV drugs.
Chanting ‘'Let Us Free'' the protestors said the pharmaceutical
firms were more interested in profits than saving lives of people
living with HIV/AIDS.
Defending his company, McKinnel said Pfizer was willing to
cooperate with any governments in need of making quality drugs
available to people living with the disease. (END/2004)
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