MSF calls for action to ensure the access to drugs for children with AIDS

Children with AIDS are dying needlessly because of a lack of suitable and adapted medicines, according to Medecins Sans Frontieres (MSF).

On the World AIDS Day, MSF calls for action to be taken to ensure children with AIDS can access to the drugs they need. A group of Legislative Councillors joined the “med/for/kid” event today and promised to try their best to help the paediatric patients.

The Legislative Councillors who were present at the event include Hon Andrew Cheng, Dr Hon Kwok Ka Ki, Dr Hon Joseph Lee, Hon Vincent Fang, Hon Bernard Chan, Dr Hon Yeung Sum, Hon Chan Yuen Han, Hon Li Fung Ying and Hon Choy So Yuk.

MSF currently provides antiretroviral treatment to more than 23,000 people living with HIV/AIDS in 27 countries in Asia, Africa, Latin America and Eastern Europe. Of these 23,000 patients, 1,400 (6%) are children.

In China, MSF is providing ARV treatment to about 170 patients and of those 20 are children. MSF is running HIV/AIDS treatment programmes in Xiangfan, Hubei and Nanning, Guangxi. Our experience in the field shows that 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).

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.

The Legislative Councillors joining the event today tried to break up a huge fake pill to experience the difficulty of treating children with AIDS. Mr Andrew Cheng, chairman of the Health Services Panel, Legco, said they fully support MSF and would try their best to raise the public awareness of the issue. MSF hope that the Legislative Councillors can use their influence to give pressure to the pharmaceutical industry to take action. We urge 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.

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.



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