Important note: Information in this article was accurate in 2005. The state of the art may have changed since the publication date.
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Agence France Presse (12.08.05) - Friday, December 09, 2005
"You can see the adults being treated but the kids still die," said Daniel O'Brien of Doctors Without Borders (DWB). More than half of African children with HIV die before age two.
Most pediatric HIV drug formulations on the market are syrups, some having to be diluted with drinking water or kept refrigerated. "All these factors mean that many doctors on the ground feel very uncomfortable about treating children," said Fernnado Pascual Martinez, a DWB pharmacist. "It's very frustrating."
"There is just not that market pressure I guess to drive pharmaceutical companies to really push for these pediatric drugs to become available," said O'Brien.
Dividing adult-size tablets has led to some encouraging results, but administering too small a dose can encourage viral resistance, while too large a dose can be toxic.
"Often, early on, it was thought it was too hard, too difficult and they were going to die quickly anyway so why put all the effort and the resources," explained O'Brien. "Over the past 12 months people have finally started to realize that antiretrovirals can work very well in children."
In Rwanda, a program launched in 2004 is now treating 1,800 children with ARVs, up five times from before. "It is possible to treat children hit by HIV/AIDS, even in countries with limited resources," so long as there is "strong political commitment," said Diane Gashumba, a doctor at Kigali's University Hospital.
A pediatric ARV treatment in tablet form remains a priority, said Siobhan Crowley of the World Health Organization.
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