BANGKOK, July 14 (AFP) - More than two million children live with HIV/AIDS but a shortage of specially adapted antiretroviral (ARV) drugs makes it harder for them to get vital treatment, according to doctors at the world AIDS forum.
Sick children are forgotten by the big drug companies who fail to produce suitable treatments or test them properly for the HIV virus at a young age, the Doctors without Borders (MSF) group told the 15th International AIDS Conference here.
Syrups are too bitter for children and pills, that cannot be crushed into powder, are too big for them to swallow, said Dr David Wilson, head of the MSF medical programme in Thailand.
"The drug companies do not produce anti-AIDS medicine under a specially adapted paediatric format because children are not an attractive enough market," he said.
Around 38 million people carry the HIV virus in the world with up to 2.5 million of them aged under 15, according to UN figures.
Every year 650,000 children are infected because of inadequate measures to prevent HIV transmission between mother and child in the world's poorest countries. Some 490,000 children, aged under 15, died of HIV/AIDS in 2003.
Children are still "marginalised" and "victims of discrimination," said Dr Wilson.
Nearly nine out of ten children who test positive for HIV/AIDS live in sub-Saharan Africa and about half of them die before the age of two, said MSF.
Diagnostic tests are not tailored for children aged under 18 months, the group said.
Dead parents, difficulties in defining the dose according to the age and weight of the child and recruiting suitable health professionals add up to a long list of problems, the group said.
"The children are badly hit. It's very difficult for them to go to hospital by themselves," said Nozi Ntuli, an MSF nurse in South Africa.
Patients as young as five or six are sometimes made responsible for their own medication with the help of stickers and colour tags made for them.
To convince young children they are capable of swallowing a tablet of the ARV Efavirenz, sweets the same size as the tablets are given for a full week to get them into the habit.
In Malawi where 45,000 people receive ARVs, not one in the programme is a child, because medical staff lack the skills, said Arnaud Janin, another MSF official.
Out of 13,000 patients who MSF have put on their ARV treatment programme only five per cent are aged under 13.
For adults, a single tablet that combines three ARVs has made it easier for patients in developing countries to follow the correct regimen, with one pill taken twice a day. No such system is available for children.
For an adult, an ARV cocktail treatment costs 200 dollars a year, but children's syrup medicine containing the same drugs is 1,300 dollars a year, MSF said.
The UN said the only hope was that generic producers come up with a children's treatment.
Indian generic drug maker Cipla and Thailand's Government Pharmaceutical Organization (GPO) are preparing to produce fixed dose medicine in the form of a dissolvable pill or one to be chewed twice a day.
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