USIS Washington File - July 27, 2006
Jane Morse, Washington File Staff Writer

That he seems like any other normal boy in the fourth grade is what makes him so remarkable: Andre has HIV/AIDS.

Andre is not his real name, because HIV/AIDS victims living in Jamaica, as he and his mother do, fear social stigmatism. But he and his mother, who also is a person living with HIV/AIDS, were courageous enough to come to the United States to participate in a press briefing held July 27 in Washington and to serve as real-life examples of the success of proper medical treatment.

The briefing was sponsored by the Elizabeth Glaser Pediatric AIDS Foundation and the Global Health Council, both nongovernmental organizations, and cosponsored by Senator Hillary Clinton (Democrat of New York) and Senator Richard Lugar (Republican of Indiana). It was designed to emphasize the urgent need to expand access to HIV/AIDS medication and general health care for children -- and their mothers -- worldwide.

Dr. Celia Christie-Samuels, professor and chair of pediatrics and director of the Kingston Pediatric and Perinatal HIV/AIDS Program at Jamaica's University of the West Indies, told participants at the press conference that current medications for pediatric HIV/AIDS "work like magic."

Christie-Samuels, who has worked with HIV/AIDS victims for many years, reported that initially the pediatric clinic at the University Hospital in Jamaica was "always depressing, with sick children always needing hospital admission."

But, thanks to the new medications, treated children "are mostly healthy, running up and down the corridor on clinic days," she said. The children are monitored for their growth, development, immune function and for renewed prescriptions for HIV medicines, Christie-Samuels said.

Although 94 percent of the HIV-diagnosed children in Jamaica are being treated, Christie-Samuels said significant problems remain, such as limited HIV drug formulations designed especially for children and lack of alternative drugs for the currently expensive -- and sometimes unavailable -- medications.

Worldwide, the outlook for the 2.3 million children living with HIV is not bright.

Pamela Barnes, the president and chief executive officer of the Elizabeth Glaser Pediatric AIDS Foundation, which is considered to be a worldwide leader in the fight against pediatric AIDS, reported that this year alone, 700,000 babies will be born with HIV.

"Without treatment half of these babies will die before they turn 2, and almost all will die before their fifth birthday," Barnes said.

Although current medications are very effective, Barnes emphasized "pills do not automatically equal treatment for children."

"More often, the greatest barrier to getting HIV-positive children on treatment is the difficulty of finding them in the first place," she said.

ACCESS TO MEDICAL CARE AND HIV/AIDS TESTING

Critical to saving more victims is access to routine medical care and testing for HIV, Barnes said.

Dr. Mark Dybul, the acting U.S. global AIDS coordinator, says the first critical step is preventing mother-to-child infections, because 90 percent of children are infected in utero through their mother's bloodstream. He emphasized that all pregnant women should be tested for HIV/AIDS.

Traditional tests for HIV/AIDS do not work on babies until they are about 18 months old, he noted, adding that many die from the disease at a younger age.

In addition to finding effective tests for the very young, new formulations for medical dosing for small children must be established, according to Dybul. Current methods for calculating the doses of HIV/AIDS medications for children are "too complicated," he said.

Dybul said pediatric HIV/AIDS treatment needs to be "mainstreamed' into health care systems. HIV-positive children have a broad range of health care needs because they are so susceptible to opportunistic infections that exploit the body's compromised immune system and lead to death, he said.

The most critical need, according to Dybul, is to preserve families and to get family-based treatments to combat HIV/AIDS.

The U.S. government, through the President's Emergency Plan for AIDS Relief (PEPFAR), is working with pharmaceutical companies and multilateral organizations to speed the work of addressing pediatric HIV/AIDS.

According to a fact sheet released by the State Department in June, the emergency plan has supported prevention of mother-to-child HIV transmission for women in more than 4.5 million pregnancies, provided anti-retroviral prophylaxis for women during 342,200 pregnancies and prevented an estimated 65,100 infant HIV infections. More than 13.6 million men, women and children have benefited from counseling and testing services, the State Department said.

PEPFAR currently is providing anti-retroviral treatment for 561,000 men, women and children in 15 of the most afflicted countries. (see Related article.)

For more information on U.S. policy, see HIV/AIDS.

(The Washington File is a product of the Bureau of International Information Programs, U.S. Department of State. Web site: http://usinfo.state.gov)

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