August 15, 2006

Pricing, Lack of Tools Hamper Child AIDS Treatment

By Cameron French

TORONTO (Reuters) - Doctors trying to treat HIV-infected newborns in sub-Saharan Africa are being held back by over-priced treatments, an absence of diagnostic tools, and a general lack of focus from policymakers and international organizations, Medecins Sans Frontieres said on Tuesday.

Most of the 2.3 million children infected with the virus live in southern Africa but the pharmaceutical industry is based largely in richer western countries, where many fewer children are infected, the group said in a report released at the 16th International AIDS conference in Toronto.

The group, also known as Doctors Without Borders, said that only five percent of the 660,000 young children in urgent need of treatment were actually receiving it. Unfortunately, they added, the treatment was hard to come by, and what was available was over priced.

"We want to do more. We know what we're doing is not enough, because our hands are tied," Moses Masaquoi, an MSF doctor working in Malawi, told a news conference.

Masaquoi said a lack of pediatric formulations of HIV drugs meant that doctors were forced to split adult tablets that were not meant to be taken in parts, while the small amount of child-designed treatment that was available is difficult to store and administer as it needed refrigeration, which could be tough in hot, poorer countries.

Pricing discrepancies also hamper their efforts, as the few companies that produce child dosages price them higher than adult dosages, even though they carry about one-fifth of the active ingredient of the adult dosages.

"Prices of pediatric formulas are not justified," Fernando Pascual, a pharmacist with MSF, told the news conference.


The group is calling on policymakers and groups such as the World Health Organization and UNICEF to give clear guidance to drug manufacturers to produce child-specific formulations, and says national governments need to take the issue more seriously.

Former U.S. President Bill Clinton lamented the fact that pediatric treatment has lagged behind other treatment, but he sounded an optimistic note, predicting funding could jump ahead over the next two years.

"I understand why governments didn't spend money on pediatric medicine in the beginning. It's expensive. (But) now we've got the price down to $200 (per child per year)," he said in a separate news conference.

"I am committed to working with others who are coming up with the funds for this to do whatever is necessary to get the pediatric medicine to children who need it."

Nine out of 10 newly infected children acquire the virus through mother-to-child transmission, but diagnostic tests generally used for adults are not always accurate for infants.

Compounding the problem is the fact that most pregnant mothers do not have access to prenatal care, MSF said.

This has frustrated doctors who have seen noticeable results when children have received treatment.

MSF studies show that of children that did receive early treatment, 80 percent were alive after 2 years, while half of children who acquired the virus through mother-to-child transmission died before the age of two.

(Additional reporting by Maggie Fox)