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Group: Kids HIV, AIDS Dying Needlessly

Posted on: Tuesday, 2 November 2004, 15:00 CST

GENEVA - Children with HIV and AIDS are dying needlessly because of ignorance and a lack of suitable medicines, and the U.N. must increase efforts to change the situation, the international medical relief group Medecins Sans Frontieres said Tuesday.

HIV-positive adults in developing countries are increasingly able to obtain necessary medication, but most dosage sizes and combinations are simply not produced for children, said MSF, which is also known as Doctors Without Borders.

Where medicines designed for children do exist, they can cost six times as much as those for adults, the group said. Most doctors are forced to create their own dosages for children by opening the pills themselves, then measuring the contents and resealing the capsules.

"I do what most doctors are doing," Dr. Koen Frederix, a pediatrician based in Lyotho, Malawi, said on the eve of a three-day U.N.-sponsored pediatric AIDS summit in Geneva. "I try to show caregivers such as grandparents how to crush and break adult tablets, hoping that the children will get the doses they need. It is easy to overdose or underdose children."

There is little impetus for drug companies to develop cheaper fixed-dose combinations for children because incidence of childhood AIDS is declining in wealthy countries. But the problem has also received insufficient attention from organizations such as the U.N. children's agency and the World Health Organization, said Daniel Berman, AIDS coordinator for an MSF campaign to improve access to essential medicines.

"UNICEF has let down children to date, because they have not challenged this reality," Berman said. "Four years ago, the common perception was 'it is too expensive to deal with AIDS in Africa.' Since then, it has gotten cheaper and easier to treat adults but today children suffer from a similar situation."

The children's agency should play the main role in highlighting this shortcoming, Berman said. "UNICEF has to make it a moral imperative to treat children with HIV/AIDS," he added. "They changed reality with immunization; why not with treatment?"

In addition, a lack of adequate testing facilities in developing countries means babies under eighteen months cannot be properly diagnosed with the HIV virus. While symptoms may give doctors a clear indication a baby is HIV positive, treatment is often blocked by national laws restricting the use of certain therapies without a definitive diagnosis.

In other cases, medical workers in developing countries, unconvinced that children can be treated, fail to give them adequate attention.

"It has just never been done," said Frederix. "We need to recognize that children are treatable."

The AIDS summit will address the lack of pediatric AIDS medicines and propose more aggressive steps to increase child access to affordable and effective drugs, said Siobhan Crowley, an AIDS expert at WHO.

"We may need to subsidize and incentivize research and development, because the market is not there," Crowley said. "We also have to find a way to get these products to have reasonable prices."

UNICEF was not immediately available for comment.

Source: Associated Press/AP Online

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