Adrianne Appel
BOSTON, Sep 28 2007 (IPS) – A new form of AIDS treatment for children, targeted at families in rural areas, will be available within months, according to an official from the World Health Organisation (WHO).
The latest formulation, made up of standard AIDS medicines, is easier to take and simpler to dispense than current drug regimens. These require many pills to be taken several times a day, and are so complicated that only health workers operating from pharmacies, city hospitals and the like can provide them, said Charlie Gilks: head of treatment in the HIV department of the WHO.
It s the reason so few kids are on treatment outside of capitals, he told IPS during a recent conference sponsored by Harvard Medical School in the eastern U.S. city of Boston.
Patients must also be able to get to clinics on a regular basis to receive the drugs, and adhere to a complicated dose schedule for the medication to be effective. This leads to the exclusion of many families in outlying regions, where transportation to the nearest health facility can be inadequate and too expensive.
With the new pills, A nurse or a rural clinic can administer them. That will make treatment much more accessible, Gilks said. We will never get to universal access if full pharmacies are required to dispense the drugs.
The WHO estimates that about 2.3 million children under the age of 15 have HIV. Of these, about 780,000 require anti-retrovirals (ARVs) to prolong their lives but only 100,000 are receiving treatment. Hopes are that the latest drug formulation will change this situation.
The new pills combine two to three standard AIDS drugs in one pill. A simple dosing chart will accompany the drugs. So, it is quite easy for staff to be trained, said Gilks.
The pills are scored down the middle so that they can easily be broken in half to make doses for very young children. They can also be easily crushed and added to food.
Jim Kim, former director of the WHO s HIV unit, said the simpler children s drugs would be a big improvement in treatment.
The syrups were notoriously difficult to give to children, he told IPS. These drugs do not have a very long shelf life and are expensive to distribute due to their heavier weight, added Kim, now head of a health and human rights project at Harvard University.
Under the WHO s children s drug plan, entire families will be targeted with distribution of the new pills, which can be taken by parents in higher doses. The very best insurance that children with HIV will thrive is for their mothers also to be well enough to care for them, Gilks said.
HIV-positive adults who have good medical care often live for 10 years or more with the virus before their immune systems fail and they become vulnerable to AIDS-related diseases. It is usually at this point that ARV treatment is given.
About 90 percent of children with HIV are infected at birth. Children who have contracted AIDS become ill with particular speed if they are not given ARVs, especially if they are poorly nourished.
Due to lack of good medical care and treatment, most children infected since the AIDS pandemic began have died, according to the Joint United Nations Programme on HIV/AIDS.
When provided, however, ARVs can turn around the life of a child AIDS patient who is very ill within just 18 months, Gilks said. Children respond even better if we catch the infection early.
The benefits of modern AIDS drugs can be seen clearly in Brazil, he added. In the 1980s, just 25 percent of children infected with HIV survived after three years of treatment. Today it is 80 percent.
The WHO has been working on the children s drug project in partnership with the European Union and the Clinton Foundation established by former U.S. president Bill Clinton for more than a year, and the new pills are all set to be distributed. The hold up is that they must be approved by the drug boards of nations around the world, Gilks said. It s been a nightmare dealing with the regulators.
He declined to name the drug companies involved in production of the new pills or the cost of the treatment.
The vast majority of children in need of ARVs are in sub-Saharan Africa, about 680,000, according to Gilks: South Africa would be one of our biggest markets.
The percentage of children in South Africa receiving AIDS drugs now stands at 21 percent of those requiring ARVs, Gilks said.
While South Africa is often knocked for not doing well enough at providing (AIDS drugs), he added, the country had over recent years increased by 50 percent the number of children receiving ARVs.
South Africa only approved a programme of anti-retroviral provision in 2003, in the wake of concerted pressure from AIDS activists.
The simplified treatment comes on the heels of a single-dose pill for adults that has been available in the United States since 2006, and is starting to be dispensed in developing countries through an initiative of the Clinton Foundation and UNITAID, a drug purchasing facility created by France, Brazil, Chile, Norway and the United Kingdom.
