更好为艾滋病儿童提供治疗

A new initiative has been launched to provide more and better treatment to children infected with HIV. Organizers say pediatric AIDS in developing countries should be considered a neglected disease because it’s not receiving the attention it should.

It’s estimated one thousand children every day are infected with the AIDS virus. It usually happens when infected women give birth. It’s also estimated that 700 children die every day from AIDS.

“It’s extremely serious. There are more than 2.5 million children who are currently living with HIV. The overwhelming majority of those – something like 92 percent – live in sub-Saharan Africa,” said Rachel Cohen, regional executive director of the Drugs for Neglected Diseases Initiative in North America.

Cohen said pediatric AIDS has virtually been eliminated in rich nations and therefore is not in the public eye.

New focus

“Our organization has historically focused almost entirely on the most neglected tropical diseases, like African sleeping sickness, visceral leishmaniasis or chaqas disease. But as a result of several international organizations approaching us – Doctors Without Borders / Medecins Sans Frontieres, UNITAID and a few others – asked us to supply our expertise in the area of drug development to the problem of pediatric HIV, which is why we started looking into it in 2010 and have now formally launched our program in 2011,” said Cohen.

Often, relatively inexpensive treatments exist for neglected diseases, but they’re not available in poor countries – or pharmaceutical companies don’t foresee much of a profit in developing new or better treatments for them.

Cohen said drugs are available to prevent mother-to-child-transmission of HIV, but not enough women are getting them.

“Many women just don’t have access to ante-natal care, so never even attend an ante-natal service where they can be diagnosed. Even if they do, very few pregnant women are offered an HIV test. And access to optimal antiretroviral prophylaxis or therapy is really insufficient. And there are a number of other barriers. Alternatives to breastfeeding are uncommon, etc. And so we still find that a huge number of children are born with HIV in poor countries,” she said.

Speeding the process

It can take years to develop antiretrovirals suitable for children. The initiative wants to speed that process because current treatments for kids don’t pass the taste test.

“Ideally, we want this pediatric therapy to be very easy to administer and better tolerated by children than the current drugs. Today there are separate liquid preparations of some antiretrovirals for children under three, but they taste terrible. Children have a difficult time to tolerate them. They’re very difficult to administer for caregivers,” Cohen said.

The drugs also need to remain stable in tropical temperatures and be available in simple doses. The drugs also have to be compatible with other medicines the HIV-infected children may be taking.

“Because tuberculosis is so highly prevalent – and many, many children are co-infected with TB and HIV– we need to find a way to ensure that the regimen that we produce is compatible with TB drugs that that they can be co-administered,” she said.

The World Health Organization recommends immediate treatment for HIV-infected children under two years of age. The Drugs for Neglected Diseases Initiative says the goal is to develop a first-line therapy for children that is effective, available and affordable.