The Washington Post

Trying to produce drugs appropriate for children with HIV

A child walks with activists in a torch light rally ahead of World AIDS Day in Kolkata, India, in 2012. (AP Photo/Bikas Das)

I never stopped to think about it, but children with HIV can't take the same doses of critically-needed medication that adults do. The pills are sometimes too big, especially for very young children, they taste terrible and they contain alcohol--none of which is conducive to keeping kids on their life-saving meds. When combinations of drugs are needed, it can often be difficult to keep children on their drug regimen.

Pediatric HIV has been nearly wiped out in the United States through the use of drugs for pregnant women, but fewer than 25 percent of the 3.4 million kids with HIV and AIDS elsewhere are getting the antiretroviral therapy they need, according to Greg Perry, executive director of the Geneva-based Medicines Patent Pool. Most of those children live in sub-Saharan Africa. Each day, Perry's non-profit organization notes, 700 children are newly infected, mostly by HIV passed on by their mothers, and 500 die of HIV- and AIDS-related illnesses.

So in conjunction with a number of other public health agencies in the U.S. and abroad, the Medicines Patent Pool kicked off an initiative Tuesday to recruit the big drug companies to produce and distribute HIV drugs in the right formulation for kids. They also want companies to share their intellectual property and data so that others can produce the drugs, and they say we need a redoubling of effort to make sure the drugs get to children in these developing countries and continue to flow there.

"For children, we've got to get to the situation where they’re taking a simple daily dose of the product, which tastes pleasant enough to take, which is small enough for children to take and which doesn't have a high alcohol content," Perry told me.

Also on board are UNITAID, another non-profit that tries to increase access to therapies for HIV/AIDS, malaria and tuberculosis, and the Drugs for Neglected Diseases Initiative, which develops new treatments for diseases that are not receiving enough attention, such as leishmaniasis, sleeping sickness (human African trypanosomiasis), Chagas disease, malaria, pediatric HIV and filarial diseases (elephantiasis).  Drug companies such as Gilead and Bristol-Myers Squibb have agreed to share their knowledge, Perry said, and the initiative is negotiating with Merck and AbbVie.

The U.S. government, of course, distributes these drugs to millions of people, most of them in Africa, through the President's Emergency Plan for AIDS Relief (PEPFAR), started in 2003 by President George W. Bush. The Global Fund to Fight AIDS, tuberculosis and malaria does the same.

"The evidence to date is that where people are getting appropriate treatment early on, they can lead normal lives," Perry said.

Lenny Bernstein covers health and medicine. He started as an editor on the Post’s National Desk in 2000 and has worked in Metro and Sports.

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