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Advocate for medicines for children living with HIV
Ecumenical Advocacy Alliance
November 02, 2006

Keep the Promise: HIV and AIDS Campaign Action Alert

Did you know?

• Without treatment, half of all children born with HIV in poor countries die before age two.
• In 2005, 2.3 million children under 15 were living with HIV and AIDS.
• Of these, 660,000 need anti-retroviral treatment now but less than 10% are getting it.
• Fewer than 10% of pregnant women living with HIV and AIDS are receiving treatment that can virtually eliminate mother-to-child transmission of HIV.
• In 2005, 380,000 children under 15 died of AIDS and over half a million were newly infected with HIV.
• Medicines to treat HIV in children can cost four times more than treatment for adults.
• Basic antibiotics can reduce deaths of children from AIDS as much as 43% by treating opportunistic infections and delaying the point at which anti-retrovirals are needed.

What can you do?
1. Take action at: http://www.e-alliance.ch/accessmeds_pediatric.jsp and
2. tell pharmaceutical companies that they need to provide equitable access for children living with HIV to diagnostics and medicines.

Send an email postcard to four key pharmaceutical companies:

• Abbott,
• Boehringer Ingelheim,
• Bristol-Myers Squibb and
• GlaxoSmithKline.

You can also send the email postcard to friends to tell them about the action.

Background
The proportion of children living with HIV or AIDS who are receiving treatment is far smaller than the proportion of adults living with HIV or AIDS and receiving treatment. For adults the percentage is 20%, but for children it is only 7.5%. Children's deaths are sometimes seen as more unavoidable, and medicines for children are less profitable.

Children need medicines which are differently formulated compared to those for adults. All children need lower dosages than adults. Babies and young children need medicines that can easily be swallowed.
Problems here include:

• For many drugs no tests have been done on their effects on children and a formulation for children has not been developed and approved for use. This includes the recent innovations of three-in-one pill combinations which
  make treatment far easier.
• Trying to divide pills intended for adults into dosages for children can lead to dangerously imprecise dosing. Syrup formulations often need refrigeration which is not available in many regions, and are still hard to dose correctly. For all but the youngest of babies, small solid pills of the appropriate dosage are preferable.
• Some formulations for children may not have been marketed outside of rich countries and thus are not available elsewhere.
• Where formulations are available, they are often more expensive than adult formulations, as mentioned above.
• Even where medicines, such as basic antibiotics, are available and affordable, many treatment programs are not yet sufficiently informed and focused on treatment for children and are thus not providing access to medicines.

Diagnosis of HIV is usually done on the basis of the presence of antibodies. However, babies acquire their mother's antibodies, which may persist until they are 18 months old. Therefore, it is not possible to use this test to see if the virus has been transmitted to the baby of an HIV positive mother. However, as half those infected will die before they are two unless they get treatment, diagnosis is needed far earlier. Once diagnosed, regular testing is needed to see when a child living with HIV needs to start treatment.

Alternative diagnostic tests which look directly for the virus are available but require expensive laboratory equipment, complex testing, reliable electricity supplies and highly trained staff. One development is a technique that allows blood to be taken to a laboratory for testing, but this still relies on the existence of an equipped laboratory within reach of transport links. What is needed is a simple, cheap diagnostic test that can be carried out on the spot.

Further resources on pediatric AIDS are available at: http://www.e-alliance.ch/accessmeds_pediatric.jsp#resources

World AIDS Day
There is now one month to World AIDS Day on 1 December, which has the theme "Stop AIDS: Keep the Promise". Within this the EAA is focusing on accountability around access to medicines to treat HIV and AIDS. Encourage people in your church or organization to take this action in the run up to World AIDS Day.

More resources for World AIDS Day, including an ecumenical liturgy which focuses on access to medicines, are available at: http://www.e-alliancech/hiv_resources.jsp

WHO Working Group on Public Health, Innovation and Intellectual Property

As reported in previous bulletins, the World Health Organization (WHO) has set up a working group to look at alternative ways of supporting research and development

For more information see: Trade for People Campaign Bulletin 2/2006 or Keep the Promise: HIV and AIDS Campaign Bulletin 2/2006 at: http://www.e-alliance.ch/newsletters.jsp

WHO has now set up an online consultation on the work of this group, and is encouraging civil society groups to contribute their opinions.
The consultation is open between 1-15 November and is at: http://igwg.who.int/phi/

For past Action Alerts and Bulletins from the HIV and AIDS campaign, see: http://www.e-alliance.ch/newsletters.jsp

*The Ecumenical Advocacy Alliance is a broad international network of churches and Christian organizations cooperating in advocacy on global trade and HIV and AIDS. The Alliance is based in Geneva, Switzerland.

For more information, see: http://www.e-alliance.ch/

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