Doctors Without Borders: Children Neglected in Battle Against AIDS

Treating HIV-positive youngsters in poor countries is a challenge because diagnostic tests and drugs have not been adapted for children, Dr. David Wilson, medical coordinator for Doctors Without Borders (DWB), said Tuesday at the 15th International AIDS Conference in Bangkok. "We need to pay more attention to [children]. They are not just small adults. There are specific issues in terms of diagnosis and specific issues in terms of treatment," Wilson said.

Worldwide, more than 2.5 million children are living with HIV/AIDS; 700,000 children were estimated to be infected last year. DWB said about half of young children with HIV/AIDS will die before their second birthday.

Unlike adult HIV treatment, there are no fixed-dose combinations for children. Doctors must calculate doses by a child's weight and change them accordingly. Though fixed-dose drugs for adults cost around $200 per person per year, the same drugs for children cost about $1,300. In addition, there is no reliable test to detect HIV in children under 18 months, whose immune systems are immature.

Many children have trouble swallowing the bitter pills and bad-tasting syrups. According to Wilson, drug companies have not developed child-friendly AIDS medicines because so few children in wealthy countries are born with HIV, so they are not an attractive market. Fernando Pascual, a Geneva-based DWB pharmacist, said drug companies completely ignore HIV in children. "They will not produce formulations for children unless there is pressure from the international community," said Pascual.

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