Aid programs and pharmaceuticals for HIV-infected children

HIV infection affects not just many adults but also children: According to the World Health Organization (WHO), about 700,000 children under the age of 15 worldwide currently require medication for their infection, most of them in developing countries. "Pharmaceutical companies do three things to provide help in this respect: They develop pharmaceuticals especially for children, make them available in developing countries on special terms and support local projects for improved medical care," said Cornelia Yzer, director general of the German Association of Research-based Pharmaceutical Companies (VFA) prior to the International AIDS Conference beginning on August 13, 2006, in Toronto.

Research-based pharmaceutical companies have developed 13 HIV drugs especially for children. Twelve of them are already available in developing countries, among them seven that can be stored without refrigeration. Other pharmaceuticals for children are being developed, including some with a novel active mechanism. For another frequently used drug, a method was found to process it into tablets that are storable without refrigeration; now a dosage form for children is also being developed.

"Dedicated groups such as 'Action against AIDS Germany' keep emphasizing the significance of child-appropriate drugs for the worldwide fight against AIDS," Yzer said. "This makes us feel justified in our development efforts."

However, new HIV drugs are just the first step toward improved medical care for infected children in developing countries. The second step consists of special supply terms. For this purpose, the manufacturers made their pharmaceuticals available at strongly reduced prices as part of aid programs such as the Accelerating Access Initiative (AAI). The AAI, which is funded by all research-based pharmaceutical manufacturers of HIV drugs, is the largest project worldwide for people infected with HIV in developing countries: At the end of 2005, the initiative supplied as many as 720,000 patients (both children and adults) with pharmaceuticals. Every six months, this number is up about 25 percent.

"Nonetheless, many other infected children have not yet received pharmaceutical care, because there are not enough physicians, medical wards and other medical infrastructure locally or because the population is barely informed about AIDS," Yzer said. "Another price reduction cannot remedy this situation either!" To make a contribution to overcoming these problems, all research-based manufacturers of HIV drugs also participate in infrastructure projects directed at children and mothers, including the following examples:

• Since 1999, Bristol-Myers Squibb has been supporting the establishment of medical infrastructure and educational measures for women and children in African countries as part of the 'Secure the Future' program.
  
• In the 'African Comprehensive HIV/Aids Partnerships' (ACHAP) in Botswana, the government, the Bill and Melinda Gates Foundation and U.S. company Merck Inc. (in Germany: MSD) cooperate in providing medical care for HIV-infected people, 12% of them children.
  
• Together with the 'European Coalition of Positive People,' Roche supports institutions for AIDS orphans in Malawi und Mozambique.
  
• Via the Gilead Foundation, Gilead promotes training and infrastructure programs for AIDS in Africa.
  
• As part of its 'Positive Action' program, GlaxoSmithKline supports numerous measures in developing countries, including some for women and families.
  
• To all poorer countries, the companies Boehringer Ingelheim and Abbott offer HIV tests and free medication to reduce the risk of virus transmission from mother to child during birth as part of the 'Viramune and Determine Donation Program.' The non-governmental organization Axios implements distribution in the more than 60 participating countries.

"For the diverse tasks that must be managed in the fight against AIDS, a partner-like collaboration of all parties involved - national governments, aid organizations and private companies - is an indispensable prerequisite for success," Yzer said. One good example of successful collaboration is Botswana, where now more than 80 percent of HIV patients are provided with antiretroviral medication - based on a program with public and industrial support.

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