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Good and bad news about HIV treatment for children

Last year, only 53% of children and infants living with HIV worldwide were correctly diagnosed and received life-saving treatment. But affordable, child-friendly HIV treatment has recently become more accessible than ever, thanks to recent advances and cost negotiations involving a generic version of the HIV drug dolutegravir.

To get the message across, international HIV and health organizations have called for greater access to HIV treatment for children and infants. A joint statement released by the World Health Organization (WHO) calls for a massive scale-up of treatment access to end pediatric AIDS.

The WHO recommends a dolutegravir regimen as first-line treatment for children. The generic 10 milligram tablets suitable for children were quickly approved by the United States Food and Drug Administration thanks to a collaboration with Unitaid, ViiV Healthcare, the Clinton Health Action Initiative (CHAI) and generic suppliers. To improve access to the medicine, Unitaid and CHAI have negotiated an agreement that reduces the cost of the medicine by 75% for children living with HIV in low- and middle-income countries.

“For the first time, children living with HIV in low- and middle-income countries will have access to the same first-line antiretroviral medicines at the same time as those in high-income countries,” said Iain Barton, CEO of CHAI, in the Joint WHO call to action. “The partnership is expected to serve as a model for breaking down barriers that impede the development of pediatric formulations to deliver cutting-edge medicines quickly and affordably.”

“This has the potential to be a game-changer for children living with HIV,” added Meg Doherty, director of global HIV, hepatitis and STI programs at WHO. “We must do everything in our power to help countries get this new [dolutegravir formulation] to all children who need it.

Also signatories to the WHO statement are the United Nations Children’s Fund (UNICEF) and its program for the fight against AIDS (UNAIDS), the United States President’s Emergency Plan for the fight against AIDS (PEPFAR), the Elizabeth Glaser Pediatric AIDS Foundation, CHAI, Unitaid and the Global Fund to Fight AIDS, Tuberculosis and Malaria.

Pediatric dolutegravir scaling up is vital. Not only is it highly effective and easier to take, therefore likely to boost adherence, but it is also desperately needed. As WHO reports, 95,000 children died of preventable AIDS-related illnesses in 2019. Additionally, of the 1.8 million children aged 14 and under who are living with HIV, 850,000 are not diagnosed or not on treatment.

A recent report by UNICEF found that 320,000 children and adolescents contracted HIV in 2019. That translates to one every 100 seconds. This was before the COVID-19 pandemic, which has only made things worse, including by disrupting treatment and services, reducing HIV services by 10% or more in many countries by compared to pre-pandemic data.

In related news, Charles Lyons, President and CEO of the Elizabeth Glaser Pediatric AIDS Foundation, wrote an opinion piece titled “Putting children first in the response to COVID-19which pushes us to learn about HIV. You can read more content about HIV related to children and adolescents on the hashtag #Pediatric. Examples of articles include “Always here“, a look at the challenges that young long-time survivors continue to face, and “Why this new strawberry-flavored HIV drug is a game-changer.”

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