It's certainly welcome news for the 530,000 young children newly infected with HIV last year and for the over 2 million children and adolescents currently living with the virus. For them, getting the treatments that have saved millions of lives in the U.S. and Europe was especially difficult in part due to the scarcity of health-care workers that can barely care for HIV-positive adults, much less babies and children, and in part due to the fact that AIDS medications simply didn't come in doses made for children. The few child-friendly regimens that have been available in liquid form came with a higher price tag than their pill-based adult counterparts, putting them out of reach for the low-income nations that harbor over 90% of the world's pediatric AIDS cases. It turns out that the bottles required to package the liquid formulations cost more to ship and make than pills.
Before these new medications get into the mouths of the babes who need them, however, they need to become part of the national formularies of developing countries. The Clinton Foundation will receive $35 million from the European international drug-buying facility UNITAID to purchase the lower-priced drugs from manufacturers in the next year, and two of the largest drug purchasers for the developing world the U.S.'s PEPFAR program and the Global Fund will follow suit. And merely funneling drugs to the youngest patients won't stem the growing tide of children infected with HIV the most common source of new infections among children now is through mother-to-child transmission at birth. Without proper prenatal prevention programs aimed at young mothers, the number of children newly infected each year will continue to climb. Once they reach the youngsters, health-care workers and families will need to work together to ensure that kids continue taking their medicines one the biggest challenges that young children in the developed world have faced. "The three biggest issues in pediatric AIDS treatment have been adherence, adherence, adherence," says Dr. Katherine Luzuriaga, professor of pediatrics at University of Massachusetts Medical School. "Studies have shown that patients have to be over 95% adherent in taking their medications in order to continue to suppress their virus. One of the biggest issues overseas is going to be making sure the medical infrastructure and personnel are trained not only to administer the drugs but to conduct the follow up that's necessary to keeping these drugs effective."
First steps first, however. In much of the developing world, AIDS's youngest patients have yet to see an anti-HIV medicine if the Clinton Foundation can change that, then problems of adherence in those regions are ones that AIDS doctors and patients alike would rather have.