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WHO intensifies efforts on child-appropriate medicines
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WHO intensifies efforts on child-appropriate medicines

Efforts to ensure children have better access to medicines appropriate for them intensified today with the unveiling of a new research and development agenda by the World Health Organization (WHO).

London/Geneva, Dec 6 : Efforts to ensure children have better access to medicines appropriate for them intensified today with the unveiling of a new research and development agenda by the World Health Organization (WHO).

The agenda, presented at the London launch of a campaign named make medicines child size, targets a range of medicines, including antibiotics, asthma and pain medication, that need to be better tailored to children's needs. It calls for further research and development of combination pills for HIV/AIDS, TB and malaria, as well as appropriate child therapy for a number of neglected tropical diseases.

"The gap between the availability and the need for child-appropriate medicines touches wealthy as well as poor countries," said Dr Margaret Chan, WHO Director-General. "As we strive for equitable access to scientific progress in health, children must be one of our top priorities."

WHO has already begun work to promote increased attention to research into children's medicines. The agency is building an Internet portal to clinical trials carried out in children and will publish the web site containing that information early next year.

WHO is also releasing today the first international List of Essential Medicines for Children. The list contains 206 medicines that are deemed safe for children and address priority conditions.

"But a lot remains to be done. There are priority medicines that have not been adapted for children's use or are not available when needed," said Dr Hans Hogerzeil, Director of Medicines Policy and Standards at WHO.

In industrialized societies more than half of the children are prescribed medicines dosed for adults and not authorized for use in children. In developing countries, the problem is compounded by lower access to medicines.

Each year about ten million children do not reach their fifth birthday. Approximately six million of these children die of treatable conditions and could be saved if the medicines they need were readily available, safe, effective and affordable.

Pneumonia alone causes approximately two million deaths in children under five each year and HIV kills 330 000 children under 15. "These illnesses can be treated but many children don't stand a chance because the medicines are either not appropriate for their age, don't reach them or are priced too high - up to three times the price of adult drugs," said Dr Howard Zucker, WHO Assistant Director-General.

WHO will also work with governments to promote changes in their legal and regulation requirements for children's medicines.

Reducing child mortality and treating children affected by major diseases are global priorities expressed in the Millennium Development Goals. A pre-condition to achieve these goals is increased production and availability of essential medicines for children. At present, many medicines for priority diseases are not developed for children; and when they are they are not reaching the children who need them most.

Children metabolize medicines differently from adults. They, therefore, need different dosage forms. Differences also exist between children of different ages, body weight and physical conditions. Child-specific medicines are those manufactured to suit the age, physical condition and body weight of the child taking them.

Apart from dosage, child specific medicines need to be in a format that is palatable to children. Small children have trouble swallowing big tablets but can tolerate oral solution or syrups. For children with chronic conditions such as HIV/AIDS, where several medicines must be taken daily, the fixed-dose combination approach - several medicines in one pill - is best. However, the few existing paediatric fixed dose combinations developed for children are generally three times more expensive than the adult dosage form.


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