WHO and UNICEF recently hosted a 2-day discussion with participants from 20 developed and developing countries and non-governmental organisations with the aim of boosting access to essential medicines for children. The results of these discussions have not yet been published but participants devised a plan that will be sent to countries for feedback about how best to implement the recommendations locally.
One short-term goal is to speed up the prequalification process of paediatric formulations of medicines for AIDS, tuberculosis, and malaria. Prequalification assures the quality of generic formulations and allows them to be placed on the WHO essential drug list. This list includes drugs that meet the priority health-care needs of individual countries. Any drug on this list should be available at all times, in adequate amounts, and in appropriate doses and formulations. Therefore, another aim in the plan is to ensure that all appropriate paediatric formulations for all childhood illnesses are placed on the essential list to help improve access.
UNICEF and WHO told The Lancet that they hope to tap into the recent political momentum to help children with AIDS, led by governments and rich charitable foundations, to progress access to treatment for the many of the neglected killer diseases of childhood. It will be an uphill struggle. First, not only are there no paediatric formulations for many of these diseases, but many drug companies are not interested in developing them. Second, drugs that were available in some countries, such as intravenous phenobarbitone, have been withdrawn and are no longer registered. Third, the formulations that are available are not usually in suitable form—most are syrups that need refrigeration. And fourth, there are no funding targets for children. Neither the Global Fund nor the World Bank, for example, currently state what proportion of funds should be spent on children.
The recent talks and forthcoming plan are a good but long overdue start. They must be followed by swift action. It is unacceptable that in 2006, thousands of children still die needlessly every day because they do not have the medicines that could save them.