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Young HIV victims must not be forgotten
By Alfred Romann (China Daily)
Updated: 2005-09-22 06:25

Costly treatment

Price is another barrier. Drug cocktails available for children can be four times as expensive as those for adults.

Low prices for locally produced first-line adult drug cocktails - the first treatment an infected person can take before developing a resistance and having to switch to second generation treatments - have allowed the government to publicly offer free drugs to all adult patients as part of its "Four Frees and One Care" programme.

But virulent side effects and a lack of variety often keep patients away. The most common treatments produced in China do not work well with a common strain of the virus that goes hand in hand with hepatitis. In fact, one of the treatments' components exacerbates hepatitis.

On the other hand, the fact that affordable drugs are available at all is an improvement. For years, drug prices in China - and around the world - were just too high.

Since the turn of the millennium prices have dropped from thousands of US dollars per year to less than a couple of hundred in some cases because of mass production and distribution, particularly in India.

"It was generic production that brought down the prices of AIDS drugs from over US$10,000 to as little as US$150 per patient per year," Ellen Hoen, director of policy advocacy for MSF, said in a report for a world conference on HIV/AIDS in Brazil in July.

Still, second-line treatments and drug combinations with milder side effects are still very expensive. Children's formulations are similarly expensive and can cost thousands of US dollars per year.

A number of factors have combined to keep drug companies from producing generic children's drugs. The low number of child patients means the market is small.

It is also much more difficult to ship and store children's treatments which are often in syrup form and must be refrigerated. Others are powders that require clean drinking water, while liquid formulations can be difficult to measure.

The result is that infected children are given adult medicines ground up to adjust the dosages.

Before the Clinton Foundation got involved, children's anti-retroviral treatments were basically not available to the Chinese population at large.
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