IATT Paediatric ARV Formulary and Limited-Use List: 2016 Update
(2016; 9 pages)

Abstract

Delivery of antiretroviral treatment (ART) to children living with HIV is associated with a complex set of clinical, operational and procurement challenges, particularly in resource limited settings where over 90% of these children receive care. Currently, children account for less than 5% of all people on ART, and as the global community gets closer to the goal of elimination of mother-to-child transmission (eMTCT), the number of paediatric patients is expected to further decrease. This makes market coordination increasingly important to ensure paediatric products remain available and accessible in resource-limited settings.

Appropriate treatment of paediatric patients requires dosing across a range of ages and weight-bands, often using different antiretroviral (ARV) formulations. In recent years, new formulations that meet the unique administration needs of children have become available, such as dispersible fixed-dose combinations (FDCs) and the WHO provides some general principles for the dosing of available ARV formulations for infants and children. These products have significantly improved the quality of paediatric HIV care in resource-limited settings; however, the proliferation of these newer options, alongside the continued availability of older sub-optimal products, resulted in fragmentation of procurement orders across multiple and often duplicative products.

The first IATT Optimal Paediatric ARV Formulary was created in 2011 by the Child Survival Working Group (CWSG) and the Supply Chain Management Working Group (SCMWG) of the Interagency Task Team (IATT) on the Prevention and Treatment of HIV infection in Pregnant Women, Mothers and Children. Since then, the group has convened in conjunction with the Antiretroviral Procurement Working Group (APWG) every 6 months and following any updates from the WHO Consolidated ARV Guidelines, to update the existing Optimal Paediatric ARV Formulary. The review process is designed to ensure the Optimal Formulary remains current in order to provide the right set of formulations to cover WHO recommended paediatric ARV regimens.

This list continues to serve as guidance for national programmes, procurement agencies, funders, and manufacturers to select products that closely align to the criteria describing optimal paediatric dosage forms

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