- All > Medicine Access and Rational Use > Better Medicines for Children
- All > Medicine Access and Rational Use > Rational Use
- All > Medicine Access and Rational Use > Selection
- Keywords > ART regimens and formulations
- Keywords > child-specific antiretrovirals
- Keywords > children - antiretroviral therapy
- Keywords > Essential Medicines List (EML)
- Keywords > HIV - regimen and formulation
- Keywords > HIV/AIDS related treatment - children
- Keywords > medicines for children - formulations and adequate dosages
- Keywords > paediatric / child dosage form
- Keywords > paediatric ARV formulations
- Keywords > procurement of antiretrovirals
(2014; 19 pages)
The complexity of HIV treatment in children is marked by a spectrum of issues, ranging from clinical management to market sustainability of antiretroviral (ARV) products. Children account for less than 7% of all patients on ART and despite the availability of multiple child-appropriate ARV formulations, demand for such products is relatively low and further fragmented across numerous, duplicative products. Consolidation of demand around a subset of optimal paediatric ARV formulations is essential to ensure a sustainable supply of drugs for children living with HIV.
In September 2013, 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 convened to update the existing optimal paediatric ARV formulary originally drafted in 2011. This list has served as guidance for national programmes, procurement agencies, funders and manufacturers. The working groups mapped out the process of revising the 2011 list, re-examined the existing selection criteria for rationalizing paediatric formulations, and evaluated all available products against these criteria.
The revision process for routine updating of the IATT optimized formulary list will be brought in line with the World Health Organization (WHO) treatment guideline revision process, while the list itself will reside within the WHO. The updated lists of optimal and limited-use products include both preferred and alternative drugs recommended in the WHO’s 2013 Consolidated Guidelines on the use of Antiretroviral Drugs for Treating and Preventing HIV Infection. A total of 10 optimal formulations for paediatric ART, including two syrups for infantprophylaxis in PMTCT, were selected. Stakeholders in the paediatric treatment landscape are encouraged to refer to these updated lists of formulations in guiding their decision-making for procurement.