Treating children with HIV: the perennial resource challenge

WHO now recommends that anti-retroviral therapy be prescribed to all children under five. But where will the drugs come from and what happens when children reach adolescence?

In June this year, the WHO published new guidelines on the prescription of anti-retroviral therapy (ART) for the treatment of HIV positive patients. One of the major changes was a recommendation to prescribe ART to all children under five, whatever their CD4 count (a measure of the strength of the immune system). Yet only 28% of children who were eligible for treatment under the previous guidelines received treatment, so can the new guidelines help break down the barriers to access to treatment?

Most health professionals think so, simply by virtue of not requiring a CD4 count before putting a child on treatment. Allan Mayi, senior technical adviser at the Elizabeth Glaser Pediatric Aids Foundation (EGPAF) in Turkana, Kenya, says that health workers often struggle to interpret CD4 count results, which can take weeks. There are only three CD4 machines in Turkana County, an area the size of Ireland, a situation that is commonplace in developing countries. Removing this requirement will be a relief, he says. “I wish the recommendation were for all children, not just those under five.”

Emilie Filou
The Gardian
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During the Canada Post strike announced September 25, 2025, the following measures will be undertaken to minimize service disruption to BC-CfE clients and providers.

  • The BC-CfE Laboratory has transitioned to private courier for delivery of outgoing reports and documents. Results required urgently can be faxed upon request. (Lab Contact Information: Phone 604-806-8775; FAX 604-806-9463)
  • The BC-CfE Drug Treatment Program (DTP) will fax outgoing forms and documents to the provider’s office. (DTP Contact Information: Phone 604-806-8515; FAX 604-806-9044)
  • St. Paul’s Hospital Ambulatory Pharmacy has transitioned to private courier for delivery of medications. We recommend requesting medication at least 2 weeks in advance in case of delivery delays, particularly to rural/remote parts of BC. (Contact Information: Phone 1-800-547-3622; FAX 604-806-8675)

During the Canada Post strike, we recommend that documents be faxed or couriered to our sites, versus utilization of regular mail service

The BC-CfE Laboratory is streamlining reporting processes for certain tests in order to simplify distribution and record-keeping, and to ensure completeness of results. Beginning September 2, 2025, results for the ‘Resistance Analysis of HIV-1 Protease and Reverse Transcriptase’ (Protease-RT) and ‘HIV-1 Integrase Resistance Genotype’ tests will be combined into a single ‘HIV-1 Resistance Genotype Report’.
For more details and example reports, please click on the button below