Treating children with HIV: the perennial resource challenge

published on September 12, 2013 in The Guardian

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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Treating children with HIV: the perennial resource challenge

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