Youngest AIDS sufferers getting least care, specialists say

Articles: Youngest AIDS sufferers getting least care, specialists say

Posted by admin on Friday, July 16, 2004 - 02:11 AM

The tiniest ones infected with AIDS often get the least attention.
AIDS treatment programs in poor countries are barely reaching an estimated 2.5 million children globally who have the disease, according to scientists and doctors at the 15th International AIDS Conference. The obstacles include insufficient medicines, too few health workers who can treat babies and small children, and lack of attention from policy makers. "This conference is devoted to access for all," said Kate Carr, president of Elizabeth Glaser Pediatric AIDS Foundation, a nonprofit group that funds treatment programs for children and adults. "We must include the youngest and most vulnerable, or else face the sad reality of children's deaths before their 5th birthdays." Among the difficulties in treating children is early diagnosis of HIV, the virus that causes AIDS, especially in poor countries that do not have up-to-date ways of detecting the disease. "Many of these children die before their 1st birthday -- one-third of them," said Dr. Phillipa Musoke, who has conducted studies of HIV-infected children in Uganda. "Half die before their 2d birthday." Musoke, and other doctors, said it was often difficult to identify HIV as the cause of a child's illness. Often, as HIV progresses into full-blown AIDS in a young child, opportunistic infections arise, but doctors don't know if the problem is caused by HIV or a disease such as malaria or pneumonia that starts to flourish. These obstacles are part of the reason that few children are receiving antiretroviral medicine. While no estimates were available for the numbers of children in developing countries on those powerful drugs, Dr. Moses Sinkala, director of the Lusaka Urban District Health Board in Zambia, said he believed the numbers were minuscule. In the last few months, he said, Zambia has put 1,000 people on antiretroviral therapy. Of those, 20 were children. Sinkala said he was embarrassed by the number. "It's because of the availability of the proper medication . . . most of the children are orphans, brought by grandmothers, caregivers, orphanages. For us to admit them into a program is challenging." Part of the answer, said Carr and others, was to put more pressure on drug companies to produce medicines that children can take, such as liquids. Training workers is perhaps equally important. The Baylor College of Medicine in Houston has produced a set of guidelines for AIDS pediatric care that has been distributed in 51 countries, said Heidi Schwarzwald, assistant professor of pediatrics. The college, assisted by the Elizabeth Glaser foundation and the government of Botswana, also has established a center in Botswana where it trains health workers from all over southern Africa. And yet, Schwarzwald acknowledged, "it's not enough."

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