"An estimated 9 million children die each year from preventable and treatable causes. Improved availability and access to safe child-specific medicines is still far from reality for many children in poor countries. This one-of-its-kind publication will be useful for organizations and personnel involved in procurement to identify where medicines may be found and what they cost," said Hans Hogerzeil, Director Essential Medicines and Pharmaceutical Policies at WHO. More than half of these deaths are caused by diseases which could be treated with safe essential child-specific medicines: acute respiratory infections - pneumonia (17%), diarrhoeal diseases (17%), neonatal severe infections (9%), malaria (7%), and HIV/AIDS (2%).
Sources and prices of selected medicines for children
The second edition of Sources and prices of selected medicines for children offers current details on 612 different paediatric formulations of 240 medicines selected from the â??WHO Model List of Essential Medicines for Children', as well as therapeutic food, and vitamin and mineral supplements, to treat major childhood illnesses and diseases. The information is vital for development and health partners who procure and supply essential medicines for children.
Challenges to obtain child-specific medicines
The guide notes that the number of sources is limited for the paediatric treatment of diarrhoea and HIV/AIDS, and there is still a serious challenge to obtain child-specific medicines to treat tropical infections endemic in Africa and Asia. The guide ranks the availability of the identified medicines, and notes that 75% of the formulations included are available for purchase. There are several sources for children's medicines and treatments to address opportunistic infections, palliative care, pain and pneumonia. Availability of paediatric formulations for treatments of malaria, maternal and newborn care, and tuberculosis was fair.
Newborn care is often lacking in poor countries, particularly in hard to reach communities. At the time of publication, there was no information from manufacturers for respiratory stimulants and pulmonary surfactants for the treatment of apnoea and respiratory distress syndrome in newborns.
Although diseases such as schistosomiasis, filariasis, and parasites transmitted through soil, are endemic in some parts of Africa and Asia, there are few manufacturers who produce child-specific medicines to treat these neglected diseases. Broadening the market search for essential medicines in this category is a serious challenge.
"While effective medicines exist to fight disease and treat life-threatening conditions like malnutrition, formulations suitable for children are often difficult to source," said Francisco Blanco, Chief of Medicines & Nutrition, UNICEF Supply Division. "The data in this edition confirms that much more research and effort needs to be made to make medicines for children more available and accessible for those who need them most."
As an alternative to missing paediatric medicines, health-care workers and parents often use fractions of adult dosage forms or prepare makeshift prescriptions of medicines by crushing tablets or dissolving portions of capsules in water. This is not always safe or effective as the dose will not be accurate. Other challenges include the need for more clinical trials and research to be carried out on paediatric medicines.
WHO recommends that wherever possible, medicines for children should be provided as flexible, solid, oral dosage forms that can be administered in a liquid when it is given to the sick child. Liquid formulations are more expensive to purchase compared with dispersible tablets and are also more costly to store, package, and transport safely.
Sources and prices of selected medicines for children is part of UNICEF/WHO work to make essential medicines for children more universally available. Since the launch of the campaign "make medicines child size" in 2007, WHO and UNICEF have been working in partnership to raise awareness and accelerate action to address the serious gaps that contribute to nine million preventable child deaths every year.
WHO is the directing and coordinating authority for health within the United Nations system. It is responsible for providing leadership on global health matters, shaping the health research agenda, setting norms and standards, articulating evidence-based policy options, providing technical support to countries and monitoring and assessing health trends. The Essential Medicines and Pharmaceutical Policies department's vision is that people everywhere have access to the essential medicines they need; that the medicines are safe, effective and of assured quality; and that they are prescribed and used rationally.
UNICEF is on the ground in over 150 countries and territories to help children survive and thrive, from early childhood through adolescence. The world's largest provider of vaccines for developing countries, UNICEF supports child health and nutrition, good water and sanitation, quality basic education for all boys and girls, and the protection of children from violence, exploitation, and AIDS. UNICEF is funded entirely by voluntary contributions.