On the eve of the XIX International AIDS Conference in Washington, DC, the Drugs for Neglected Diseases initiative (DNDi), a not-for-profit research and development (R&D) organisation, announced a new collaboration with Indian drug manufacturer Cipla to develop and produce an improved first-line antiretroviral (ARV) combination therapy specifically adapted to meet the treatment needs of infants and toddlers living with HIV/AIDS. The goal of the collaboration between DNDi and Cipla is to develop a 4-in-1 ARV combination product for HIV-infected children under the age of three years, including those who have been exposed to drugs while in the womb, and also those who are co-infected with TB.
Once delivered, this new paediatric ARV combination could help to accelerate the provision of care to the world’s youngest children living with HIV/AIDS, who are at very high risk of dying without treatment. An estimated 3.4 million children have HIV/AIDS, but less than a quarter currently have access to antiretroviral therapy (ART), compared with 54 per cent for adults. Without treatment, more than half of children with HIV/AIDS will die before their second birthday, and 80 per cent will die before they turn five.
Historically, major pharmaceutical companies have invested little in R&D specifically aimed at addressing the needs of young children with HIV/AIDS largely because of the absence of a viable market. The virtual elimination of mother-to-child transmission of HIV in high-income countries means that nearly all HIV-positive children live in low—and middle-income countries, with over 90 per cent in sub-Saharan Africa. The global strategy to eli