Amsterdam - Children with AIDS are dying needlessly because of a lack of suitable and adapted medicines. On World AIDS Day, December 1, MSF is calling on the World Health Organisation (WHO), UNICEF and national governments to ensure the availability of appropriate drugs and treatment protocols for children with HIV/Aids There are 2.5 million children with HIV/Aids worldwide.

In Africa 500,000 children die of the disease each year; in Europe an estimated 100 children die each year. MSF has been able to expand treatment in resource poor settings thanks to low priced generic fixed-dose combination therapies. Most adult patients treated by MSF now take either a triple fixed-dose combination treatment - one pill twice a day - or one double combination plus a third drug.

But these combination pills are not available in dosages for children, which means they have to swallow a large amount of pills every day. When childhood doses are available, they come at a high price. It can cost over six times more to treat a child than to treat an adult - US$ 1,300 versus US$ 200 per year. The vast majority of children with HIV/AIDS live in developing countries.

Due to improved treatments, mother-to-child transmission is hardly seen anymore in wealthy countries. Therefore, investing in and producing antiretroviral drugs for children are not interesting for the pharmaceutical industry.

The few drugs, which have been developed for children, are too expensive for developing countries and very complicated to deliver. MSF doctors find that adult pills are often not easy to break to ensure that children get the right dose for their weight, which is very important to ensure they are treated and to prevent the development of drug resistance in the future.

"There is a limited selection of ARVs available," says doctor Heather Culbert of the MSF team in Bukavu, in the east of the Democratic Republic of Congo (DRC). "The problem is that these are difficult to dose and to administer, especially to older children, which makes our work highly frustrating."

The problems in fighting HIV/AIDS in children are not limited to just the price and the availability of drugs. Also the methods to diagnose the disease are not adapted for children.

Besides this, there is a lack of simple guidelines to facilitate prescription, which makes it difficult to determine the right dosage for a child of a particular age. MSF treats some 23,000 HIV/AIDS patients in 27 countries of which five percent are children under 13 years old.