WHO has received US$ 9.7 million in grant from the Bill & Melinda Gates Foundation to work with UNICEF to conduct crucial research in children's medicines, with the aim of increasing the number of child-size medicines designed and formulated specifically for children.
Currently, many medicines are only designed for adults. More than 50% of medicines prescribed for children have either not been developed specifically for children or have not been proven to be effective and safe for their use. Therefore, many children lack access to essential treatment because no suitable paediatric dosage or formulation of the necessary medicine exists, or those that do exist are not available or are too expensive.
"We must take the guess work out of medicines for children," said Carissa Etienne, Assistant Director-General, WHO. "Children are suffering and dying from diseases we can treat, and yet we lack the critical evidence needed to deliver appropriate, effective, affordable medicines that might save them."
As an unsafe 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. Other challenges include the need for more clinical trials and research to be carried out on paediatric medicines.
"Some progress has been made on children's medicines but too many medicines are still given to children that have never been properly tested for them," said Dr Hans Hogerzeil, Director of Essential Medicines and Pharmaceutical Policies, WHO. "This work is an excellent example of coordination of United Nations agencies and key experts in the world to address this urgent problem."
The grant provides support for essential research to:
- determine the optimum dosage forms for paediatric medicines (e.g. small tablets, dispersible tablets, powders);
- develop dosing guides (e.g. a review of existing priority medicines and the identification of the appropriate doses for new medicines for children);
- develop guidelines for testing, treatment and use of medicines in children, including guidelines on conducting clinical trials in children.
Globally, 1000 children under the age of five die every hour. Diarrhoeal diseases account for 17% of these deaths. The optimal treatment for diarrhoea is zinc with oral rehydration salts. Yet, in a recent study of health facilities zinc was the least available of all paediatric medicines. And when zinc is available, it is not licensed as a treatment to reduce diarrhoea -- leaving pharmacists to concoct doses -- and it is both unpleasant tasting and difficult to administer. To reduce child mortality in this area, easy-to-use, palatable and appropriate dosages are needed.