Nine out of ten children with HIV do not have access to life-saving anti-retroviral drugs. Governments and donors need to be more ambitious in bringing existing paediatric HIV tests and drugs to the children who need them.

According to medical humanitarian organization Medicines Sans Frontières (MSF) this is particularly threatening for babies who are born with the virus as half of them will die before their second birthday if untreated.

An estimated 1.9 million children are in need of anti-retroviral treatment but only around 200,000 are able to get the medicines they need.

MSF calls on governments and donors to roll out existing tests faster and to considerably increase the use of a paediatric version of a standard fixed-dose combination (FDC) drug – a pill that combines all needed drugs in one tablet.

“It was when we introduced this easy-to-use pill that we were able to boost the number of children on anti-retroviral treatment in our projects,” said Dr Tido von Schoen-Angerer, Director of MSF’s Campaign for Access to Essential Medicines.

“We are showing that HIV care for children is possible. We challenge governments and donors to set ambitious goals and stop abandoning the majority of children with HIV to their fate.”

In wealthy countries, paediatric HIV infection has nearly been eliminated through successful prevention of mother-to-child transmission which is why HIV in children is almost entirely a problem of poor countries. Companies see little financial incentives in developing easier tests and newer drugs for children with HIV.

“We can treat today but we also need more child-friendly drugs and diagnostics. Most of the life-saving medicines exist only in adult versions. This needs to change,” said Dr von Schoen-Angerer.

Drug companies should pledge to come up with and test easy-to-use paediatric versions of all their HIV medicines or governments will need to pressure them to do this.

The lack of a simple HIV test hampers children’s access to HIV care, as the detection of the infection is a pre-condition to start treatment. Currently a complicated DNA-based test requiring transport of blood samples to advanced laboratories remains the only option for diagnosing infants.

The vast majority of children become infected with HIV through transmission from the mother during pregnancy, childbirth or breastfeeding. Greater efforts to prevent mother-to-child transmission are crucial and the two million children already infected need care.

During the last five years, nearly 10,000 children under the age of 15 were started on anti-retroviral therapy in MSF’s programs worldwide, 4,000 are children under five years of age.