Children’s medicines matter
Editors spend so much of every day with their heads thoroughly immersed, indeed swimming, in research papers, that it can be heartening to hear about initiatives that aim to prioritise the studies that really will make a difference. Yesterday I happenned to drop in to a press conference that was being held to launch the World Health Organization’s new initiative, “Make Medicines Child Size“.
This initiative takes as its starting point the huge, and global, gap between the need for children’s medicines and their availability. Howard Zucker, Assistant Director-General of the WHO, highlighted the surprising and shocking fact that, in the developed world, 50% of children take medicines that have have either only been tested on adults, or are not authorized for use in children at all. WHO has already made important steps towards framing the extent of this problem, by releasing a model list of essential medicines for children (PDF 371kb) and by identifying a set of key priority research targets. The three most important research priorites, according to WHO, include research targetted towards second-line treatments for TB; studies aimed at developing medicines for TB/HIV coinfection; and drug development for neglected diseases such as schistosomiasis and filariasis.
Clearly, these advances cannot happen overnight. Hans Hogerzeil emphasised the need for additional funding for the research and development efforts that WHO has identified. The pharmaceutical industry can be incentivised (as for example, certain legal changes in the US have done), but cannot be expected to deliver solutions to every one of these challenges. Encouragingly, Nathalie Seigneuret (European Medicines Agency) noted that funding will be available from the European Union’s Framework Programme 7 budget for certain trials which drug companies are unlikely to deliver.
And finally, a theme emphasised by several speakers was the importance of improving access to medicines. In many instances, drug regulatory systems will need to be changed to ensure that evidence relating to drug efficacy and safety can be used globally to allow countries to import the drugs that are needed.
The subject was treated rather sensationally in the UK but Prof Warner called for researchers to study children.
“To create the best therapies for children we need to include them in our research. A lot of paediatricians’ work doesn’t have much of a scientific evidence base and we prescribe drugs by extrapolating from what we know about adult bodies. We have a desperate need to understand precisely how children’s bodies work so that we can custom-design therapies for them and their problems.”