Good Things that Pharma Companies Do Mark W. Kline, M.D. Professor and President Baylor International Pediatric AIDS Initiative Baylor College of Medicine Texas Children s Hospital
New Pediatric AIDS Cases, U.S. 1000 945 919 823 800 684 600 526 400 200 339 247 190 124 115 109 69 48 0 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004
Global HIV Prevalence
HIV/AIDS: The Global Picture More than 95% of the 13,400 new HIV infections and 8500 HIV/AIDS-associated deaths that occur each day are in developing countries Children account for 14% of all new infections and 18% of all deaths (1560/day)
Deaths Under Five Years of Age Attributable to HIV/AIDS Global 4.0% Botswana 57.7% Zimbabwe Swaziland Namibia Zambia 42.2% 40.6% 36.5% 33.6% 0% 10% 20% 30% 40% 50% 60% 70%
The AIDS Orphan Crisis More than 15 million African children have been orphaned by HIV/AIDS There may be 20 million AIDS orphans by 2010
In the instance of antiretroviral therapy, the scenario for children is, quite simply, doomsday. Stephen Lewis January 18, 2005
Pediatric HIV/AIDS Treatment: The Global Picture Children are underrepresented among those accessing treatment in virtually every setting worldwide Currently, no more than 60,000 children receive antiretroviral treatment, fewer than 3% of all HIV-infected children globally
Barriers to Pediatric HIV/AIDS Care and Treatment Lack of infrastructure Lack and loss of human capacity Expense Lack of commitment to treatment of children Perceived complexity of pediatric treatment
The Baylor International Pediatric AIDS Initiative (BIPAI) Established 1996 Committed to improving the health and lives of HIV-infected children and families globally Currently active in Romania, Ukraine, Mexico, China and 20 countries in Africa
Facts About HIV/AIDS in Romania Romania accounts for over half of all European pediatric HIV/AIDS cases Children account for 90 percent of all HIV/AIDS cases in Romania
Annual Pediatric HIV/AIDS Death Rate: Constanta, Romania 15% 13% 10% 7% 5% 3% 1% 0% 1998-2001 2002 2003 2004-2006
Annual Pediatric HIV/AIDS Death Rate: Botswana COE 5% 4.7% 4% 3% 2% 1% 0% 2.1% 1.1% 0.3% 2003 2004 2005 2006
The Children s Clinical Centers of Excellence Network Established January, 2004 Committed to high quality, high impact, highly ethical pediatric and family HIV/AIDS care and treatment, health professional training and clinical research Designed to catalyze pediatric HIV/AIDS care and treatment globally
The BIPAI Children s Clinical Centers of Excellence Network
Defining Characteristics of the Centers of Excellence Collaborative Comprehensive Family-centered Care and treatment focused Provide support for regional and national scale up of pediatric and family HIV/AIDS care and treatment
Spin-off Benefits of the Centers of Excellence Building capacity for pediatric health care and clinical research generally (collateral benefit) Reversal of brain drain Powerful impetus for HIV testing Destigmatization
Pediatricians/100,000 Children 120 100 106 80 60 40 20 0 2.5 0.6 0.4 0.2 U.S.A. Botswana Swaziland Lesotho Malawi
Contributing Factors in the Dearth of African Pediatric Health Professionals Low productive capacity of African professional schools Exodus of African health professionals to the developed world Deaths of professionals from HIV/AIDS and other causes Crushing burden of care and treatment posed by HIV/AIDS and other diseases
Features of the Pediatric AIDS Corps Announced in June, 2005 Recruitment of BE/BC pediatricians, internists and family doctors (50/year) Attachment to seven children s centers in Africa Minimum one-year commitment Training in tropical medicine and HIV Living stipend Housing Student loan debt repayment
Goals of the Pediatric AIDS Corps Provide primary pediatric and HIV/AIDS care and treatment directly to at least 80,000 African children and families Train hundreds of African health professionals in the care and treatment of pediatric HIV/AIDS Dramatically expand access of African children to HIV/AIDS care and treatment
BIPAI Network Activity 20,000 19,266 15,000 12,300 13,063 15,698 16,302 10,000 5,000 5,315 6,345 6,925 7,224 8,472 0 Dec '06 Feb '07 Apr '07 Jun '07 Aug '07 Active patients Patients receiving HAART
HIV-Infected Children Receiving Care and Treatment 20,000 19,266 15,000 10,000 11,000 15,000 5,000 4,000 0 U.S.A. Western Europe U.S. + Western Europe BIPAI Network
Areas of Focus for the Remainder of 2007 and Beyond Prevention of mother-to-child HIV transmission Hospital-based HIV testing Satellite and outreach services Accountability and evaluation of outcomes
LERATO: Lesotho Expansion of Rural AIDS Treatment and Outreach
Summary Providing lifesaving care and treatment to HIV-infected children in Africa and around the world is a test of our ingenuity, our commitment and our compassion We have a unique opportunity to change the world for hundreds of thousands of HIVinfected children and their families
Our Partners and Funders Bristol-Myers Squibb Foundation Abbott Fund UNICEF U.S. Centers for Disease Control and Prevention Fogarty International Center / NIH