Progress of the National Pediatric Free Antiretroviral Therapy program in China

Abstract

In 2003, the Chinese Government initiated a free antiretroviral therapy (ART) program focusing on adult AIDS patients. Pediatric antiretroviral (ARV) formulations were yet unavailable. It was not until July 2005, with the initiation of a two-stage program implemented by the Chinese Ministry of Health, that pediatric formulations became accessible in China. Initially, the pediatric ART program was piloted in six provinces with the highest incidences of pediatric HIV/AIDS. The pilot stage allowed the Chinese Center for Disease Control and Prevention (CCDC) to finalize entry criteria, treatment regimen, and patient monitoring and follow-up procedures. The second stage commenced at the end of 2006 when the program was scaled-up nationally. In order to guarantee treatment of pediatric patients, extensive training in the selection of appropriate ARV drug regimen and dosage was provided to doctors, often through on-site collaboration with domestic and international experts. The CCDC simultaneously established a pediatric ARV management system and a pediatric ART information system. CD4 count and other laboratory tests are being routinely performed on these pediatric patients. By the end of June 2009, 1529 pediatric patients had received ARV under the national program. However, challenges remain. Firstly, many children infected with HIV/AIDS live in rural areas where the treatment quality is hindered by the limited number of medical facilities and skilled medical workers. Secondly, much of the pediatric ARV drug supply depends on donation. An effort needs to be made by the Chinese Government to establish China's own drug procurement and supply system.

Keywords:

• children
• HIV
• ART
• HAART

Acknowledgements

The authors would like to thank all of the pediatric antiretroviral treatment centers and provincial CDC staff in China and all of the international partners (The Clinton Foundation HIV/AIDS Initiative, WHO China Office, CDC GAP). This program was funded by the Chinese Ministry of Science and Technology Grant (2004BA719A11) and the Important National Science and Technology Specific Projects (2008ZX10001-007). The authors also wish to acknowledge Kai Sun (Washington University School of Medicine), Ray Chen (Office of Global Research, National Institutes of Health), Naomi Juniper (National Center for AIDS/STD Control and Prevention), and Marc Bulterys (CDC-GAP China Office) for their contribution to fix this manuscript.