Only 7% of pharma research projects target children below 12: report

Even as Moderna and Pfizer test their Covid-19 vaccines on children, a study by Netherlands-based Access to Medicine Foundation found that less than seven per cent of the research projects underway at large pharmaceutical companies targeted children below 12 years.

“Far too often, the youngest members of society are at the back of the queue when it comes to receiving treatment due to the lack of availability of appropriate medicines,” said ATM, an independent non-profit organisation.

Despite advances in bringing down child mortality rates, huge discrepancies continue to exist between countries regarding the mortality of children under five years.

“..almost 5.2 million children under five still die every year from preventable and treatable diseases, most of whom are in low- and middle-income countries (LMICs),” the report noted.

The obstacles are known, the medicines are “hard pills or bitter syrups that are difficult to swallow, few treatments are tested in clinical trials in children, and the small and fragmented nature of the paediatric market provides little incentive for industry investment,” the study said

As a result, it takes far longer for child-friendly medicines to reach the market than adult versions, and there are significant gaps in the paediatric drugs pipeline. “...only 69 – or less than 7 per cent– of the 1,073 research and development projects underway at leading pharmaceutical companies target children below 12,” the report said on an analysis from the ATM Index (2021).

Some of the new treatments could prove to be game-changers for children, the report said, adding that it could improve the health of children in LMIC,“ provided they reach the patients that need them most.”

“Our research shows that access to medicine does not happen by itself - it requires concrete plans to ensure supply and address affordability for specific groups, among other issues. That planning starts with the pharma companies that hold the reins for delivery,” observed Claudia Martinez, Index research programme manager.

Child versions

Outlining examples of breakthrough products, the report said,

Eli Lilly’s glucagon nasal powder (Baqsimi®) is the first dry nasal spray that can treat severe hypoglycaemia

in children with diabetes over the age of four. “It is a form of glucagon given as a puff in the nose, enabling easy administration,” and is the first of its kind in the market.

Bristol Myers Squibb’s dasatinib (Sprycel®) was the first oral suspension formulation for paediatric patients from the age of one with acute lymphoblastic leukaemia. Another example was Astellas and MSD* oral suspension of fidaxomicin (Dificid®) for treating a common cause of diarrhoeal disease in children aged six months. Across LMICs, one in ten deaths in children younger than five years is attributable to this illness, the study said.

Dolutegravir (Tivicay®) by GSK (through ViiV Healthcare) is the first dispersible tablet formulation of dolutegravir to treat HIV in children weighing at least 3kg and from four weeks of age. For use in combination with other antiretroviral agents for the treatment of HIV, this treatment is taste-masked and can be dispersed in water, making it easier to administer to children.

"Ramping up access for children is technically difficult, though it can and must be done. This is why companies, regulators and governments prioritise ways to remove barriers, share risks and shape an environment for faster innovation and faster access," said Jayasree K. Iyer, Executive Director, Access to Medicine Foundation.

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