Improving drug use for children in the developing world

Children differ significantly from adults in the way they absorb, metabolise, and excrete drugs. 1 These parameters also vary as children grow from neonates through to adolescence. The practical implications and challenges that this presents are well know to anyone who is involved in the medical management of sick children. The importance of paediatric medication safety and efficacy has been gaining increasing attention in the developed world over the past decade. The United States has introduced a carrot and stick approach to increase research into medications for children with the "paediatric exclusivity provision'' and the "paediatric rule''. The European Union is also investigating ways of improving the availability of medications for children. Unfortunately, this increased focus on appropriate medicines for children, which has occurred in the developed world, has not been mirrored in developing nations. Currently more than 10 million children under the age of 5 years die each year, 2 3 with only six countries accounting for 50% of these deaths. The majority of these deaths are from treatable or preventable diseases. 4 The developed world has a moral and ethical obligation to share its gains with the children of the world.