Vatican officials have begun pushing a unique project to rapidly expand the availability of antiretroviral drugs for children

The face of the AIDS epidemic has changed dramatically in recent years as scientists have created antiretroviral drugs that lower levels of the virus in the bloodstream, allowing those infected with HIV to live relatively normal lives.

Yet getting those drugs into the hands of everyone who needs them remains difficult. Worldwide, only 17 million of the 36.7 million people who carry the virus are receiving treatment, U.N. officials told delegates to the International AIDS Conference here. As long as those numbers do not improve, untreated carriers will continue to pass on the virus to others.

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So a major point of discussion at the conference, which ended July 22, was how to get more drugs to more people. Despite what many dub "AIDS fatigue," Catholics and other religious leaders recommitted themselves to work to expand treatment, especially among children.

Vatican officials have already begun pushing a unique project to rapidly expand the availability of antiretroviral drugs for children.

The first step was getting drug manufacturers on board. Since not many children in developed countries contract HIV these days, there's no sizable market to recoup research and development and manufacturing costs. With only poor children needing the drugs, there's less of an incentive to manufacture pediatric medicines or the specific diagnostic tools that are also needed.

"We have a commitment to make those medicines for children at the right dosage levels, but it's not a very profitable business. But then none of this HIV work is," Anil Soni, vice president for infectious diseases at Mylan, the largest producer of generic antiretroviral medicines, told a gathering of religious activists held in conjunction with the AIDS conference.

Soni was one of a handful of pharmaceutical executives invited to Rome for meetings in April and May with high-level Vatican officials and AIDS experts from the United Nations and the United States. The meetings came after years of lobbying by church officials to get governments and drug makers to take action on their own. Frustrated by the lack of progress that produced, the Vatican decided to more directly intervene. It did so by appealing to their sense of morality.

"We recognized up front that this wasn't something companies could make a lot of money on, but we also think there's a moral imperative for them to act," said Msgr. Robert J. Vitillo, who became the general secretary of the International Catholic Migration Commission in May. Until a successor is named, he also continues as the Vatican's special adviser on HIV and AIDS.

Msgr. Vitillo told Catholic News Service that the Vatican did not invite Martin Shkreli, the U.S pharmaceutical boss who increased the price of an HIV-related drug by 5,000 percent. Shkreli has been indicted for fraud in a U.S. federal court. An off-Broadway musical about his greed opened in July.

Pope Francis was scheduled to meet with the group April 16, but a last-minute trip to the Greek island of Lesbos took him out of Rome.

"He did send a personal message to the group, however. It was strong motivation to these corporate executives to hear the pope state that what they're doing is vitally important, and that they must do it together," Msgr. Vitillo said.

Msgr. Vitillo said he found participants open to new ideas and wanting to be involved.

"I didn't hear anyone say we can't do this. They did share the challenges they face and a belief that if we could share some kind of united approach" that guaranteed enough of a market, their companies could participate, even if it wouldn't be a highly profitable.

The meetings gave enough encouragement to AIDS officials that a new target for reaching children with life-saving drugs was inserted into a document signed at the High-Level Meeting on Ending AIDS held at the United Nations in June. Not all of the details have been worked out yet, and Msgr. Vitillo took advantage of the presence of all the players in Durban to continue refining their plans.

He said the next steps include forming a working group with a smaller number of representative stakeholders, then bringing an action plan back to the larger group. Msgr. Vitillo said they would probably start pilot projects in Nigeria, Zimbabwe and Congo.

The target numbers the group will pursue are ambitious: getting 1.6 million children under 15 on antiretroviral medications in the next two years. Msgr. Vitillo called that a major step toward eliminating AIDS as a major public health crisis by 2030.

Soni said new approaches will be necessary to meet that goal, because what has been tried with children until now simply is not working. He said he was recently in China, where some people crush adult tablets to treat children.

"It's the wrong dosage and it's a taste that the children can't take," he said.

Soni said researchers are developing new pediatric formulations that can, for example, be sprinkled on food. But these must be brought to market quickly. He said half of children born with HIV will die within 24 months of birth if not treated.

Faith-based groups, which in several countries are among the largest providers of health care, must continue to push their corporate partners, Soni said.

"From our perspective in industry, we appreciate and really look to faith-based organizations for their leadership in reaching out to communities, identifying patients and supporting them and offering both care and prevention services," he said. "The church has shown tremendous leadership this year in encouraging all partners to reach the children who are living with or affected by HIV to receive treatment and care."

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