GLOBAL ACCELERATOR FOR PAEDIATRIC FORMULATIONS (GAP-f)

Resources

Rome Action Plan

In November 2017, a High-Level Dialogue on Scaling Up Early Diagnosis and Treatment of Children and Adolescents was convened by His Eminence Peter Kodwo Appiah Cardinal Turkson, Prefect of the Dicastery for the Promotion of Integral Human Development, with PEPFAR, UNAIDS and Caritas Internationalis, and in close collaboration with the World Council of Churches-Ecumenical Advocacy Alliance, the Elizabeth Glaser Pediatric AIDS Foundation (EGPAF) and the WHO. Key principles of the GAP-f set the basis of discussion, which led to an action plan including an impressive list of commitments from industry, regulators, UN agencies and other stakeholders.

The commitments from the Rome action plan promote three key principles:

  1. Focusing on priority paediatric drugs and formulations
  2. Accelerating development, review, and introduction of paediatric formulations
  3. Collaborating to expedite the development and introduction of paediatric products.

Action Plan for Scaling Up Early Diagnosis and Treatment of Children and Adolescents 

17 November 2017
See the action plan here | See the action plan monitoring tracker here

High-Level Dialogue to Assess Progress and Intensify Commitment to Scaling Up Diagnosis and Treatment of Paediatric HIV 

6-7 December 2018 | Pontifical Academy of Sciences (Vatican City)
See the EGPAF/WHO press release “A new push for timely diagnosis and treatment of children with HIV” here

Implementing Optimized Paediatric ARV Formulations Webinar

28 February 2020
See the webinar here

This WHO webinar, convened in collaboration with GAP-f member organizations (PENTA, CHAI, MPP, EGPAF) and GAP-f partners (DNDi, ICAP and Unicef), provides country programmes and key stakeholders with the latest information on optimal paediatric ARV formulations as well as provide an opportunity for an open dialogue regarding immediate challenges and opportunities to accelerate access to better paediatric formulations for children living with HIV.

Prioritization

PADO-TB – List of priority paediatric antituberculosis drug formulations 
First Paediatric Antituberculosis Drug Optimization Meeting (PADO-TB 1)

See the PADO-TB 1 meeting report and list of prioritized paediatric antituberculosis drug formulations here

PADO-HIV 4 – Review of priority paediatric ARV formulations 
Paediatric ARV Drug Optimization 4 Review

See the summary report and read about the review process here

Paediatric Drug Development Resources

ILF – Policy brief on advance procurement of paediatric drug formulations 
The many challenges of developing drugs appropriately formulated for children are compounded by a series of market factors that make these efforts costly and complex, discouraging drug manufacturers – especially generic drug manufacturers – from prioritizing investments in new paediatric treatment options. This brief explores the concept of advance procurement as a method for reducing uncertainty within the paediatric ART market and spurring investment in adapted child-friendly drug formulations. Access the policy brief here.

EMA – Paediatric medicines: Overview 
The European Union Paediatric Regulation enables the EMA to stimulate research into the uses of medicines in children and to overview their authorisation.

EMA – European Medicines Agency and European Commission (DG Health and Food Safety) action plan on paediatrics 
This action plan takes into account the suggestions made at a multi-stakeholder workshop convened by the European Commission and the European Medicines Agency on 20 March 2018, where ways to improve the implementation of the Paediatric Regulation were discussed. 

FDA – Quality attribute considerations for chewable tablets: Guidance for industry 
Recommendations on critical quality attributes that should be considered when developing chewable tablets and selection of acceptance criteria that are appropriate and meaningful indicators of product performance throughout the product shelf life. 

FDA – Pediatric HIV infection: Drug product development for treatment – Guidance for industry 
General recommendations on the development of antiretroviral products for the treatment of HIV infection in paediatric patients (birth to younger than 17 years of age). 

2018 Optimal Formulary and Limited-Use List for Paediatric ARVs 
Fifth edition of the Optimal Formulary and Limited-use List supporting the transition to optimal WHO-recommended regimens for infants and children.

Presentations

Implementing Optimized Paediatric ARV Formulations Webinar

Bringing it all together: The Global Accelerator for Paediatric Formulations (GAP-f) 
Accelerating the development and uptake of the most needed drug formulations for children, AIDS 2018
Penazzato & Domanico – July 2018 | Amsterdam, the Netherlands

The Global Accelerator for Paediatric Formulations (GAP-f): Accelerating the development and uptake of the most needed drug formulations for children 
11th World Meeting on Pharmaceutics, Biopharmaceutics and Pharmaceutical Technology
Morin, Cohn, Vicari, Domanico, Lewis, Watkins, Pascual, Lee, Sugandhi, Eisenhawer, Pérez Casas, Auton, Siberry, Giaquinto, Penazzato, On behalf of GAP-f partners — March 2018 | Granada, Spain

Peer-reviewed Publications

Mind the Gap: Filling Knowledge Gaps in Paediatric and Adolescent HIV for an AIDS Free Generation 
J Int AIDS Soc, 2018, 78(S1)

Paediatric and Adolescent HIV and the Sustainable Development Goals: the road ahead to 2030 
J Int AIDS Soc, 2018, 21(S1)

Hepatitis C virus infection in children and adolescents
Indolfi, Easterbrook, Dusheiko, El-Sayed, Jonas, Thorne, Bulterys, Siberry, Walsh, Chang, Meyers, Giaquinto, Wirth, Chan & Penazzato
The Lancet Gastroenterology & Hepatology, 2019, Published online first

Treating young children co-infected with tuberculosis and HIV
Turkova & Bamford
The Lancet HIV, 2019, 6(1): PE4-E6

Catalysing the development and introduction of paediatric drug formulations: a new global collaborative framework for action 
Penazzato, Watkins, Morin, Lewis, Pascual, Vicari, Lee, Hargreaves, Doherty & Siberry
The Lancet HIV, 2018, 5(5): 259-e264

Completion Rate and Safety of Tuberculosis Infection Treatment With Shorter Regimens 
Cruz & Stark
Pediatrics, 2018, 141(2)

Challenges of using new and repurposed drugs for the treatment of multidrug-resistant tuberculosis in children 
Schaaf, Garcia-Prats, McKenna & Seddon
Expert Rev Clin Pharmacol, 2018, 11(3):233-244

Shortening the decade-long gap between adult and paediatric drug formulations: a new framework based on the HIV experience in low- and middle-income countries 
Penazzato, Lewis, Watkins, Prabhu, Pascual, Auton, Kreft, Morin, Vicari, Lee, Jamieson & Siberry
J Int AIDS Soc, 2018, 21(S1), e25049

Prevention and treatment of HIV infection in neonates: evidence base for existing WHO dosing recommendations and implementation considerations 
Clarke, Penazzato, Capparelli, Cressey, Siberry, Sugandhi & Mirochnick, WHO Paediatric Antiretroviral Working Group
Expert Rev Clin Pharmacol, 2018, 11(1):83-93

Meeting the goal of concurrent adolescent and adult licensure of HIV prevention and treatment strategies 
Hume, Lewis & Nelson
J. Med. Ethics, 2017, 0: 1-4

Recommendations for Optimizing Tuberculosis Treatment: Therapeutic Drug Monitoring, Pharmacogenetics, and Nutritional Status Considerations 
Choi, Jeong, Koh & Lee
Ann Lab Med, 2017, 37(2): 97-107

Prioritizing the most needed formulations to accelerate paediatric antiretroviral therapy scale-up 
Penazzato, Palladino & Sugandhi, on behalf of the PADO 3 Meeting participants
Curr Opin HIV AIDS, 2017, 12:369-376

Optimizing Research to Speed Up Availability of Pediatric Antiretroviral Drugs and Formulations 
Penazzato, Gnanashanmugam, Rojo, Lallemant, Lewis, Rocchi, Saint Raymond, Ford, Hazra, Giaquinto, Belew, Gibb, & Abrams, for the PAWG
Clin Infect Dis, 2017, 64(11):1597-1603

Optimization of the strength of the efavirenz/lamivudine/abacavir fixed-dose combination for paediatric patients 
Bouazza, Cressey, Foissac, Bienczak, Denti, McIlleron, Burger, Penazzato, Lallemant, Capparelli, Treluyer & Urien
J Antimicrob Chemother, 2017, 72(2):490-495

Online Resources

EuPFI – European Paediatric Formulation Initiative 
With subgroups focused on administration devices, biopharmaceutics, taste masking/testing, age appropriateness, and excipients

Enpr-EMA – European Network of Paediatric Research at the European Medicines Agency 
Network of research networks, investigators and centres with recognised expertise in performing clinical studies in childrens

GPFC – Goodman Pediatric Formulations Centre (GPFC) 
Rosalind & Morris Goodman Family Pediatric Formulations Centre of the CHU Sainte-Justine

LEAP – Long-Acting / Extended Release Antiretroviral Resource Program 
Portal funded by the U.S. National Institutes of Health

MAP-IT Model – Model for Assessment of Pediatric Interventions for Tuberculosis 
RTI International, TB Alliance, Unitaid

PaedForm – European Paediatric Formulary 
Council of Europe

PDCO – Paediatric Committee 
European Medicines Agency

STEP database – Safety & Toxicity of Excipients for Paediatrics 
European Paediatric Formulation Initiative

USPFI – United States Pediatric Formulation Initiative 
In the context of the Best Pharmaceuticals for Children Act (BPCA) and with groups focused on scientific/technical/regulatory barriers, taste/smell/flavour, economics/partnerships, and use/application of new delivery systems

Global Accelerator for Paediatric Formulations (GAP-f)

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