Lead Author: Jonathan Klein
Additional Authors: Kate Armstrong and Mychelle Farmer
Organization: NCD Child
Country: USA; Australia 


This submission addresses the importance of inclusion of children and adolescents as needing specific consideration in access to medicines and medical devices.


NCD Child, its leaders, and member organizations request the United Nations High Level Panel of Access to Medicines give careful consideration to the specific needs of children and adolescents, who require age appropriate medications and medical devices. Children of all ages are affected by chronic diseases, including heart disease, chronic respiratory diseases, diabetes, and cancer. Seventy percent of adult deaths result from antecedent behaviors or illness that begin in childhood and adolescence. The global medical community needs to focus on the unique needs to promote medical research, innovative development of pediatric medical devices and medicines, and diagnostics designed for infants and children. This approach will improve health outcomes for children and adolescents, it is consistent with the UN Convention on the Rights of the Child, and it will improve global efforts to achieve Sustainable Development Goal Three, to ensure healthy lives and promote well-being for all at all ages.

Non-communicable diseases (NCDs) have a significant impact on children and youth. Approximately 1.2 million deaths from NCDs occur each year in people under the age of 20, over 13% of all NCD mortality. Children die from treatable NCDs, including rheumatic heart disease, type-1 diabetes, asthma, and leukemia. Ensuring child health care systems have adequate detection, treatment, and management services for children living with NCDs is essential. Inadequate diagnostic capacity, unaffordable interventions, and an inadequate child health care workforce lead to unnecessary suffering, early mortality and preventable disability.

We note that many of the behaviors that lead to adult NCDs start during childhood and adolescence. NCD rate are increasing faster in low- and middle-income countries, with worse outcomes than in wealthier countries. NCDs also reduce economic progress, increasing poverty and the potential for political instability. Children and adolescents living with NCDS or caring for family members with NCDs have lower educational attainment and poorer access to employment opportunities. To eradicate extreme poverty, and maximize the potential of all children, health services must include resources to reduce the long-term economic burden of the NCD epidemic. Children and youth living with and at risk for NCDs require health care, education, and social and community services that are specific to their and their families’ needs. Affordable diagnosis and treatment, including access to medicines, pain management and palliative care, must be provided as a matter of human rights, and should be established as a priority for health and sustainable human development.

Investing in prevention through strengthening the availability and quality of routine health care for children and youth should also be a priority. Governments, professional organizations, community-based institutions, donor agencies, and public private partnerships must collaborate to support sustainable enduring health care systems, integrate funding streams, and avoid duplication and waste.

Plans for access to medicines and medical devices must be inclusive of children and adolescents, and allow for country-level policy, planning and accountability. Whether for specific diseases or risk factor targets, for access to medicines, or for universal coverage – specific indicators and measures addressing children and youth are needed in order to drive accountability. Thus goals for children and adolescents will be included in the High-Level Panel on Access to Medicines. Additionally, national governments are encouraged to understand and act upon the need for access to care for children and youth living with cancer, heart disease, diabetes, respiratory diseases, and other NCDs by developing systems, personnel and resources for universal health care that provides equitable access to families and individuals living with NCDs. Countries should also be encouraged to include these issues in planning and surveillance of their own populations’ health and health care needs.

NCD Child endorses the calls for specific actions in the APPES – CLAN Equity (ACE) Working Group online contribution, and the UICC paper on Children and Cancer. While specific to the Asian Pacific region, and to childhood cancer, the strategies that these submissions call for are excellent examples of the approaches needed in every region, and for every condition leading to and requiring special health care resources. Children's rights to health and well-being require that we do nothing less.

Bibliography and References


Call to Action on NCDs, Child Survival, and Child Health. 2015

The 2014 NCD Child Conference Report: Doing What Needs to Be Done. April, 2014.