Treating children with HIV/AIDS in poor nations is an uphill battle because drugs and diagnostic tests have not been adapted for youngsters, a leading medical and humanitarian organization said Tuesday.

“Up until now they have been a discriminated minority,” Dr David Wilson, the medical coordinator of Medicins Sans Frontieres (MSF) in Thailand, told a global AIDS conference.

“We need to pay more attention to them. They are not just small adults.

There are specific issues in terms of diagnosis and specific issues in terms of treatment.”

More than 2.5 million children are living with HIV/AIDS and 700,000 were estimated to have been infected last year. About half of young children with HIV/AIDS die before their second birthday, says MSF, a private medical and humanitarian organization.

Although access to universal treatment has been a central theme at the 15th International AIDS Conference, Wilson and his colleagues said drug companies did not develop child-friendly AIDS medicines because few youngsters in wealthy countries are born with the virus, so children are not an attractive market.

Children in South Africa as young as four who are fortunate to receive treatment can rattle off the names of drugs they must take, but many have trouble swallowing the bitter pills and foul-tasting syrups.

“HIV in children is completely neglected by the companies,” said Fernando Pascual, an MSF pharmacist based in Geneva. “They will not produce formulations for children unless there is pressure from the international community,” he added.

Unlike adult therapies, there are no fixed-dose combinations for children. Doctors must calculate doses by the child’s weight and must change them as it increases.

Some medications must also be mixed with water or refrigerated, which is difficult in poor countries.

A fixed-dose combination for adults costs about $200 per person per year, but the same drugs for children are about $1,300.

There is also no reliable test to detect the virus in children under 18 months, whose immune systems are immature.

To make the bitter pills and syrups easier to swallow, the doctors and nurses are combining them with better-tasting vitamins and using sticker charts to make sure the children take them every day so they do not develop resistance.

In Thailand, health workers are also using an illustrated story book about a wicked witch who uses a virus to take over a village, as a communications tool for children living with HIV.