Advancing Pediatric, Maternal and Child Health

As a result of our continued dialogue with our collaborators and stakeholders, NIAID is considering how best to address the HIV/AIDS research agenda for the maternal and pediatric populations within the Institute's future clinical trial networks. Significant progress has been made in maternal and child health with the development of methods to prevent mother-to-child transmission of HIV. While these successes are quite evident in the developed world, there is still a sizeable implementation gap for maternal, pediatric and child health services within resource-limited settings. Looking ahead, there are still significant research areas that need to be addressed for these special populations. Specifically, we have identified the following six research priorities:

• define optimal, safe drug doses for antivirals and anti-infectives (e.g., new tuberculosis medicines) used in infants, children, adolescents, as well as pregnant women and women who have recently given birth
• management of HIV-related co-infections, co-morbidities and consequences of chronic antiretroviral drug exposure;
• build on established findings involving prevention of mother-to-child transmission of HIV and other associated infectious diseases;
• target the prevention of HIV infection among adolescents in resource-limited and domestic settings through collaborative studies with other clinical trials networks;
• improve diagnostics for use in children affected by HIV and associated diseases; and
• evaluate the safety and immunogenicity of vaccines designed to protect against HIV and other infectious co-morbidities in infants, children, adolescents, pregnant women, and women who breastfeed their babies.

To address these scientific areas, NIAID has teamed with the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), also part of the NIH, to support a stand-alone pediatric, maternal and child health leadership group in connection with the new clinical trial network structure. We believe that a dedicated leadership group would enable us to preserve the synergies between these areas of research while promoting efficiency and effective collaborations with other network leadership groups to achieve mutual goals. Additionally, we expect to use the revamped NIAID clinical research infrastructure to perform pediatric research involving other types of infectious diseases.

These topics among others will be discussed at an Oct. 26 townhall meeting in Arlington, Va. on the future of NIAID's clinical trial networks. To register for the meeting, please visit: www.blsmeetings.net/NIAIDTownhall/registration.cfm.

Carl W. Dieffenbach, Ph.D., is the director of NIAID's Division of AIDS. Edward Handelsman, M.D. is chief of NIAID's Pediatric Medicine Branch within the Division of AIDS. Lynne Mofenson, M.D., is chief of the Pediatric, Adolescent and Maternal AIDS Branch within the Eunice Kennedy Shriver National Institute of Child Health & Human Development.