Talking It Over

If you're a parent, chances are that you don't stop to think about the medicine your pediatrician prescribes when your child has a common illness. You're probably just relieved that the symptoms can be treated and your son or daughter will feel better in time.

Yet while many medications prescribed for children are safe and effective, many other drugs have never been tested specifically for use on infants, toddlers and older children.

A wide range of asthma treatments, for example, are routinely given to children even though they were tested only on adults. This poses a particular problem because of the rise of asthma and the severe impact it has on children. As of 1994, 4.8 million children under 18 have been diagnosed with asthma. Indeed, the hospitalization rate for children under 5 has increased by 57 percent since 1980.

Likewise, it was shocking to discover that Ritalin, a drug prescribed to millions of children diagnosed with Attention Deficit Disorder, has never been thoroughly tested for use on very young people. The same is true for Prozac, which is used increasingly to treat children with depression.

Children and adults suffer from many of the same diseases, but this doesn't mean they will react to drugs in the same way. For many important medicines, there is a startling lack of information on safe and effective doses for children. In fact, according to the American Academy of Pediatrics, less than 50 percent of the medicines that have proved helpful to children have not been tested for use on kids.

As a result, many pediatricians are forced to guess the proper dose for a child or forgo what might be the most useful treatment available. Parents are left to worry that their children are not getting the best possible care.

The terrible dimensions of this problem were made clear to many of us by Elizabeth Glaser, the crusading mother who helped found the Pediatric AIDS Foundation.

Elizabeth contracted HIV from a blood transfusion she received shortly after giving birth to her daughter Ariel in 1981. Elizabeth unwittingly passed the virus on to Ariel through her breast milk.

Yet while Elizabeth was able to take the drug AZT to fight the disease, Ariel was not. The medication — the most effective treatment at the time — was not available for children. As one doctor told Elizabeth, "We don't even know what dose to give her. We can't just experiment. This is a toxic drug. It could kill her."

Elizabeth was put in a heartbreaking position: She was able to extend her life but not the life of her daughter. By fighting for action in Congress, the White House and around the country, she was able eventually to secure AZT for Ariel. But precious time had been lost. Ariel died in 1988. Elizabeth passed away in 1994.

This is but one example of a problem that exposes a dangerous gap in our system of medical treatment. Fortunately, it is a gap that parents, health activists, pharmaceutical companies, the medical community, the government and my husband are working to close.

This week, the President announced that the Food and Drug Administration will propose a rule to require the manufacturers of medicine needed urgently by children to study the effects in young people and provide information on dosages. The information will be displayed on drug labels to help pediatricians and other health-care professionals make good decisions about how to treat their young patients.

The President's action will apply to new medicines now in development as well as medicines already on the market. And it will extend not just to medications for critical illnesses but also to widely used treatments for conditions like asthma, allergies, ear infections and pain.

Vital medications will be tested and made available to children more efficiently than ever before. Children will get the same access to newly developed drugs as their parents. As important, better testing will point out drugs that either should not be prescribed for children or should be prescribed in far fewer instances.

The result will be simple peace of mind for doctors and parents alike. Doctors will have the information they need. When it comes to treating a sick child, they will not have to rely on guesswork.

And parents will know that if there is a medicine out there that can help their child, then they will be able to have access to it. The best medicine in the world will no longer be stuck on a shelf — it will be put at the service of our families and our children. And that's how it ought to be.

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