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ObjectiveChina has undertaken several initiatives to improve the accessibility of safe and effective medicines for children. The aim was to determine the availability, price and affordability of essential medicines for children.DesignCross-sectional survey.SettingSix cities of Jiangsu Province, China.Participants30 public hospitals and 30 retail pharmacies.Primary and secondary outcome measuresThe WHO/Health Action International standardised methodology was used to collect the availability and price data for 40 essential medicines for children. Availability was measured as the percentage of drug outlets per sector where the individual medicine was found on the day of data collection, and prices were measured as median price ratios (MPRs). Affordability was measured as the number of days’ wages required for the lowest paid unskilled government worker to purchase standard treatments for common conditions.ResultsThe mean availabilities of originator brands (OBs) and lowest priced generics (LPGs) were 7.5% and 34.2% in the public sector and 8.9% and 29.4% in the private sector. The median MPRs of LPGs in both sectors ranged from 1.41 to 2.12 and 1.10 to 2.24, respectively. However, the patient prices of OBs far exceeded the critical level in both sectors, with median MPRs ranging from 2.47 to 8.22. More than half of these LPGs were priced at 1.5 times their international reference prices in the public sector. Most LPGs were affordable for treatment of common conditions in both public and private sectors, as they each cost less than the daily wage for the lowest paid unskilled government worker.ConclusionsAccess to essential medicines for children is hampered by low availability. Further measures to enhance access to paediatric essential medicines should be taken, such as developing a national essential medicine list for children and mobilising the enthusiasm of pharmaceutical firms to develop and manufacture paediatric medicines.

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Inspired by the distinctive merits of carbon nanoparticles (CNPs) and poly(amidoamine) (PAMAM) dendrimers, we synthesized PAMAM modified CNPs (CNPs-PAMAM). First, CNPs were prepared using citrate acid and 1, 2, 4-triaminobenzene. Then, PAMAM was anchored on the surface of CNPs. The structure of PAMAM would remain unchanged under mild conditions of the postmodification method, making PAMAM retain its excellent drug carrying ability. Particularly, CNPs-PAMAM had exceptional optical properties of excitation-independent long wavelength emission. Excitation-independent emission can ensure the sensitivity of bioimaging. Long wavelength emission can avoid the autofluorescence interference of biological matrixes and have good tissue penetration. Further studies demonstrated that CNPs-PAMAM were able to electrostatically bind and condense small interfering RNA (siRNA) into stabilized nanocomplexes. The siRNA complexed with CNPs-PAMAM was endowed with an increased resistance against degradation and an enhanced cellular uptake. Moreover, CNPs-PAMAM-complexed siRNA targeting histone deacetylase 2 (HDAC2) could be effectively delivered into the neuron-like PC-12 cells, and exert its gene-silencing effect. Precisely inhibiting the so-called undruggable target HDAC2 opens a novel strategy for ischemic stroke treatment. Thus, CNPs-PAMAM offer a promising delivery carrier to unleash the siRNA’s therapeutic potential.

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