WIth the advent of FDCs and free ART, antritretroviral therapy has become affordable and convenient for children. However most of the pediatric FDCs are avaibale with NVp and EFV is mainly kept aside to be used in children on ART with TB coinfection.
But there is a problem there. There are some instances when patients who have been on EFV based therapy for years when go to the government centre are shifted to NVP as the govt plan has no provision for EFV in these children. Also if a child is on anti TB treatment (ATT) and he is started on ART then he is given EFV for the time that he is on ATT and then shifted to NVP once ATT is stopped.

Also there is no govt provision for children less than 3 years and when requiring ART with ATT..

When will this interchangibility end? Logistically it may be a lot of money but resistance is a major issue. The rules need to be more open to EFV based regime in these children or allow NVP to be increased to a dose of 400mg/sqm/day when the child is on ATT.