Since its establishment in 1988, the national drug monitoring centre in South Africa (NADEMC) has provided drug monitoring to the country's population of 44 million people. It also serves as a direct link between clinical medicine institutions, drug information centres, the Medicines Control Council (MCC), and the World Health Organization. This service needs to be efficient, but at minimum cost and our explicit policy has been to encourage involvement from the academic sector.

The national drug monitoring centre is integrated into the academic activities of a university department and teaching hospital. There are a number of advantages to this arrangement. Firstly, NADEMC has a close working relationship with the national drug regulatory authority, the Medicines Control Council, which pays for its activities and for the salaries of its officers. The centre also sends reports to a data base housed in the WHO Collaborating Centre for International Drug Monitoring in Uppsala, Sweden. The functioning of NADEMC is based on daily review meetings, close links with the WHO Collaborating Centre, the Medicines Control Council and consultations with hospital clinicians when adverse drug events are reported. Ready access to reports and other materials and data bases is possible at the Medicines Information Centre.

Reporting forms are distributed to health care professionals on a regular basis. When a report is made, the information is entered into the national data base and an evaluation process is initiated for each report received. The manufacturer and reporter are consulted routinely, and they are informed of the outcome of any MCC decision and action. When necessary, a report will be made in the medical journal or corrective action will be taken by the manufacturer. During 1996, 150 reports were received from industry, and 200 reports from health care professionals. The objective of NADEMC is to achieve a rate of 2000 reports yearly within four years, and to link more effectively with other national centres, particularly in southern and eastern Africa. The reporting rate is currently below what might reasonably be expected from a national centre supporting 44 million people, and this we attribute to the weak culture of reporting of drug safety issues and the necessity for training programmes.

In the future, operational systems will need improvement, and research should be undertaken. In this respect, the centre can also provide training. A plan is under way to improve collaboration with the traditional medicines centre of the university and a system for the safety monitoring of traditional medicines will soon be established. We aim to improve the systems that we use in dealing with the media, and to encourage greater participation of consumer groups and the legal profession in our work.

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