The monitoring of medicine safety in countries where there is no regulatory or safety monitoring system in place, or in remote areas with little or no health care surveillance or infrastructure, has been identified as a matter for concern. The problems are especially apparent in situations that involve the use of medicines in specific communities, for example, for the treatment of tropical diseases such as malaria, leishmaniasis and schistosomiasis, and for the treatment of HIV/AIDS and tuberculosis. In some settings several disease control initiatives involving the administration of medicines to large communities are being implemented within the same population with little knowledge of, or regard to, how these various medicines could interact with each other. Pharmacovigilance should be a priority for every country with a public health disease control programme.
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Box 6 Malaria: an example of pharmacovigilance in public health
In view of the increasing resistance to existing antimalarial medicines, several countries have switched to using combinations of various artemisinin derivatives as their first- and second-line treatments for malaria. The change to artemisinin combination therapies (ACTs) has provided a timely opportunity to introduce a pharmacovigilance system in those countries that hitherto had no established systems for safety monitoring of medicines. In 2003, participants from five African countries were trained in the basic methods of medicine safety monitoring with a view to facilitating the introduction of a common system of pharmacovigilance for new antimalarial treatments. Since then two of these countries have formally established a pharmacovigilance centre; the others are also making progress in monitoring antimalarials.
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