Pharmacovigilance in low- and middle-income countries: A review with particular focus on Africa

Kiguba, R ORCID: 0000-0002-2636-4115, Olsson, S ORCID: 0000-0002-6078-0649 and Waitt, C ORCID: 0000-0003-0134-5855 (2023) Pharmacovigilance in low- and middle-income countries: A review with particular focus on Africa British Journal of Clinical Pharmacology, 89 (2). pp. 491-509. ISSN 0306-5251, 1365-2125

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Abstract

Low- and middle-income countries (LMIC) face unique challenges with regard to the establishment of robust pharmacovigilance systems capable of generating data to inform healthcare policy and practice. These include the limited integration and reliability of pharmacovigilance systems across LMIC despite recent efforts to harmonize pharmacovigilance rules and regulations in several regional economic communities. There are particular challenges relating to the need to translate reporting tools into numerous local languages and the low numbers of healthcare providers relative to number of patients, with very short consultation times. Additional factors frequent in LMIC include high uptake of herbal and traditional medication, mostly by self-medication; disruptive political conflicts jeopardizing fragile systems; and little or no access to drug utilization data, which makes it difficult to reliably estimate the true risks of medicines use. Pharmacovigilance activities are hindered by the scarcity of well-trained personnel with little or no budgetary support from national governments; high turnover of pharmacovigilance staff whose training involves a substantial amount of resources; and little awareness of pharmacovigilance among healthcare workers, decision makers and consumers. Furthermore, little collaboration between public health programmes and national medicines regulatory authorities coupled with limited investment in pharmacovigilance activities, especially during mass drug administration for neglected tropical diseases and mass vaccinations, produces major challenges in establishing a culture where pharmacovigilance is systematically embedded. Very low spontaneous reporting rates with poor quality reports hinders robust signal detection analyses. This review summarises the specific challenges and areas of progress in pharmacovigilance in LMIC with special focus on the situation in Africa.

Item Type:	Article
Uncontrolled Keywords:	Africa, medicines safety, pharmacovigilance
Divisions:	Faculty of Health & Life Sciences Faculty of Health & Life Sciences > Inst. Systems, Molec & Integrative Biology > Inst. Systems, Molec & Integrative Biology
Depositing User:	Symplectic Admin
Date Deposited:	16 Dec 2021 08:26
Last Modified:	01 Mar 2026 00:02
DOI:	10.1111/bcp.15193
Open Access URL:	https://doi.org/10.1111/bcp.15193
Related Websites:	Author Publisher
URI:	https://livrepository.liverpool.ac.uk/id/eprint/3145455
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