The Global Fund and pharmacovigilance systems in resource-limited settings.

1 Raine JM. Drug safety: reporting systems for the general public. BMJ 2012; 345: e4916. 2 Bakare N, Edwards IR, Stergachis A, et al. Global pharmacovigilance for antiretroviral drugs: overcoming contrasting priorities. PLoS Med 2011; 8: e1001054. 3 Global Fund to fi ght AIDS, Tuberculosis and Malaria. Final report of the third board meeting. http://www.theglobalfund.org/en/ board/meetings/fourth/documents/ (accessed March 27, 2013). 4 Global Fund to fi ght AIDS, Tuberculosis and Malaria. Report of the High Level Independent Review Panel on Fiduciary Controls and Oversight Mechanisms. http://www. theglobalfund.org/en/highlevelpanel/report/ (accessed March 27, 2013). management tools to stimulate the systematic implementation of quality pharmaco vigilance programmes in grants. This process was aligned with the Fund’s perspective that there is a need to invest more of grant budgets, systematically, in pharmacovigilance programmes that monitor the quality, use, and effi cacy of the drugs it buys, and that can track adverse events and other post-marketing product defects. A new (unpublished) analysis of grant applications shows that these eff orts have paid off . The number of applications that describe pharmacovigilance activities that are either in progress, or in the planning stage, has gone up. South Africa, Vietnam, Liberia, Morocco, Indonesia, Thailand, and Colombia are some of the countries that have requested specifi c funding for pharmacovigilance as part of round 10. In previous grants in which no resources have been requested for pharmacovigilance activities, redirection of unspent Fund resources towards pharmacovigilance activities should be discussed. WHO and its network of pharmacovigilance experts could participate in such discussions, to facilitate the development of a pharmacovigilance strengthening plan and to provide relevant technical assistance to countries. The Fund’s strategy for 2012–16 stresses the need to invest in pharmaceutical and health product management systems, to improve procurement outcomes and mitigate risk, and for the systematic inclusion of funding requests for strengthening of pharmaceutical and health product management in proposals from countries that lack pharmacovigilance capacity. The strategy thus provides an unprecedented opportunity to develop and strengthen pharmacovigilance systems—an opportunity that countries, in the interest of patients’ safety, can neither overlook nor ignore.