In the beginning of 2017 a follow up report (of the HARM study and HARM Wrestling report, see GIMS library) was released which made clear that:

For patients over 65 years:

Investigation period was 2008-2013,

10% of the hospitalisations were medicine related,

50% of these were potentially avoidable!

for the Dutch situation that comes down to about 50.000 potentially avoidable hospitalisations per year!

For report:

eindrapport-vervolgonderzoek-medicatieveiligheid (1)

Again, as described in the underneath mentioned article,  it is made clear that there is still a lot of work to be done concerning Medication Safety…

And it is quite safe to estimate that it is not only a problem in Africa!

‘Irrational prescriptions are a major global health problem. The World Health Organisation estimates that more than half of all medicines are inappropriately prescribed, dispensed or sold. In addition, half of all patients fail to take them correctly.

In Africa, where most countries have weak health systems and underdeveloped mechanisms for routine monitoring of medicines, this problem is common.’

For full article:

poor practices-across-africa-are-putting-patients-at-risk/

The very fine article ‘Specific features of medicines safety and pharmacovigilance in Africa’ already made rather clear:

‘The pharmaceutical industry also poses a major
challenge to the growth of pharmacovigilance. As
a major stakeholder, it should be proactive in
efforts to ensure the safety of medicines and not
merely opting to remain a marketing outfit as
seen in African countries. It is hoped that appropriate
legislation will address this aberration.’

Specific features of medicines safety and pharmacovigilance in Africa (2012)

A lot of work concerning Medication Safety still has to be done as can be the conclusion from the article in the Expert Review of Clinical Pharmacology; ‘Pharmacovigilance in resourve-limited countries’ (June 2015).

Abstract; ‘In the past 20 years, many low- and middle-income countries have created national pharmacovigilance (PV) systems and joined the WHO’s global PV network. However, very few of them have fully functional systems. Scientific evidence on the local burden of medicine-related harm and their preventability is missing. Legislation and regulatory framework as well as financial support to build sustainable PV systems are needed. Public health programs need to integrate PV to monitor new vaccines and medicines introduced through these programs. Signal analysis should focus on high-burden preventable adverse drug problems. Increased involvement of healthcare professionals from public and private sectors, pharmaceutical companies, academic institutions and the public at large is necessary to assure a safe environment for drug therapy. WHO has a major role in supporting and coordinating these developments.’

Pharmacovigilance in resource limited countries 2015

MSH (Managements Sciences for Health) published it’s MDS-3 , 2014, (Managing Access to Medicines and Health Technologies) in which clear statements are made about medication safety risks which are likely to exist in low- and middle income countries.

From summary chapter 35:

‘Poor product quality, adverse drug reactions and medication errors greatly influence health care systems by negatively affecting patient care and increasing costs. Most of the statistics documenting the issues and highlightening the importance of pharmacovigilance come from developed countries, therefor low- and middle income countries likely have greater problems because of the poorer state of their health system infrastructure, the unreliable supply and quality of medicines, the lack of adequately trained essential health care staff, and their limited access to communication and information technology.’

Women and men are equal, but logically they are not the same.

Or to put it a rather bluntly, as neuro scientist Danielle Posthuma from Vrije Universiteit Medical Center did: ‘Human females are genetically more related to female Chimpansees than to human men….’

The physiological differences between women and men also have an impact on the way how their bodies react onto fysiological active substances like medicines. More specifically; sexe differences can have a serious effect on the farmaco kinetic and farmaco dynamic aspects of a medicine. At this present day the largest differences are found on medicines which are active in the Central Nervous Systeem.