Challenges in International Pediatric Pharmacology
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Challenges in International Pediatric Pharmacology A Milestone Meeting in Shanghai Stuart MacLeod,1,2,3 Robert Peterson,1,2 Yi Wang,4 Zhiping Li,4 Yonghao Gui4,5 and Jane Schaller1,3,6 1 2 3 4 5 6
University of British Columbia, Vancouver, British Columbia, Canada Child & Family Research Institute, Vancouver, British Columbia, Canada Centre for International Child Health, Vancouver, British Columbia, Canada Fudan University Children’s Hospital, Shanghai, China Chinese Paediatric Society, Shanghai, China International Paediatric Association, Vancouver, British Columbia, Canada
There has been a rapid growth in the awareness of the importance of issues surrounding the choice of optimal drug therapy for children in recent years as the proportion of children internationally has grown. In many parts of the developing world, children now make up more than 50% of the population and, according to United Nations Children’s Fund (UNICEF) figures, there are now close to 3 billion children aged 0–18 years worldwide.[1] It is generally recognized that drug therapy for children is often instituted without an adequate scientific foundation.[2-4] Many drugs commonly used in pediatrics have not been adequately studied in an infant, child, or adolescent population, and new therapies are regularly introduced without a requirement for study in these target groups. The international scientific establishment engaged in the study of basic, clinical, and population pharmacology in children is extremely limited. Furthermore, most recognized centers of excellence in pediatric pharmacology are located in high-income countries where the pediatric population proportion is low. There is an urgent public health need for the transfer of knowledge from pediatric pharmacology research units in developed countries to centers of populations in low- and middle-income countries. There is a parallel need for enhanced research capacity in Asia, Africa, and Latin America where most of the world’s children reside. The Millennium Development Goals (MDGs) for the years 1990–2015 give substance to a number of pediatric pharmacology issues.[5] For example, MDG 4 calls for a two-thirds reduction in child mortality and much of the effort needed will center on improved approaches to therapeutics for infectious diseases (diarrhea, pneumonia, malaria, HIV/AIDS) and improved immunization. MDG 5 calls for improvements in maternal health, including a reduction in maternal mortality, which is essential to better child survival and health. Again, many of the issues to be addressed are
related to optimal drug therapy. MDG 6 specifically addresses the challenges of reducing mortality from HIV/AIDS, malaria, and tuberculosis. Finally, MDG 8 calls for assurance of availability and access to appropriate essential therapies at a country level. This array of challenges led to the planning of an international satellite symposium on challenges in pediatric pharmacology, which was held in Shanghai,
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