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UCLA Brain Research Institute

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World Health Organisation (WHO)

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Chimimba, F.

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Cole, M.J.

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Dzabala, N. et al.

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Institute for Health Metrics and Evaluation

Jusot, V.

Kaplan, W.A.

Kwan, G.F.

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Organisation for Economic Co-operation and Development (OECD)

Posner, M.I.

Substance Abuse and Mental Health Services Administration

Tang, R.

Tang, Y.Y.

Wirtz, V.J.

Publication Years

2020-2025

2010-2019

Enhancing Pharmacovigilance in Sub‑Saharan Africa Through Training and Mentoring: A GSK Pilot Initiative in Malawi

Jusot, V.; Chimimba, F.; Dzabala, N. et al. Drug Safety (2020) CC

Introduction Pharmacovigilance (PV) systems to monitor drug and vaccine safety are often inadequate in sub-Saharan Africa. In Malawi, a PV enhancement initiative was introduced to address major barriers to PV. Objective The objective of this initiative was to improve reporting of adverse events (A ... Es) by strengthening passive safety surveillance via PV training and mentoring of local PV stakeholders and healthcare providers (HCPs) at their own healthcare facilities (HCFs). Methods An 18-month PV training and mentoring programme was implemented in collaboration with national stakeholders, and in partnership with the Ministry of Health, GSK and PATH. Two-day training was provided to Expanded Programme on Immunisation coordinators, identified as responsible for AE reporting, and four National Regulatory Authority representa- tives. Abridged PV training and mentoring were provided regularly to HCPs. Support was given in upgrading the national PV system. Key performance indicators included the number of AEs reported, transmission of AE forms, completeness of reports, serious AEs reported and timeliness of recording into VigiFlow. Results In 18 months, 443 HCPs at 61 HCFs were trained. The number of reported AEs increased from 22 (January 2000 to October 2016) to 228 (November 2016 to May 2018), enabling Malawi to become a member of the World Health Organization Programme for International Drug Monitoring. Most (98%) AE report forms contained mandatory information on reporter, event, patient and product, but under 1% were transmitted to the national PV office within 48 h. Conclusion Regular PV training and mentoring of HCPs were effective in enhancing passive safety surveillance in Malawi, but the transmission of reports to the national PV centre requires further improvement. more

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Status report on alcohol consumption, harm and policy responses in 30 European countries 2019

World Health Organisation (WHO) World Health Organization (WHO) (2019) C_WHO

The report provides an overview of alcohol consumption, related health harm, and policy responses in 30 European countries (EU Member States, Norway, and Switzerland). It highlights the high levels of alcohol consumption in the WHO European Region, which contribute to a significant disease burden co ... mpared to other regions. The report covers trends in alcohol consumption and harm between 2010 and 2016, noting some progress in reducing alcohol-attributable mortality but stagnation in consumption reduction and heavy episodic drinking. The assessment of alcohol policies shows variability in implementation across countries, particularly in areas like pricing and reducing the negative consequences of drinking. It emphasizes the need for stronger evidence-based policies, such as better regulation, taxation, and accessibility restrictions, to further reduce alcohol-related harm and achieve health-related Sustainable Development Goals. more

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Deaths from illicit drugs, World, 2019

Our World in Data (2019) CC

Shown in blue is the estimated annual number of deaths attributed to drug use. Shown in red is theestimated annual number of deaths from drug use disorders. The difference between them is that theyrelate to indirect and direct causes of death, respectively.

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Drug use disorder death rate, 2019

Our World in Data (2019) CC

Estimated annual number of deaths from drug use disorders per 100,000 people.

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Drug use disorder deaths, 1990 to 2019

Our World in Data (2019) CC

Estimated annual number of deaths from drug use disorders, by type of drug.

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Access to Medications for Cardiovascular Diseases in Low- and Middle-Income Countries

Wirtz, V.J.; Kaplan, W.A.; Kwan, G.F. Circulation (2016) CC

Cardiovascular diseases (CVD) represent the highest burden of disease globally. Medicines are a critical intervention used to prevent and treat CVD. This review describes access to medication for CVD from a health system perspective and strategies that have been used to promote access, including pro ... viding medicines at lower cost, improving medication supply, ensuring medicine quality, promoting appropriate use, and managing intellectual property issues. Using key evidence in published and gray literature and systematic reviews, we summarize advances in access to cardiovascular medicines using the 5 health system dimensions of access: availability, affordability, accessibility, acceptability, and quality of medicines. There are multiple barriers to access of CVD medicines, particularly in low- and middle-income countries. Low availability of CVD medicines has been reported in public and private healthcare facilities. When patients lack insurance and pay out of pocket to purchase medicines, medicines can be unaffordable. Accessibility and acceptability are low for medicines used in secondary prevention; increasing use is positively related to country income. Fixed-dose combinations have shown a positive effect on adherence and intermediate outcome measures such as blood pressure and cholesterol. We have a new opportunity to improve access to CVD medicines by using strategies such as efficient procurement of low-cost, quality-assured generic medicines, development of fixed-dose combination medicines, and promotion of adherence through insurance schemes that waive copayment for long-term medications. Monitoring progress at all levels, institutional, regional, national, and international, is vital to identifying gaps in access and implementing adequate policies. more

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Mindfulness meditation improves emotion regulation and reduces drug abuse

Tang, Y.Y.; Tang, R.; Posner, M.I. Drug and Alcohol Dependence (2016) CC

Background The core clinical symptoms of addiction include an enhanced incentive for drug taking (craving), impaired self-control (impulsivity and compulsivity), emotional dysregulation (negative mood) and increased stress reactivity. Symptoms related to impaired self-control involve reduced activi ... ty in anterior cingulate cortex (ACC), adjacent prefrontal cortex (mPFC) and other brain areas. Behavioral training such as mindfulness meditation can increase the function of control networks including those leading to improved emotion regulation and thus may be a promising approach for the treatment of addiction. Methods In a series of randomized controlled trials (RCTs), we tested whether increased ACC/mPFC activity is related to better self-control abilities in executive functions, emotion regulation and stress response in healthy and addicted populations. After a brief mindfulness training (Integrative Body-Mind Training, IBMT), we used the Positive and Negative Affect Schedule (PANAS) and Profile of Mood States (POMS) to measure emotion regulation, salivary cortisol for the stress response and fMRI for brain functional and DTI structural changes. Relaxation training was used to serve as an active control. Results In both smokers and nonsmokers, improved self-control abilities in emotion regulation and stress reduction were found after training and these changes were related to increased ACC/mPFC activity following training. Compared with nonsmokers, smokers showed reduced ACC/mPFC activity in the self-control network before training, and these deficits were ameliorated after training. Conclusions These results indicate that promoting emotion regulation and improving ACC/mPFC brain activity can help for addiction prevention and treatment. more

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