Organizational capacities of national pharmacovigilance centres in Africa: assessment of resource elements associated with successful and unsuccessful pharmacovigilance experiences.

BACKGROUND: National pharmacovigilance centres (national centres) are gradually gaining visibility as part of the healthcare delivery system in Africa. As does happen in high-income countries, it is assumed that national centres can play a central coordinating role in their national pharmacovigilance (PV) systems. However, there are no studies that have investigated whether national centres in Africa have sufficient organizational capacity to deliver on this mandate and previous studies have reported challenges such as lack of funding, political will and adequate human resources. We conducted interviews with strategic leaders in national centres in 18 African countries, to examine how they link the capacity of their organization to the outcomes of activities coordinated by their centres. Strategic leaders were asked to describe three situations in which activities conducted by their centre were deemed successful and unsuccessful. We analyzed these experiences for common themes and examined whether strategic leaders attributed particular types of resources and relationships with stakeholders to successful or unsuccessful activities. RESULTS: We found that strategic leaders most often attributed successful experiences to the acquisition of political (e.g. legal mandate) or technical (e.g. active surveillance database) resources, while unsuccessful experiences were often attributed to the lack of financial and human resources. Stakeholders that were most often mentioned in association with successful experiences were national government and development partners, whereas national government and public health programmes (PHPs) were often mentioned in unsuccessful experiences. All 18 centres, regardless of maturity of their PV systems had similar challenges. CONCLUSIONS: The study concludes that national centres in Africa are faced with 3 core challenges: (1) over-reliance on development partners, (2) seeming indifference of national governments to provide support after national centres have gained membership of the World Health Organization (WHO) Programme for International Drug Monitoring (PIDM) and (3) engaging public health programmes in a sustainable way.

O Estado de São Paulo como um ator internacional / x

Discussão da influência do cenário internacional sobre as decisões dos governos subnacionais e sua ascensão como novos atores neste contexto. As informações apresentadas neste artigo resultaram da pesquisa "Gestão Pública Estratégica de Governos Subnacionais Frente aos Processos de Inserção Internacional e Integração Latino-Americana", que está sendo realizada pela Fundap, PUC-SP e Cedec, e analisam de que modo um governo subnacional reage aos efeitos e à nova realidade internacional, utilizando-se o caso de São Paulo.

A discussion of how the international scene affects the decisions of sub-national governments, and of their ascension as new actors within this context. The information presented in this article was extracted from a research project entitled "Strategic Public Strategies of Sub-national Governments Within the Context of the Processes of Latin American Global Insertion and Integration," currently being conducted by Fundap, (Foundation for Public Administration), PUC-SP (Catholic University of São Paulo) and Cedec. This article examines how sub-national governments react to changing realities at the international level, using the government of the State of São Paulo as a case in point.

Mercosul e sociedade civil / x

Os pontos principais referem-se a aspectos parciais de uma pesquisa em andamento sobre "gestão pública estratégica dos governos subnacionais diante dos processos de inserção internacional e integração latino-americana", desenvolvida por equipes dos quadros da Fundap, do Cedec e da PUC-SP. Das três partes constituintes do projeto temático, serão feitas referências àquela pertinente à participação da sociedade civil no processo de integração regional, tendo por centro o Mercosul.

The main points of this article are extracted from a research project that is currently underway entitled "Strategic Public Strategies of Sub-National Governments Within the Context of the Processes of Latin American Global Insertion and Integration" carried out by researchers from Fundap (Foundation for Public Administration), Cedec, and the Catholic University of São Paulo. Reference will be made to a section of the study dealing with the participation of civil society in regional development, in this case, in the context of Mercosul.