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We strive to promote drug discovery and the rational and cost-effective use of medicines to serve the health needs of people in Africa through teaching, mentorship, research, and clinical consultation. The division teaches undergraduate medical and physiotherapy students. The focus of our teaching to medical students is rational prescribing of essential medicines for primary care. Most of the teaching is done in smaller groups. Pharmacology teaching is integrated in the 2nd through to 6 th MBChB years, with specific pharmacology blocks in the 4th and 5th years — we also teach physiotherapy undergraduate students. The Division offers post-graduate training at several scientific levels and one clinical specialist level. Information is available from the Faculty of Health Science postgraduate-programme handbook. The pharmacology honours programme is a one year full-time course aimed at graduates with backgrounds in life science, chemistry or pharmacy who wish to pursue careers in technical areas or are considering higher degrees and careers in research.. The course introduces students to techniques cell culture, mass spectrometry, chromatography, and antimicrobial assays. Each student undertakes a research project, usually in natural products, toxicology, or clinical bioanalysis. A series of theory modules are taught in parallel with the research project. Prospective applicants can contact the course coordinator Ms Sharne Dunn sharne. This degree offers postgraduate training in the drug development process, via coursework and a research projectwith a mini-dissertation. The objective of this course is to educate and train researchers in the clinical pharmacology of drug development. The curriculum is comprised of the following modules: drug development, bioanalysis, pharmacometrics, pharmacokinetic-pharmacodynamic principles The course is undertaken full-time over two years or part-time over a longer period. Prospective applicants can contact the course convenor Prof Lubbe Wiesner. This dissertation-based degree is aimed at graduates with an Honours degree in life sciences or chemistry, or with a pharmacy or medical degree who wish to pursue a career in research. The degree programme requires registration for a minimum of two years. Depending on progress and the nature of the project, students may be eligible to upgrade to a PhD in the 3rd year of study. Enrolment in the MSc programme is dependent on availability of funding and supervision capacity. The project will be supervised by one or more senior academics. Prospective Doctoral candidates should contact the research groups directly to enquire about availability of funding and supervision capacity see under MSc Med above. For PhD in pharmacometrics please contact pharmacometrics research group at pharmacometrics uct. This specialist qualification is only offered to medical graduates MBChB wishing to specialise in Clinical Pharmacology. The registrar rotation is a 4 year programme. All candidates need to write the exams set by the Colleges of Medicine of South Africa and submit a mini-dissertation. Prospective candidates should contact Professor Marc Blockman. Information on course outlines is available in the Faculty of Health Science postgraduate-programme handbook. Please click here for the College of Clinical Pharmacology Cirriculum. For applications, please email Ruwayda Philander. The division provides a clinical and laboratory pharmacology service to Groote Schuur hospital as well as secondary and primary centres within our drainage area. Therapeutic drug monitoring with input from clinical pharmacologists is offered for a wide variety of drugs, including antiretroviral and anti-tuberculosis drugs. Clinical consultation is offered to regional hospitals. A copy of the test request form is available here: Pharmacology Test Request Form. The division produces the South African Medicines Formulary, currently in its 14 th edition. You will now be able to access all of SAMF's content online. We conduct clinical research focused on drugs for malaria, tuberculosis, and HIV. The research in these fields is broad and encompasses drug discovery, pharmacokinetics and pharmacodynamics, pharmacometrics, pharmacogenomics, clinical trials, pharmacovigilance, and pharmacoeconomic evaluation. Our peer-reviewed publications for the last 3 years are listed below. Liquid chromatography tandem mass spectrometry is used as bioanalysis platform and various extraction techniques are used for sample preparation depending on matrix complexity and the calibration range. The laboratory is well equipped with 9 liquid chromatography tandem mass spectrometry workstations, including 2 highly sensitive systems for detecting very low concentrations e. Pharmacometrics, or quantitative pharmacology, is the science quantifying drug and disease information with the purpose to aid efficient drug development or regulatory decisions, or to improve the clinical use of drugs. Mathematical and statistical models, also known as nonlinear mixed-effects models, are used to describe the relationship between drug dose, exposure pharmacokinetics , and response pharmacodynamics for both desired and undesired effects, and individual patient characteristics. Her interests are in translational research from drug development, through dose optimisation in vulnerable populations to the comprehensive evaluation of changes in antimalarial treatment policy. Prof Lubbe Wiesner heads malaria pre-clinical drug development research, in collaboration with Prof Kelly Chibale, using tissue culture and small animal models. Prof Gary Maartens leads research on the effectiveness, adherence, and pharmacoeconomics of antiretroviral therapy in resource-limited settings. Prof Helen McIlleron leads clinical pharmacokinetic research into antiretroviral drug interactions, and dose optimisation in children and pregnancy. Prof Gary Maartens leads research on treatment optimisation of HIV-associated tuberculosis and treatment of drug-resistant tuberculosis. Department of Medicine. Breadcrumb Home Division. Clinical Pharmacology. Antimicrob Agents Chemother ; 67 : e A genome-wide association study of plasma concentrations of warfarin enantiomers and metabolites in sub-Saharan black-African patients. Front Pharmacol ; Male partner age, viral load, and HIV infection in adolescent girls and young women: evidence from eight sub-Saharan African countries. AIDS ; — Antimicrob Agents Chemother ; J Acquir Immune Defic Syndr ; 26— Abacavir dosing in neonates from birth to 3 months of life: a population pharmacokinetic modelling and simulation study. Clin Infect Dis ; — Total bodyweight and sex both drive pharmacokinetic variability of fluconazole in obese adults. J Antimicrob Chemother ; — Training, guideline access and knowledge of antiretroviral interactions: Is the South African private sector being left behind? Antimicrob Agents Chemother ; e Am J Trop Med Hyg ; — J Infect Dis ; — Bedaquiline exposure in pregnancy and breastfeeding in women with rifampicin-resistant tuberculosis. Br J Clin Pharmacol ; — One dose does not fit all: revising the WHO paediatric dosing tool to include the non-linear effect of body size and maturation. Lancet Child Adolesc Heal ; 6: 9— Spatiotemporal spread of Plasmodium falciparum mutations for resistance to sulfadoxine-pyrimethamine across Africa, — Pharmacokinetics of standard versus high-dose isoniazid for treatment of multidrug-resistant tuberculosis. Population pharmacokinetics of esomeprazole in patients with preterm preeclampsia. Pharmacokinetic and pharmacogenetic associations with dolutegravir neuropsychiatric adverse events in an African population. J Antimicrob Chemother ; —7. J Infect Dis ; published online Jan Pharmacogenetics of interaction between depot medroxyprogesterone acetate and efavirenz, rifampicin, and isoniazid during treatment of HIV and tuberculosis. Pharmacogenet Genomics ; 24— What babies need: accelerating access to current and novel antiretroviral drugs in neonates through pharmacokinetic studies. Adherence challenges with daily oral pre-exposure prophylaxis during pregnancy and the postpartum period in South African women: a cohort study. Chromatographia ; — J mass Spectrom Adv Clin lab ; 7— Making data map-worthy—enhancing routine malaria data to support surveillance and mapping of Plasmodium falciparum anti-malarial resistance in a pre-elimination sub-Saharan African setting: a molecular and spatiotemporal epidemiology study. Malar J ; Mapping genetic markers of artemisinin resistance in Plasmodium falciparum malaria in Asia: a systematic review and spatiotemporal analysis. The Lancet Microbe ; 3: e— Recency of HIV infection, antiretroviral therapy use and viral loads among symptomatic sexually transmitted infection service attendees in South Africa. S Afr Med J ; Ethically acceptable consent approaches to adolescent research in South Africa. Haematological consequences of acute uncomplicated falciparum malaria: a WorldWide Antimalarial Resistance Network pooled analysis of individual patient data. BMC Med ; McIlleron H. Treating children with tuberculosis-Using pharmacometrics to do better. Br J Clin Pharmacol ; —6. Validation and application of a quantitative liquid chromatography tandem mass spectrometry assay for the analysis of rifapentine and O-desacetyl rifapentine in human milk. J Pharm Biomed Anal ; Clin Pharmacokinet ; — Clin Infect Dis ; —7. Altered drug exposures of first-line TB drugs in a moxifloxacin-containing treatment regimen. Int J Tuberc Lung Dis ; — The impact of enteral feeding and therapeutic monitoring of rifampicin with dose escalation in critically ill patients with tuberculosis. Int J Infect Dis ; — Post FA, Sinxadi P. Tenofovir disoproxil and renal mitochondrial toxicity: more studies in Africans are needed. AIDS ; —8. Pharmacotherapy ; published online May PLoS One ; e Safety of single-dose primaquine as a Plasmodium falciparum gametocytocide: a systematic review and meta-analysis of individual patient data. South African Gen Pract ; 3: — The knowledge and attitudes of South African-based runners regarding the use of analgesics during training and competition. South African J Sport Med ; Population pharmacokinetics of ethambutol in African children: a pooled analysis. Abacavir pharmacokinetics in African children living with HIV: A pooled analysis describing the effects of age, malnutrition and common concomitant medications. Dolutegravir twice-daily dosing in children with HIV-associated tuberculosis: a pharmacokinetic and safety study within the open-label, multicentre, randomised, non-inferiority ODYSSEY trial. N Engl J Med ; — Pharmacokinetics of bedaquiline in cerebrospinal fluid CSF in patients with pulmonary tuberculosis TB. J Antimicrob Chemother ; —4. Open forum Infect Dis ; 9: ofac Linezolid toxicity in patients with drug-resistant tuberculosis: a prospective cohort study. Detection of karakin poisoning using a targeted mass spectrometric workflow. S Afr Med J ; —3. The evaluation of ADME and pharmacokinetic properties of decoquinate derivatives for the treatment of malaria. Twice neglected? Neglected diseases in neglected populations. Pharmacometrics in tuberculosis: progress and opportunities. Int J Antimicrob Agents ; Antimicrob Agents Chemother ; 65 : e Pharmacokinetic profile of amodiaquine and its active metabolite desethylamodiaquine in Ghanaian patients with uncomplicated falciparum malaria. Malar J ; 20 : Clin Pharmacol Ther ; : — Transfusion ; 61 : — Clin Infect Dis ; 73 : — PLOS Med ; 18 : e Clin Infect Dis ; published online Aug J Acquir Immune Defic Syndr ; 87 : —9. Neuropsychiatric toxicity and cycloserine concentrations during treatment for multidrug-resistant tuberculosis. Int J Infect Dis ; : — Wellcome Open Res ; 6 : Pharmacogenetics of tenofovir and emtricitabine penetration into cerebrospinal fluid. Optimizing dosing and fixed-dose combinations of rifampicin, isoniazid, and pyrazinamide in pediatric patients with tuberculosis: a prospective population pharmacokinetic study. QT effects of bedaquiline, delamanid, or both in patients with rifampicin-resistant tuberculosis: a phase 2, open-label, randomised, controlled trial. Lancet Infect Dis ; 21 : — Pharmacokinetics and safety of high-dose rifampicin in children with TB: the Opti-Rif trial. J Antimicrob Chemother ; 76 : — Pharmaceutics ; 13 : N Engl J Med ; : — Clin Infect Dis ; 73 : e—9. Virologic efficacy of tenofovir, lamivudine and dolutegravir as second-line antiretroviral therapy in adults failing a tenofovir-based first-line regimen. AIDS ; 35 : — J Bacteriol ; Pharmacogenetic predictors of nevirapine pharmacokinetics in Ghanaian children living with HIV with or without TB coinfection. Infect Genet Evol ; 92 : Clin Infect Dis ; 73 : e— A validated liquid chromatography tandem mass spectrometry assay for the analysis of pretomanid in plasma samples from pulmonary tuberculosis patients. J Pharm Biomed Anal ; : Clin Infect Dis ; : 1— Drug Saf ; 44 : 41— Chembiochem ; 22 : — Relation between organophosphate pesticide metabolite concentrations with pesticide exposures, socio-economic factors and lifestyles: A cross-sectional study among school boys in the rural Western Cape, South Africa. Environ Pollut ; : S Afr Med J ; : —8. Br J Clin Pharmacol ; 87 : — Adult medical emergency unit presentations due to adverse drug reactions in a setting of high HIV prevalence. African J Emerg Med ; 11 : 46— Pediatr Infect Dis J ; 40 : — Meta-analytic magic, ivermectin, and socially responsible reporting. South African Med J ; : Clin Infect Dis ; published online July J Antimicrob Chemother ; 76 : —7. Isoniazid preventive therapy plus antiretroviral therapy for the prevention of tuberculosis: a systematic review and meta-analysis of individual participant data. The treatment gap for mental disorders in adults enrolled in HIV treatment programmes in South Africa: a cohort study using linked electronic health records. Epidemiol Psychiatr Sci ; 30 : e Anticoagulation in sub-Saharan Africa: Are direct oral anticoagulants the answer? A review of lessons learnt from warfarin. Effect of malnutrition on the pharmacokinetics of anti-TB drugs in Ghanaian children. Int J Tuberc Lung Dis ; 25 : 36— Pharmacokinetic interactions of modern antiretroviral therapy. AIDS ; 35 : S— J Acquir Immune Defic Syndr ; 86 : — Clin Pharmacokinet ; 60 : — Microbiol Spectr ; 9 : e Analgesic practices and predictors of use in South Africa-based runners. S Afr Med J ; : —6. Front Pharmacol ; 12 : Clin Infect Dis ; published online Nov Mycobacterium tuberculosis precursor rRNA as a measure of treatment-shortening activity of drugs and regimens. Nat Commun ; 12 : Constructing a representative in-silico population for paediatric simulations: Application to HIV-positive African children. Molecules ; Pharmacokinetics of high-dose isoniazid in children affected by multidrug-resistant TB. Int J Tuberc Lung Dis ; 25 : — Clofazimine pharmacokinetics in patients with TB: dosing implications. Neurol Clin Pract ; 15— BMC Infect Dis ; Mycobacterium tuberculosis bloodstream infection prevalence, diagnosis, and mortality risk in seriously ill adults with HIV: a systematic review and meta-analysis of individual patient data. Open Forum Infect Dis ; 7: S Afr Med J ; —6. Incentives conditioned on tenofovir levels to support PrEP adherence among young South African women: a randomized trial. Factors affecting the electrocardiographic QT interval in malaria: A systematic review and meta-analysis of individual patient data. PLOS Med ; e J Trop Pediatr ; — Pharmacokinetics and other risk factors for kanamycin-induced hearing loss in patients with multi-drug resistant tuberculosis. Int J Audiol ; — Acceptability, safety, and patterns of use of oral tenofovir disoproxil fumarate and emtricitabine for HIV pre-exposure prophylaxis in South African adolescents: an open-label single-arm phase 2 trial. Lancet Child Adolesc Heal ; 4: — Adverse drug reactions reported to a provincial public health sector pharmacovigilance programme in South Africa. Clin Infect Dis ; e—8. The ethicolegal framework relevant to human faecal microbiota transplants in South Africa: Part 1. A legal vacuum. S Afr Med J ; —5. Why is WHO failing women with falciparum malaria in the first trimester of pregnancy? Lancet ; Quinoline-triazole half-sandwich iridium III complexes: synthesis, antiplasmodial activity and preliminary transfer hydrogenation studies. Dalt Trans ; — Misrepresentation of research on academic promotions at the University of Cape Town. Cogent Soc Sci ; 6: Trials ; Population pharmacokinetics and dosing of ethionamide in children with tuberculosis. Antimicrob Agents Chemother ; 1— CheXaid: deep learning assistance for physician diagnosis of tuberculosis using chest x-rays in patients with HIV. J Infect Dis ; 4: 1— ACS Infect Dis ; 6: — J Infect Dis ; —7. Front Pharmacol ; 1—8. Dolutegravir with emtricitabine and tenofovir alafenamide or tenofovir disoproxil fumarate versus efavirenz, emtricitabine, and tenofovir disoproxil fumarate for initial treatment of HIV-1 infection ADVANCE : week 96 results from a randomised, phase 3, non-inferiority trial. Lancet HIV ; 7: e— Antimicrob Agents Chemother ; 1—8. HIV, drugs and the kidney. Drugs Context ; 9: 1— Front Chem ; 7: 1— S Afr Med J ; —9. Benefit v. Serious adverse drug reactions at two children's hospitals in South Africa. BMC Pediatr ; 3. A cross-sectional evaluation of five warfarin anticoagulation services in Uganda and South Africa. Safety implications of combined antiretroviral and anti-tuberculosis drugs. Expert Opin Drug Saf ; Detectable HIV-1 in semen in individuals with very low blood viral loads. Virology Journal ; 5. J Antimicrob Chemother ; 74 : — BMC Cancer ; 19 : Population pharmacokinetics of abacavir and lamivudine in severely malnourished human immunodeficiency virus-infected children in relation to treatment outcomes. Br J Clin Pharmacol ; 85 : — Antimicrob Agents Chemother ; 63 : e Equitable data sharing: challenges and suggestions for ways forward. Wellcome Open Res ; 4 : Bosentan for sarcoidosis-associated pulmonary hypertension: A double-blind placebo controlled randomized trial. Chest ; : — Antimicrob Agents Chemother ; 64 : 1— The palladacycle complex AJ-5 induces apoptotic cell death while reducing autophagic flux in rhabdomyosarcoma cells. Cell death Discov ; 5 : Rifampicin effect on intracellular and plasma pharmacokinetics of tenofovir alafenamide. J Antimicrob Chemother ; 74 : —8. Effect of efavirenz-based antiretroviral therapy and high-dose rifampicin on the pharmacokinetics of isoniazid and acetyl-isoniazid. Quantitative assessment of the activity of antituberculosis drugs and regimens. Expert Rev Anti Infect Ther ; 17 : — Cohen K, Maartens G. A safety evaluation of bedaquiline for the treatment of multi-drug resistant tuberculosis. Expert Opin Drug Saf ; 18 : — Cohen K, Orrell CJ. Transition to third-line ART in resource-limited settings. J Acquir Immune Defic Syndr ; 80 : — Clin Pharmacol Ther ; 81 : — Effect of tablet crushing on drug exposure in the treatment of multidrug-resistant tuberculosis. Int J Tuberc Lung Dis ; 23 : — Clin Pharmacokinet ; 58 : — Pharmacogenetics and pharmacokinetics of CNS penetration of efavirenz and its metabolites. The Lancet Respiratory Medicine Commission: update: epidemiology, pathogenesis, transmission, diagnosis, and management of multidrug-resistant and incurable tuberculosis. Lancet Respir. J Trop Pediatr ; 4 : — Antimicrob Agents Chemother ; 63 : 1—8. Pharmacokinetics, optimal dosing, and safety of linezolid in children with multidrug-resistant tuberculosis: Combined data from two prospective observational studies. PLoS Med ; 16 : 1— Antimicrob Agents Chemother ; 63 : 1—7. Open forum Infect Dis ; 6 : ofz Am J Trop Med Hyg ; : 13— Adverse drug reactions in South African patients receiving bedaquiline-containing tuberculosis treatment: an evaluation of spontaneously reported cases. BMC Infect Dis ; 19 : Projected population-wide impact of antiretroviral therapy-linked isoniazid preventive therapy in a high-burden setting. AIDS ; 33 : — Clin Infect Dis ; 69 : — Emtricitabine-induced pure red cell aplasia. AIDS Behav ; 23 : — Current research toward optimizing dosing of first-line antituberculosis treatment. Expert Rev Anti Infect Ther ; 17 : 27— Management of active tuberculosis in adults with HIV. Lancet HIV ; 6 : e— Clin Infect Dis ; 6 : — J Acquir Immune Defic Syndr ; 80 : 73—8. Trials ; 21 : J Acquir Immune Defic Syndr ; 81 : —8. Lopinavir—ritonavir super-boosting in young HIV-infected children on rifampicin-based tuberculosis therapy compared with lopinavir—ritonavir without rifampicin: a pharmacokinetic modelling and clinical study. Lancet HIV ; 6 : e32— Safety and tolerability of single low-dose primaquine in a low-intensity transmission area in South Africa: An open-label, randomized controlled trial. Malar J ; 18 : Absence of kelch13 artemisinin resistance markers but strong selection for lumefantrine-tolerance molecular markers following 18 years of artemisinin-based combination therapy use in Mpumalanga Province, South Africa Structure-activity relationship studies of antiplasmodial cyclometallated ruthenium II , rhodium III and iridium III complexes of 2-phenylbenzimidazoles. Eur J Med Chem ; : 11— Academic promotions at a South African university: questions of bias, politics and transformation. Higher Education ; 78 : — Clinical, microbiologic, and immunologic determinants of mortality in hospitalized patients with HIV-associated tuberculosis: A prospective cohort study. Low antituberculosis drug concentrations in HIV-tuberculosis-coinfected adults with low body weight: Is it time to update dosing guidelines? Antimicrob Agents Chemother ; 63 : 1— Detectable prednisolone is delayed in pericardial fluid, compared with plasma of patients with tuberculous pericarditis: A pilot study. IJC Hear Vasc ; 22 : — Evaluation of PTA-derived ruthenium II and iridium III quinoline complexes against chloroquine-sensitive and resistant strains of the Plasmodium falciparum malaria parasite. J Inorg Biochem ; : — Ferroquine-derived polyamines that target resistant Plasmodium falciparum. Eur J Med Chem ; : 78— J Infect Dis ; : — Front Pharmacol ; 10 : Low-dose ritonavir-boosted darunavir once daily versus ritonavir-boosted lopinavir for participants with less than 50 HIV RNA copies per mL WRHI : a randomised, open-label, phase 3, non-inferiority trial. Pharmacokinetics of dolutegravir mg once daily with rifampicin. Int J Antimicrob Agents ; 54 : — Linezolid resistance in patients with drug-resistant TB and treatment failure in South Africa. Ali, A. Population pharmacokinetics of the antimalarial amodiaquine: A pooled analysis to optimize dosing. Antimicrobial Agents and Chemotherapy , 62 10 , 1— Eliciting adverse effects data from participants in clinical trials. Cochrane Database of Systematic Reviews , 5. International Journal of Infectious Diseases , 75 , 67— Uct, a next-generation plasmodium falciparum pi4k inhibitor preclinical candidate for the treatment of malaria. Trials , 19 1 , Journal of Antimicrobial Chemotherapy , 74 1 , — Artemisone and artemiside are potent panreactive antimalarial agents that also synergize redox imbalance in plasmodium falciparum transmissible gametocyte stages. Antimicrobial Agents and Chemotherapy , 62 8 , 1— Quality assurance of rifampicin-containing fixed-drug combinations in South Africa: dosing implications. Steady state pharmacokinetics of cycloserine in patients on terizidone for multidrug-resistant tuberculosis. Complex interactions between malaria and malnutrition: A systematic literature review. BMC Medicine , 16 1 , Efficacy and safety of artemether-lumefantrine, artesunate-amodiaquine, and dihydroartemisinin-piperaquine for the treatment of uncomplicated Plasmodium falciparum malaria in three provinces in Angola, Malaria Journal , 17 1 , Population pharmacokinetic properties of sulfadoxine and pyrimethamine: A pooled analysis to inform optimal dosing in african children with uncomplicated malaria. Antimicrobial Agents and Chemotherapy , 62 5 , 1— Routine data underestimates the incidence of first-line antiretroviral drug discontinuations due to adverse drug reactions: Observational study in two South African cohorts. Poor anticoagulation control in patients taking warfarin at a tertiary and district-level prothrombin clinic in Cape Town, South Africa. South African Medical Journal , 6 , The Pediatric Infectious Disease Journal , 37 12 , — Antibiotic prescribing practice and adherence to guidelines in primary care in the Cape Town Metro District, South Africa. South African Medical Journal , 4 , Investigating sulfoxide to sulfone conversion as a prodrug strategy for a PI4K inhibitor in a humanized mouse model of malaria. Antimicrobial Agents and Chemotherapy , 62 12 , 1— Clinical Infectious Diseases , 66 9 , — Planta Medica , 84 12—13 , — Evaluation of the adequacy of WHO revised dosages of the first-line antituberculosis drugs in children with tuberculosis using population pharmacokinetic modeling and simulations. Antimicrobial Agents and Chemotherapy , 62 9 , 1— BMC Public Health , 18 1 , Antimicrobial Agents and Chemotherapy , 62 11 , 1— Rapid Communications in Mass Spectrometry , 32 8 , — Artemether-lumefantrine dosing for malaria treatment in young children and pregnant women: A pharmacokinetic-pharmacodynamic meta-analysis. PLoS Medicine , 15 6 , e How good are our guidelines? South African Medical Journal , 11 , — Antimicrobial Agents and Chemotherapy , 63 1 , 1— Hemozoin inhibiting 2-phenylbenzimidazoles active against malaria parasites. European Journal of Medicinal Chemistry , , — Pharmacokinetic interaction between bedaquiline and clofazimine in patients with drug-resistant tuberculosis. New England Journal of Medicine , 20 , — C-reactive protein and procalcitonin to discriminate between tuberculosis, Pneumocystis jirovecii pneumonia, and bacterial pneumonia in HIV-infected inpatients meeting WHO criteria for seriously ill: A prospective cohort study. BMC Infectious Diseases , 18 1 , Impact of alcohol consumption on tuberculosis treatment outcomes: A prospective longitudinal cohort study protocol. Pharmacogenomics , 19 1 , 17— Disruption of maternal gut microbiota during gestation alters offspring microbiota and immunity. Microbiome , 6 1 , AI-derived three-way concentration-dependent antagonism of gatifloxacin, pyrazinamide, and rifampicin during treatment of pulmonary tuberculosis. The Next Generation Scientist program: Capacity-building for future scientific leaders in low- and middle-income countries. BMC Medical Education , 18 1 , Higher Education. Clinical Pharmacokinetics , 57 11 , — Effect of bedaquiline on mortality in South African patients with drug-resistant tuberculosis: a retrospective cohort study. The Lancet Respiratory Medicine , 6 9 , — Clinical Infectious Diseases , 67 5 , — Pharmacokinetics of rifampicin in adult TB patients and healthy volunteers: A systematic review and meta-analysis. Journal of Antimicrobial Chemotherapy , 73 9 , — Relative bioavailability of bedaquiline tablets suspended in water: Implications for dosing in children. British Journal of Clinical Pharmacology , 84 10 , — Clinical Pharmacokinetics , 57 5 , — Kidney International , 93 3 , — Single low-dose primaquine for blocking transmission of Plasmodium falciparum malaria - a proposed model-derived age-based regimen for sub-Saharan Africa. Biomedical Chromatography , 32 9 , e Evaluation of tuberculosis treatment response with serial C-reactive protein measurements. Open Forum Infectious Diseases , 5 11 , ofy ACS Chemical Biology , 13 10 , — Antimicrobial agents and chemotherapy. Effect of diurnal variation, CYP2B6 genotype and age on the pharmacokinetics of nevirapine in African children. J Antimicrob Chemother. Determinants of virological outcome and adverse events in African children treated with paediatric nevirapine fixed-dose-combination tablets. Blockman M. Warfarin: better the devil you know. Cardiovascular Journal of Africa ; Molecules Basel, Switzerland. South African guideline for the management of community-acquired pneumonia in adults. Journal of Thoracic Disease ;9 6 International Journal of Antimicrobial Agents ;49 2 Antimicrob Agents Chemother. Diagnostic outcomes after chest radiograph interpretation in patients with suspected tuberculosis and negative sputum smears in a high burden HIV and tuberculosis setting. Pharmacokinetics of sulfadoxine and pyrimethamine for intermittent preventive treatment of malaria during pregnancy and after delivery. Changes in estimated glomerular filtration rate over time in South African HIVinfected patients receiving tenofovir: a retrospective cohort study. The epidemiology, pathogenesis, transmission, diagnosis, and management of multidrug-resistant, extensively drug-resistant, and incurable tuberculosis. Lancet Respir Med. Ebrahim I, Blockman M. Metabolic acidosis in a patient with metformin overdose. S Afr Med J ; 2 The Cape Town clinical decision rule for streptococcal pharyngitis in children. Synthesis and biological characterisation of ester and amide derivatives of fusidic acid as antiplasmodial agents. First-line antiretroviral drug discontinuations in children. Clin Pharmacol Ther. PLoS Med. A comparison of self-report and antiretroviral detection to inform estimates of antiretroviral therapy coverage, viral load suppression and HIV incidence in Kwazulu-Natal, South Africa. BMC Infect Dis ; Clinical Infectious Diseases ; Hemostatic changes associate with mortality in hospitalized patients with HIV-associated tuberculosis: a prospective cohort study. Journal of Infectious Diseases ; South African Medical Journal ; 10 Compatibility of next generation first line antiretrovirals with rifampicin-based anti-tuberculosis therapy in resource limited settings. Working towards consensus on methods used to elicit participant-reported safety data in uncomplicated malaria clinical drug studies: a Delphi technique study. Malar J. Clin Infect Dis. Prevention of TB using rifampicin plus isoniazid reduces nevirapine concentrations in HIV-exposed infants. Effect of Moringa oleifera Lam. Key toxicity issues with the WHO-recommended first-line antiretroviral therapy regimen. Expert Review of Clinical Pharmacology ; J Clin Pharmacol. Effect of rifampicin and efavirenz on moxifloxacin concentrations when co-administered in patients with drug-susceptible TB. Journal of Medicinal Chemistry ; Post-treatment effect of isoniazid preventive therapy on tuberculosis incidence in HIV-infected individuals on antiretroviral therapy. AIDS ; Late efavirenz-induced ataxia and encephalopathy: a case series. Journal of Acquired Immune Deficiency Syndromes ; Hexahydroquinolines are antimalarial candidates with potent blood-stage and transmission-blocking activity. Nature Microbiology ; 2 10 Changes in body fat distribution on dual-energy x-ray absorptiometry in black South Africans starting first-line antiretroviral therapy. Cyclopalladated organosilane-tethered thiosemicarbazones: novel strategies for improving antiplasmodial activity. Dalton Trans. Bioisosteric ferrocenyl-containing quinolines with antiplasmodial and antitrichomonal properties. Synthesis, characterization, antiplasmodial evaluation and electrochemical studies of water-soluble heterobimetallic ferrocenyl complexes. Inorganica Chimica Acta ; Prolonged tuberculosis-associated immune reconstitution inflammatory syndrome: characteristics and risk factors. BMC Infectious Diseases ;16 1 Plasma efavirenz exposure, sex, and age predict virological response in HIV-infected African children. J Acquir Immune Defic Syndr ;73 2 The impact of genetic polymorphisms on the pharmacokinetics of efavirenz in African children. Br J Clin Pharmacol. J Antimicrob Chemother — What is a 'good' result after transcatheter mitral repair? J Thorac Cardiovasc Surg. N-acetylcysteine for non-paracetamol drug-induced liver injury: a systematic review. Random lopinavir concentrations predict resistance on lopinavir-based antiretroviral therapy. International Journal of Antimicrobial Agents ;48 2 Antiretroviral therapy increases the prevalence of dyslipidemia in South African HIV-infected patients. Moderate to severe HIV associated neurocognitive impairment: a randomized placebo controlled trial of lithium. Medicine Baltimore Nov;95 46 :e Efficacy of artemether-lumefantrine in relation to drug exposure in children with and without severe acute malnutrition: an open comparative intervention study in Mali and Niger. BMC Med. Clinician compliance with laboratory monitoring and prescribing guidelines in HIV1-infected patients receiving tenofovir. South African Medical Journal ; Selected questions and controversies about bedaquiline: a view from the field. Lancet ; PLoS Pathog ;12 11 : e Population pharmacokinetic drug-drug interaction pooled analysis of existing data for rifabutin and HIV PIs. J Acquir Immune Defic Syndr. Results from a Population-Based Survey. Risk factors for incident diabetes in a cohort taking first line non-nucleoside reverse transcriptase inhibitor-based antiretroviral therapy. Medicine Baltimore ;e BMC Infectious Diseases ; J Pediatric Infect Dis Soc. Recent developments in percutaneous mitral valve treatment. Expert Rev Cardiovasc Ther. J Med Chem. Combinations of potent topical steroids, mercury and hydroquinone are common in internationally manufactured skin-lightening products: a spectroscopic study. Clin Exp Dermatol. Bioavailability of two licensed paediatric rifampicin suspensions: implications for quality control programmes. Int J Tuberc Lung Dis. Pediatr Infect Dis J. Adverse drug reactions causing admission to medical wards: A cross-sectional survey at 4 hospitals in South Africa. Lancet Infect Dis. Design, synthesis, and In vitro antituberculosis activity of 2 5H -Furanone derivatives. Drug Safety Feb;39 2 International Journal of Antimicrobial Agents Jun;47 6 Drug-drug interactions between bedaquiline and the antiretrovirals lopinavir-ritonavir and nevirapine in HIV-infected patients with drug resistant tuberculosis. Journal of Antimicrobial Chemotherapy ; Plasma efavirenz concentrations are associated with plasma lipid and glucose concentrations. Medicine Baltimore. Severe antiretroviral-associated skin reactions in South African patients: a case series and case-control analysis. Pharmacoepidemiology and Drug Safety ; Mono- and multimeric ferrocene congeners of quinoline-based polyamines as potential antiparasitics. Front Genet. J Infect Dis. Curr Drug Deliv. Linezolid in the treatment of drug-resistant tuberculosis: the challenge of its narrow therapeutic index. Expert Review of Anti-infective Therapy ;14 10 Synthesis and biological evaluation of a series of non-hemiacetal ester derivatives of artemisinin. Eur J Med Chem. Efficacy and pharmacokinetic evaluation of a novel anti-malarial compound NP in a mouse model. Lipid-based nutrient supplements do not affect efavirenz but lower plasma nevirapine concentrations in Ethiopian adult HIV patients. HIV Medicine ;— Changes in blood pressure, glucose levels, insulin secretion and anthropometry after long term exposure to antiretroviral therapy in South African women. Improved antiparasitic activity by incorporation of organosilane entities into half-sandwich ruthenium II and rhodium III thiosemicarbazone complexes. Dalton Trans ;44 5 Updated recommendations for the management of upper respiratory tract infections in South Africa. S Afr Med J. Comparison of outcomes of percutaneous MitraClip versus surgical repair or replacement for degenerative mitral regurgitation in octogenarians. Am J Cardiol. Molecules ;20 12 Impact of nonlinear interactions of pharmacokinetics and MICs on sputum bacillary kill rates as a marker of sterilizing effect in tuberculosis. Antimicrob Agents Chemother ;59 1 Antimicrob Agents Chemother ;60 1 Ferrocene-pyrimidine conjugates: Synthesis, electrochemistry, physicochemical properties and antiplasmodial activities. Eur J Med Chem ; N-acetylcysteine for non-paracetamol drug-induced liver injury: a systematic review protocol. Syst Rev ; Optimization of a multi-well colorimetric assay to determine haem species in Plasmodium falciparum in the presence of anti-malarials. Malar J Jun 24; Antiplasmodial activity, in vivo pharmacokinetics and anti-malarial efficacy evaluation of hydroxypyridinone hybrids in a mouse model. Malar J Dec 16;14 1 Malar Res Treat. PLoS One Dec 3;10 12 :e Two-stage activity-safety study of daily rifapentine during intensive phase treatment of pulmonary tuberculosis: Int J Tuberc Lung Dis ;19 7 —6. Central nervous system penetration of antiretroviral drugs: pharmacokinetic, pharmacodynamic and pharmacogenomic considerations. 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Department of Medicine
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Katerina Horackova, Czechia. Thank you all for being here and thanks to all our cosponsors. I ask all speakers to only speak for maximum 3 minutes so that we have enough time for discussions. I ask you all to touch on what is the biggest challenge for human rights from your perspective, barriers for implementing evidence-based drug policies, gender issues and the rights of women, and the issue of negative consequences of prohibition. I now pass the floor to Mr. Jondrich Voboril. Do you know the game true or false? Please raise your hands. The drug conventions assume that we can reach a full abstinence society — true or false? Possession of drugs for personal use must be illegal according to convention — true or false? Some of you read the INCB report! Penalising people for possession of drugs, when they are diagnosed with addiction disorders, is against international human rights law — true or false? When the conventions were drafted, they agreed to eliminate certain drugs by banning them. Because of that, we put millions of people in prisons, we executed hundreds of thousands of people since then. We denied treatment, we labelled people as antisocial because they use drugs. We know that certain behaviour in our penal systems can go so far as to obstructing people from basic rights such as the right to life or right to liberty. I want to finish with a remark: we have the option of continuing with an abstinence based policy of drug free world, or an option of policy focusing on minimising the harms and risks, forgetting the push and promise of a world free of drugs. In , we produced a poster: people who use drugs do not lose their human rights. But we still ahem to do more work. The death penalty is one of these issues. Most countries also continue to criminalise. We have achieved very little. We are making the 75th anniversary of the Universal Declaration on Human Rights. We should look at the measures we are taking and how far we are going with that. During the last 6 decades, numerous commitments have been made to respect human rights in drug control efforts. These are the good momentums that were created. How can we move away from human rights violations? We have opportunities to change the discourse. In , there will be an opportunity to contribute and reevaluate what we have achieved with regards to human rights in drug policy and what can be done. Tomorrow, there will be an informal at the Human Rights Council to adopt a resolution for the OHCHR to publish a report on human rights and drug policy for This is giving us the opportunity to highlight the situation and define the way forward. We need to connect the dots between Geneva and Vienna, as well as with New York. I also want to mention that one member of the Committee addressed the Commission: their voices are heard here, and recommendations are provided. The Committee on Economic, Social and Cultural Rights is involved in a process to draft a general comment on drug policy. Continued support for civil society and a safe space are critical. Civil society must be supported. Ambassador Raphael Nageli, Switzerland. Switzerland is proud of its efforts for pushing for human rights approach in international drug policy. Today, our national drug policy includes a 4 pillar approach: prevention, therapy, harm reduction and repression. We promote an inclusive approach of all relevant actors, including civil society. Our system is far from being perfect. Every drug policy must reflect realities in our society. But a holistic approach putting public health in the centre, with human rights, is necessary, but also imperative and will be successful. Drug policies are never static. Drug policies evolve, and many countries have evolved. Here I sense some push back. There were 24 countries calling for a human rights report in the World Drug Report, and there was stiff opposition on this. And this is hard to expect from us there at the United Nations. There are also delegations that are pushing against the inclusion of civil society. This cannot be a solution. So we are in the middle of a process. There is push back but there are encouraging signs. Thank you to our co-sponsors and particularly to the Czech Republic and the other Member States — all of whom have consistently championed civil society participation in UN drug policy debates. We also welcome the conference room paper Katerina mentioned at the beginning. IDPC was set up in as a global coordination structure for collectivising civil society advocacy at the UN — which is where we still focus a large part of our efforts although we also work with members at the regional as well as national levels. This achievement is important because civil society voices have traditionally not been valued within drug policy debates, especially when it has been framed as a security issue, and it has been a fight to ensure that CSOs and representatives of affected communities are heard. And I think we can see at the UN level and CND that sustained advocacy from pro-reform civil society actors has been crucial in shifting the rhetoric towards upholding human rights, ensuring the centrality of public health as well as promoting just and proportionate criminal justice responses. In order to broaden out the debate here in Vienna, we have consistently noted that drug policy does not operate in a vacuum and Vienna-based drug control bodies must acknowledge and welcome the input and expertise of other specialised UN entities and experts. The CND may have the prime responsibility for drug policy in at the UN — but precisely because of this role it has the obligation to genuinely integrate the contributions by UN bodies on human rights and health. And of course CND does not have a monopoly over drug-related matters. This highlights the importance of gathering here today. We should talk about it. I thought of 4 elements that are important to highlight. I could echo the Ambassador, Zaved and Ann, but I will provide a different perspective. A balanced approach is also about the health perspective, the law enforcement perspective. I discovered listening to the general debate that there was very little talk about prevention. And prevention is still necessary: explaining what risks are related to the use of drugs. We face problems with large criminal organisations. We can look back from that and try to protect society and people. So part of the law enforcement politics should be about giving people opportunities and helping them with their lives. We have an approach comparable to Switzeelrnad. Prevention is better than cure, cure is better than harm reduction, but harm reduction is absolutely essential. I just came from a side event on drug checking, and this is essential, we are talking about saving people. We should be kind to each other and help each other when somebody needs help. I am very fond of decriminalisation because it means that somebody who has taken drugs, and something foes wrong, he or she can ask for help from a doctor, a first help station, without being in a criminal act, and this is essential just to have the possibility to ask for help. This is one of the key elements of our policy. And it works also in another way around: it helps to reduce stigma. In your policy, when you can talk about drug use, it is a step forward. In high school, we talk about drug use, but we also need to talk to parents about the risks for drug use and how to reduce harms. Communication is essential. David Filomena, Ministry of Justice, Colombia. It is not a political statement, it is a statement based on evidence that can be supported by hundreds of publications and research. We should have to review classifications, and eventual regulation of some substances. We have to see opportunities to review the medical and scientific uses of some substances to move slowly and gradually towards a regulation that can achieve peace in countries, and to improve health. Where do you see human rights and drug policy going in the coming years? Norway has found many areas to improve. Police are taking two steps back, social services are taking two steps forward. The police are now increasing the number of seizures as they no longer prioritise criminalising drug use. So what do you think about that? I agree with you that we have certain behaviours that international law accepts we can put people in prison for. Do we put them in prison? Decriminalisation hinders access to treatment and increases stigma and discrimination so human rights bodies are clear on the need to decriminalise. With regard to children, there is a need for prevention, but we need a human rights lens. If you criminalise and stigmatise them from the get go, they will be criminalised and stigmatised throughout their lives. I do think that criminalising people for drug use, regardless of whether they are dependent or not violates human rights, in particular the right to health, it creates a structural barrier in access to services. The argument from the human rights perspective not to criminalise people fro drug sue and possession is quite clear, and reduces instances of abuse and violence by the state. The conventions allow for people dependent on drugs to be diverted from the criminal justice system, and in general, decriminalisation should apply across the board. It is honest to acknowledge who benefits from criminalisation. Because there is no much business at stake from the prison industrial complex, police, etc. Could somebody comment on this too? The Czech Presidency led on a document signed by the European Council on human rights in drug policy. It was a very tough debate in the EU. The main argument against it is something we need to work around: we have human rights, and we have security. And security is a commandment against decrim and the humanisation of drug policy. Addressing this issue and the impacts on the criminal justice system: criminalisation creates over incarceration all over the world. And there is an impact on the whole criminal justice system. We have seen in many countries the collapse of the criminal justice system because of over-incarceration, and we must look at the issue from this perspective. Governments are willing to discuss the issue because of the impact on the criminal justice system, in various instances. We should not criminalise use. In the Netherlands possession is not decriminalised, our public prosecution service will not go after a person stopped for possession for personal use. You have to think of how the systems work and who is benefiting. The issue should be about ending the criminalisation of everything, but then you take away the profit models. But I am from the Ministry of Health and I see the health risks here. But this is all about finding a balance. But I think we can agree here that you should not put people in prisons for possession for small quantities of drugs. In a way, the conventions can help manage the problem by fighting against criminal organisations but also relieving the prison system from marginalised populations. I am new here, I have a lot of experience working with families. But we see prisons meaning a lot as a relief. Psychologists and social workers talk to families, but prisons are the only way in which families are in touch with the health system in Austria. When I start to work with my families, I have one message: police and social workers are our friends. This is my experience in Vienna. Iran Human Rights. I wanted to say a few words about the death penalty for drugs. There are countries executing people for drug trafficking, including in my country in Iran. At that time, UNODC had projects in Iran and Iran used that excuse to justify the executions as being at the forefront of combatting drugs. But we recently saw a huge reduction in the number of executions because of the change in the law, through pressure from countries, funding from UNODC projects inside Iran. So for 3 years we had low numbers of executions, but the trend has now reversed. Since , we had more than 2 executions every day, with 85 executions, and there has been no reaction to that from UNODC, and I wonder why. Human rights are a pillar of the UN. So why is there no reaction to this? We will have a discussion on the death penalty tomorrow, so we can discuss then. I want to pick up on our Vienna colleague. I think that your experience with the police is exceptional. We have colleagues from South East Asia, and many other parts of the world and the story is very different. In British Colombia they have decided to implement a three-year project for the police not to target people who use drugs as the police recognised that they were exacerbating the problem and risks to fatal overdose. We need to continue the conversation about the roel of the police, but we have to consider decrim as the next step. Your email address will not be published. Save my name, email, and website in this browser for the next time I comment. Side event: Licit uses of coca crops in Colombia. Leave a Reply Cancel reply Your email address will not be published.
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