Clinical pharmacology and optimal therapeutics in developing countries: aspirations and hopes of the Pediatric Clinical Pharmacology Subcommittee

Abstract

By the year 2000 the world's population will exceed 6 billion people, of whom one-half will be under the age of 15. Many of these children will die unnecessarily from diseases readily treatable with pharmaceutical agents. The discipline of pediatric clinical pharmacology has the potential to provide significant benefit to the world's children. Critical to the recognition of this potential is the blending of the expertise to be found in the disciplines of pediatrics, toxicology, clinical pharmacology, pharmacogenetics and clinical epidemiology. Through a marriage of these disciplines and an appropriate admixture of social sciences we may create a strong discipline focused on the encouragement of optimal drug therapy for children and for their protection from inappropriate drug exposure in utero. Such a development is the prime objective of the Pediatric Clinical Pharmacology Subcommittee: International Union of Pharmacology, Section of Clinical Pharmacology.

PIP: A brief history of the development of the field of clinical pharmacology and the recent emergence of the Pediatric Clinical Pharmacology Subcommittee of the International Union of Pharmacology precedes an exposition of the near-term future of the field of pediatric clinical pharmacology, especially for developing countries. The Pediatric Clinical Pharmacology Subcommittee was officially launched in Stockholm in 1971, stimulated by crises of chloramphenicol and thalidomide toxicity in the 1950s and 1960s. A recent review for the committee revealed 25 international training programmes devoted to pediatric pharmacology. A meeting of training program leaders in 1989 resulted in a 4-part mission statement involving research, dissemination of optimal drug therapy, new drug development and optimization of existing drugs, and training of physicians and scientists in the discipline. Pediatric pharmacology is vital because by 2000 almost half of the world's 6 billion persons will be under 15, and 97% of childhood deaths occur in developing countries. Some of the issues in need of attention are more effective teaching, practice guidelines, unnecessary, inappropriate and toxic drug treatments, new research on problems such as HIV, development of new drugs from natural products, new information technology, and risk-benefit analysis of drug therapy. Quality of life for children will be improved by bridging the disciplines of epidemiology, immunology, infectious disease, genetics and health economics with pediatric pharmacology.