Kathy Moscou

Kathy Moscou

PhD Student

Pharmaceutical Sciences

University of Toronto

Research Description

My research investigates the influence of transnational actors and global initiatives in shaping domestic pharmacovigilance policies, practice and innovation in India and Kenya. Transnational actors such as the WHO are a potential resource for building capacity, promoting best practices, supporting innovation and assuring accountability for pharmacovigilance in under-resourced settings. The research will contribute to the identification of policies and strategies to improve pharmacovigilance in low and middle income countries. Findings will have implications for the domestic population in India and Kenya as well as low-income, middle-income, and high-income countries like Canada for whom India and Kenya supply new and generic combination therapies. 


Adverse drug reactions (ADRs) are among the top 10 leading causes of death in many countries and populations of low and middle-income countries are at increased risks for potential ADRs. Information gaps exist regarding the safety and real-world effectiveness of new antimalarials, artemisinin-based combination therapies, and generic combination antiretrovirals used in the rapid scale-up of HIV/AIDS, TB, and malaria treatments, for the 30 million people living with AIDS and 216 million cases of malaria (2010), in countries classified as low and middle-income by the World Bank. Moreover, most clinical trials are conducted in high-income countries in patients without co-morbidities such as malaria and tuberculosis. Pharmacovigilance increases our understanding of ADRs to prevent patient harm however in most low and middle-income countries pharmacovigilance is implemented within the context of poverty and an overburdened, under-resourced health care system. Additional innovations are needed to enhance postmarket drug safety.