Optimizing Treatment for Children in the Developing World

Since 2003, Dr Stuart MacLeod has been Professor of Pediatrics at the University of British Columbia in Vancouver, Canada. He was also Director of the Child & Family Research Institute at BC Children’s Hospital until January 2010 and remains a senior clinician scientist at the Institute.Dr MacLeod received an MD from the University of Toronto in 1967 and completed postgraduate training in clinical pharmacology in 1973 at McGill University where he obtained a PhD in pharmacology in 1972. In the early stages of his career his research interests focused on biochemical pharmacology, drug hepatotoxicity and drug biotransformation. In 1979 Dr MacLeod became the founding leader of a Division of Pediatric Clinical Pharmacology at Toronto’s Hospital for Sick Children. This University of Toronto unit has now thrived for 35 years and is the world’s leading centre for training and research in pediatric pharmacology and toxicology. Dr MacLeod served as Dean of the Faculty of Health Sciences at McMaster University (1987-1992) and following the deanship founded the Centre for Evaluation of Medicines with a focus on therapeutics teaching, clinical pharmacology, population health sciences and pharmacoepidemiology.Since 1986, Dr MacLeod has held a major interest in international health with a focus on African maternal-child health. His current scientific interests embrace the multitude of factors that influence safe and effective drug treatments for children and the use of research findings to inform clinical and public policy.

• Foreword.- Shifting demographics and regional disparities.- Access issues.- Ending stockouts.- Improved formulations and optimal dosing.- Deficient and counterfeit products.- Knowledge gaps in pregnancy and lactation.- Factors enabling improved therapy.- Regulatory science.- Human resource planning.- Information and communications technology.- Pharmaceutical care.- Networks (GRIP, INRUD, MSH, PTN,MYCRN, IABMC).- Research challenges.- Research standards for clinical trials in low and middle income countries.- Innovative appropriate trial methods.- Nutrition/micronutrients.- Impact on therapeutic outcomes.- Drug safety and pharmaco-epidemiology.- Personalized treatment and Pharmacogenomics.- Neglected diseases.- Health outcomes and economics.- Enhanced industry engagement.- Incorporating social science perspectives.- Clinical settings.- Treatment in the community.- Treatment at the district hospital level.- Care of the critically ill child.- Palliative care and pain management. – Conclusion.- The light at the end of the tunnel: future directions.