Publication:

Pharmacovigilance in rural India: challenges, opportunities and the way forward

Pharmacovigilance (PV) plays a crucial role in safeguarding drug safety, yet its reach in rural India, home to approximately 65% of the population, remains markedly limited compared to urban centres. Drawing from our experiences in adverse drug reaction (ADR) monitoring at peripheral health centres, this article explores key barriers, including inadequate awareness, infrastructural deficits, and sociocultural hurdles, that hinder effective PV implementation. It highlights opportunities through community health workers (CHWs), low-bandwidth mobile technologies, and innovative models such as Delay-Tolerant Networking (DTN) for offline reporting. Recommendations include embedding PV within existing national programs like the National Health Mission (NHM) and Ayushman Bharat Digital Mission (ABDM), enhancing contextualised training, and pursuing policy reforms through the PV Programme of India (PvPI). By systematically addressing these gaps, India can acheive more equitable drug safety, reduce preventable ADRs, and strengthen public health in its most underserved communities. This review offers practical, field-informed insights for policymakers, practitioners, and program implementers.