CONCLUSION
We have shown that evidence of the burden of serious ADRs in SSA is patchy and highly heterogeneous. Nevertheless, a few high-quality studies suggest that the burden is considerable. A unique feature of the ADR burden in this region is the frequency at which people living with HIV appear affected, and the frequency with which ART and medicines used in the management of opportunistic infections are implicated in this burden. However, the risk of ADRs should be considered against the risks associated with non-treatment64, and there is no doubt that the benefit of these medicines massively outweigh their risk of harm. Further characterisation of the serious ADR burden in SSA is required, particularly in paediatric and elderly populations, and in countries other than South Africa and Nigeria. This should ideally be performed by conducting studies of standardised methodology.