Patient safety is a core dimension of quality of care and a key policy priority for health systems, given the substantial burden of preventable harm associated with unsafe care and inappropriate use of medicines. Medication-related harm, including the inappropriate use of antimicrobials, is among the most common and avoidable sources of patient safety incidents, contributing to adverse drug events and the growing threat of antimicrobial resistance. In response, the World Health Organization has articulated the Global Patient Safety Action Plan 2021‑2030 (Astier-Peña et al., 2021[1]), which calls for stronger governance, learning systems and safer medication practices across countries. This section brings together two complementary indicators to assess progress in this area: the extent to which countries have established the system-level foundations for patient safety in line with the Action Plan, and patterns of antimicrobial consumption, which provide insight into prescribing practices and potential risks related to unsafe or inappropriate use. Together, these indicators highlight both the policy commitment to patient safety and how it translates into everyday prescribing behaviour, offering a more comprehensive picture of patient safety and safe prescribing in the region.
The Global Patient Safety Action Plan 2021‑2030 sets out a comprehensive framework for strengthening patient safety through governance, learning systems, workforce training and patient engagement. Across Latin America and the Caribbean, progress in meeting these criteria remains uneven. No country in Latin America and the Caribbean fully meets all assessed requirements (Figure 7.14), while six countries meet most criteria and can be considered as having broadly aligned patient safety systems. Uruguay stands out with the highest level of alignment, meeting 10 of the assessed criteria, followed by Cuba and Ecuador (eight criteria each). A second group of countries – including Colombia and Costa Rica (seven criteria each), as well as the Dominican Republic and Peru (six criteria) – meet several core elements but still show gaps, particularly in national target-setting and public reporting. The majority of countries partially meet the Global Patient Safety Action Plan criteria, typically having foundational policies in place – such as reporting systems for never events or participation in international safety initiatives – but lacking comprehensive national action plans, regular publication of patient safety performance, or explicit targets to reduce medication-related harm. At the lower end of the distribution, Guyana, Haiti and Paraguay meet few criteria, indicating limited system-level patient safety infrastructure.
Average antimicrobial consumption in Latin America and the Caribbean varies widely across countries and therapeutic groups. During the period 2019‑2022, total consumption ranged from 23.9 defined daily doses per 1 000 inhabitants per day (DID) in Argentina and 22.0 DID in Colombia, to below 6 DID in Chile (5.4 DID) and Trinidad and Tobago (5.9 DID), and 2.9 DID in Saint Kitts and Nevis (Figure 7.15). In all countries, consumption is dominated by beta-lactams, penicillins (J01C), which account for the largest share of use, reaching 11.8 DID in Argentina and 7.7 DID in Colombia, followed by macrolides (J01F) and quinolones (J01M) – two classes commonly associated with inappropriate prescribing when used outside guideline‑recommended indications. Higher-consumption countries also tend to show broader use across multiple antimicrobial classes, whereas lower-consumption countries display more concentrated prescribing patterns. Colombia, for instance, is advancing the formulation of a policy document under the National Council for Economic and Social Policy (CONPES) to reduce the impact of antimicrobial resistance, covering both human and veterinary use. These large cross-country differences likely reflect a combination of variation in disease burden, access to medicines, prescribing practices and regulatory oversight, and underscore the importance of strengthening antimicrobial stewardship and safe prescribing policies to reduce unnecessary exposure and mitigate the risks of antimicrobial resistance and medication-related harm.
