World Health Organization · 1st edition, 2017 · 16 pages
WHO's third Global Patient Safety Challenge to reduce severe avoidable medication-related harm by 50% in 5 years.
- Issuer
- World Health Organization
- Edition
- 1st edition, 2017
- Audience
- Ministries of health, health system leaders, health care professionals, patients, regulatory authorities, educational institutions
- Evidence
- Expert consensus and evidence synthesis
- Reviewed
- 23 Oct 2026 · GMJ
What this guideline says
GMJ summary
Medication Without Harm is the WHO Global Patient Safety Challenge launched in March 2017 to address unsafe medication practices and medication errors, which are a leading cause of avoidable harm globally. The cost of medication errors has been estimated at US$ 42 billion annually, and patients in low-income countries experience twice as many disability-adjusted life years lost due to medication-related harm than those in high-income countries.
The Challenge sets a goal to reduce severe, avoidable medication-related harm by 50% over 5 years by strengthening systems for prescribing, dispensing, administering, monitoring and use. It identifies three early priority action areas: high-risk situations (particularly involving young children, the elderly, and those with kidney or liver disease), polypharmacy (routine use of four or more medications), and transitions of care (when patients move between facilities, sectors or staff).
The Strategic Framework addresses four domains: patients and the public (empowering informed engagement); medicines (improving naming, labelling and packaging); health care professionals (safer prescribing and administration); and systems and practices (designing more resilient medication processes). The Challenge emphasizes that medication errors are rarely due to individual neglect but result from flawed systems and processes, making them potentially preventable through systematic improvement.
Key points
For clinicians — doses and thresholds as stated in the guideline
- Global goal: reduce severe, avoidable medication-related harm by 50% over 5 years
- Polypharmacy defined as routine use of four or more over-the-counter, prescription and/or traditional medications at the same time by a patient
- Medication errors cost an estimated US$ 42 billion annually worldwide
- Patients in low-income countries experience twice as many disability-adjusted life years lost due to medication-related harm compared to high-income countries
- Three priority action areas: high-risk situations, polypharmacy, and transitions of care
- Medication reconciliation (formal comparison of medicines pre- and post-care) is vital during transitions of care
- Errors occur most frequently during administration, but there are risks at all stages of the medication process
- High-alert medications require special tools and technologies; wrong dose, wrong route, and failure to follow treatment regimens are common errors in high-risk situations
From the guideline
Verbatim
“Reduce the level of severe, avoidable harm related to medications by 50% over 5 years, globally”
Editor’s perspective
Why this matters for Georgia and the region
Prof. Giorgi Pkhakadze, MD, MPH, PhD
Editor-in-Chief, Georgian Medical Journal · Chair, Public Health Institute of Georgia · WHO consultant, health and migration
As WHO consultant and chair of Georgia's Public Health Institute, I have witnessed firsthand how medication errors undermine our health system gains, particularly as our UHC programme expands pharmaceutical coverage. This Challenge offers Georgia a proven framework to systematically address medication safety—an issue that has received insufficient attention compared to communicable disease control. I would stress to Georgian clinicians the imperative of medication reconciliation during the frequent transitions between our fragmented primary, secondary and tertiary facilities, and the need to regularly review polypharmacy in our rapidly ageing population. The realistic implementation caveat is that achieving the 50% harm reduction target requires investment in reporting systems, pharmacy staffing, and electronic prescribing infrastructure that will compete with other urgent priorities in our constrained health budget.
ORCID 0000-0001-7609-4515 · Perspective written for the GMJ Guidelines Library, 23 Oct 2026
Applicability
Georgia and the South Caucasus
For Georgia and the South Caucasus, this Challenge is highly relevant as health systems in the region continue to develop medication safety infrastructure. A national medication safety programme would need to consider: establishing medication error reporting systems (currently limited or absent in many facilities); implementing medication reconciliation protocols during transitions between primary, secondary and tertiary care; addressing polypharmacy in the ageing population; strengthening pharmacy capacity for dispensing verification; and developing patient education materials in Georgian, Armenian and Azerbaijani languages. The Challenge framework can guide Georgia’s ongoing universal health coverage reforms by integrating medication safety into the State Programme for inpatient and outpatient pharmaceutical coverage, and aligns with existing infection prevention and control programmes in prioritizing systematic safety improvements over individual blame.
Questions this guideline answers
Quick answers
What is polypharmacy and why is it a priority?
Polypharmacy is the routine use of four or more over-the-counter, prescription and/or traditional medications at the same time by a patient. It has increased dramatically with greater life expectancy and as older people live with several chronic diseases. Polypharmacy increases the likelihood of side effects, interactions between medications, and may make adherence more difficult, requiring optimal medication management with regular reviews.
What are transitions of care and why are they high-risk?
Transitions of care occur when a patient moves between facilities, sectors and staff members (e.g., emergency room to intensive care, nursing home to hospital, primary care doctor to specialist, or between nurses during shift changes). These transitions increase the possibility of communication errors leading to serious medication errors. Good communication and medication reconciliation—a formal comparison of medicines pre- and post-care—are vital to prevent harm.
How can patients protect themselves from medication harm?
Patients can: 1) maintain a current medicine list updated when any medicine changes occur; 2) actively participate in medication reconciliation during transitions of care; 3) report adverse medication events themselves; 4) take an active role in their own medical care and medication management; and 5) be informed and empowered participants rather than passive recipients, asking questions and spotting potential errors.
What is the estimated global cost of medication errors?
The cost associated with medication errors has been estimated at US$ 42 billion annually globally. This substantial economic burden, combined with the human cost of preventable harm, disability and death, makes medication safety a critical priority for health systems worldwide, particularly as patients in low-income countries experience twice the burden of medication-related harm compared to those in high-income countries.
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- Issuer
- World Health Organization
- Type
- Guideline
- Edition
- 1st edition, 2017
- Status
- Current
- Published
- 2020-10-15
- Languages
- English
- Scope
- Global, all health care settings
- Audience
- Ministries of health, health system leaders, health care professionals, patients, regulatory authorities, educational institutions
- Pages
- 16
- Licence
- CC BY-NC-SA 3.0 IGO
- Evidence
- Expert consensus and evidence synthesis
- Record history
- Created 23 Oct 2026 · updated 23 Oct 2026 · next check Apr 2027
World Health Organization. Medication Without Harm – Global Patient Safety Challenge on Medication Safety. Geneva: World Health Organization; 2017. (WHO/HIS/SDS/2017.6).GMJ Guidelines Library records are original summaries written by the GMJ editorial team from the issuer’s published document and reviewed by a physician. They do not replace the full guideline. The document is the copyright of its issuer and is linked, not hosted. Spotted an error or a newer edition? Tell the Guidelines Desk.
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