Equity in Pharmacovigilance: The Role of Health Literacy in Centering Marginalized Patient Voices

Health literacy is a critical yet often overlooked determinant in pharmacovigilance, particularly in the context of socioeconomically disadvantaged populations. This article explores how low health literacy impedes the recognition and reporting of adverse drug reactions (ADRs), contributing to systemic underreporting and inequity in drug safety monitoring. Despite global advances in pharmacovigilance infrastructure, marginalized groups, such as rural communities, indigenous populations, and low-income patients, remain underrepresented in safety databases due to barriers in accessing, understanding, and acting upon medication-related information. Cultural misconceptions, linguistic challenges, limited digital access, and distrust in health systems further exacerbate this exclusion. The article advocates for an equity-based approach to pharmacovigilance that prioritizes tailored communication strategies, community engagement, and participatory design of ADR tools. It highlights the role of community health workers, culturally appropriate education, and inclusive digital platforms in bridging the literacy gap. Policymakers are urged to integrate health literacy and equity into pharmacovigilance frameworks, invest in localized interventions, and support research that measures the impact of such efforts. Ultimately, enhancing health literacy is not merely a public health goal but a moral imperative, necessary to empower patient voices, improve drug safety outcomes, and build a truly inclusive pharmacovigilance ecosystem that leaves no one behind.