Building medical toxicology capacity in Africa: a review and strategic perspective on the need for fellowship training programs.

INTRODUCTION: Toxic exposures and poisoning constitute a substantial but underestimated public health hazard throughout Africa, for which pesticides, drugs, traditional medicine, snake venom, and industrial chemicals are a disproportionate cause of avoidable disease and death. METHODS: This narrative review takes into account existing global models of toxicology education while considering African epidemiology and the constraints of its healthcare systems. MAIN FINDINGS: Partly due to this disparity between burden and capacity, medical toxicology is not well established on the continent as a whole, with minimal diagnostic capability, few toxicovigilance programs, and no established fellowship training programs or poison centers. While there are advancements in global models of toxicology education, African researchers should work on a context and locally adapted solution that considers its epidemiology and the constraints of its healthcare system. Fellowship programs supported by governments, academia, and international donors can enhance patient outcomes, strengthen public health surveillance, and support health system resilience. CONCLUSION: This review highlights the current toxicological landscape in Africa, the capacity gap in clinical and public health, and presents a strategic framework for setting up medical toxicology fellowship programs in response to the African reality.