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Adverse reactions to approved prescription drugs are a major health concern and children are particularly vulnerable. These adverse drug reactions (ADRs) cause 10,000-22,000 deaths and cost the Canadian healthcare system over $13B per year. The GATC projects were funded to study ADRs and to develop a routine tool for clinicians to tailor medications to individual patients based on genetic data. These projects build on previous investments that resulted in the establishment of a major clinical surveillance network – the Canadian Pharmacogenomics Network for Drug Safety – of over 2,000 pediatricians that has leveraged significant additional project funding from other Canadian funding organizations. To date, the network has demonstrated the utility and cost-effectiveness of pharmacogenetic testing in BC looking at two drugs: cisplatin-induced deafness and anthracycline-induced heart failure; with the goal of making it routine clinical practice. Based on this work, the FDA changed the cisplatin drug label to include warnings about the pharmacogenetic risk of cisplatin-induced hearing loss.