Transcript Medicines Transparency Alliance: Under New Management Dr Tim Reed Director, Health Action International (Global) International MeTA Secretariat Dr Gilles Forte Coordinator, Programmes Coordination, Policy and Information,

Medicines Transparency Alliance:
Under New Management
Dr Tim Reed
Director, Health Action International (Global)
International MeTA Secretariat
Dr Gilles Forte
Coordinator, Programmes Coordination, Policy and Information, WHO
International MeTA Secretariat
MeTA
25 05 09
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MeTA Hypotheses
H1: Transparency of the pharmaceutical sector will bring about
efficiencies in medicines supply chain and increase access to
medicines
H2: All stakeholders with an interest in the outcome of the
medicines market must be brought together and engage in a policy
dialogue that should foster transparency and accountability
MeTA Core Principles
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Governments are ‘responsible’ for providing access to
health care, including access to essential medicines
Stronger and more transparent systems and improved
supply chain management will increase access
Increasing equitable access to medicines improves health
and enables other human development objectives to be
achieved
Improved information about medicines can inform public
debate, and provide a basis for better policy
A multi-stakeholder approach that involves all sectors –
private, public and civil society - will lead to greater
accountability
MeTA Scope
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MeTA aims at improving access to quality medicines by
increasing transparency of the pharmaceutical sector
through collection of reliable data, valid analysis, and then
disclosure for advocacy and policy dialogue among
stakeholders e.g. private sector/public sector/civil society.
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7 pilot countries: Ghana, Jordan, Kyrgyzstan, Peru,
Philippines, Uganda and Zambia.
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Pilot Phase 2008-2010. MeTA Councils established in every
country and work plans were developed, implemented and
monitored.
MeTA multi-stakeholder approach
Pharmaceutical companies
(generic and innovator)
Access to more information on
medicines needs
Active role in national policy agenda
Visibility & concerned by public
health issues
Address quality matters
Government
Wholesales, distributors, retailPrivate
pharmacies
sector
Access to more information
Opportunity for building capacity &
improve business practices
Active role in policy agenda
International
institutions
International Institutions
Promote transparency & good
governance agenda
Improve health systems
efficiency & access to medicines
Ministers, Regulators & civil
servants
Improve health systems efficiency &
access to medicines
Commitment to good governance &
transparency agenda
Promote multi stakeholders
inclusive approach
Civil
society
DPs
Civil Society
Active role in policy agenda
Supportive environment for
advocacy
Financial and other support
Improved dialogue with
public and private sectors
Development Partners
Good governance agenda
Tackle corruption
Increase access to medicines
Support responsible business
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Government at country level
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Ministries of Health
Medicines Regulators
Government Insurance Funds
Government Procurement
Chief Pharmacists/Medical Officers
et al …
Private sector at country level
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Multinationals and Innovators
Generic importers
Local Manufacturers
Wholesalers, distributors
Retail pharmacies
Drug shops
Private health care providers
Mission Sector
Insurance companies
et al …
Civil Society at country level
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Health NGOs/CSOs (domestic & international)
Medicines NGOs/CSOs
Transparency NGOs
Patient Groups
Consumer Groups
et al …
What could be disclosed?
Medicines Registration and Quality Assurance Data
 Market registration procedures
 Registration status of all medicines
 Good Manufacturing Practice (GMP) outcomes for domestic
and foreign manufacturers
 Quality assurance processes in public and non-profit tenders
 Quality assurance data during registration or procurement
 Routine quality testing and adverse event monitoring
What could be disclosed?
Medicines Availability
 Volume and value of medicines procured in the
public and non-profit sectors
 Volume and value of medicines supplied in the
private sector
 Availability of medicines to consumers
 Routine audits for public, private, and non-profit
medicines outlets
What could be disclosed?
Medicines Prices
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Consumer and ex-manufacture prices of medicines in the public, private,
and non-profit sectors
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Public sector medicines procurement prices
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Medicines price components in the public, non-profit, and private sectors
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Pharmaceutical patents held in-country
Medicines use and Promotion
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Standard treatment guidelines
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Essential medicines list
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Medicines promotion regulations, policies, and industry practices
New WHO Pharmaceutical Sector
Monitoring Tools
High-level policy information (Country Profiles)
• Questionnaire to Ministry of Health
• Mostly Pharmaceutical sector indicators on structures & policies
• Data on outcomes from Level II and III.
• Regularly carried out
Household and health facilities surveys (Level II)
•Surveys based on samples
• Monitoring of pharmaceutical policy outcome & impact.
•Upon request
Topic-specific studies (Level III)
•More detailed indicators for monitoring and
evaluating specific areas/components
•Upon request
CP
High-level information
Mostly structures and
policies
Level II
Core outcome/impact indicators
& household survey
Level III
Indicators for specific components of the
pharmaceutical sector:
Pricing
Human Resources
Procurement and Supply
Rational use
Assessing regulatory capacity
Pilot Outcomes
Robust & relevant information
(Transparency)
Multi-sector data sharing and analysis
(with MeTA TA)
(Accountability)
Better policies and implementation
(Efficiency)
Improved access to medicines
Routine Data Collection
Good on the first two, but in MeTA 2 we need to convert
transparent data into initiatives that bring about better
policies and improved access.
Pilot Successes
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The National Medicines Regulatory Authorities of Kyrgyzstan, Uganda and
Zambia have created web-sites on which they make available key
information: registered medicines list, list of authorized wholesalers, etc.
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Peru developed a database of medicines prices in public and private
pharmacies. The system allows consumers to compare the prices and
choose where to buy. This increased competition is meant to reduce prices
of medicines.
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Jordan conducted studies on access to medicines in health facilities and
households. The studies indicated issues with rational use of medicines
and therefore MeTA has supported the country to develop Standard
Treatment Guidelines for key diseases.
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In the Philippines MeTA contributed to the enactment of the "Cheaper
Medicines Act" 2008 and to the establishment of an e-procurement system
for medicines.
Pilot Lessons
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Multi-stakeholder working is a new concept – not easy – it
takes patience, understanding, diplomacy and tact
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Identifying champions in each sector can greatly expedite the
process of multi-stakeholder engagement and transparency
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Each sector needs to “give & take” to build consensus
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Conflict of Interest identification - transparency
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The MeTA process needs to be country-led but with guidance
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Gaining consensus and understanding requires a constant and
frank exchange of views
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Tools for gathering baseline data on access do already exist; a
new tool to measure multi-stakeholder collaboration has been
developed; new innovative ‘useable’ tools required
MeTA 2: What’s changed
Pilot Model:
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Non-technical International MeTA Secretariat (IMS) based in UK, external
consultant driven technical support
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International Consultants appointed in UK to facilitate in-country work
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Short timeline – Two years
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Financing and Sustainability
MeTA2:
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IMS joint ownership WHO and HAI
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In-country technical support by WHO
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In-country Civil Society support by HAI
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Longer timeline - Four years
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Sustainability model
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Expansion into new countries? Year three ….