Transcript Medicines Transparency Alliance Presented by Deirdre Dimancesco Department of Essential Medicines and Health Products, WHO at the Technical Briefing Seminar 15 April, 2013

Medicines Transparency
Alliance
Presented by Deirdre Dimancesco
Department of Essential Medicines and Health Products, WHO
at the
Technical Briefing Seminar
15 April, 2013
MeTA aim
 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.
2|
The MeTA Hypothesis
Robust & relevant
information
collected
Information made
available to
relevant
stakeholders
3|
Multi-sector data
sharing and
analysis
Evidence-based
policies and
implementation
Improved access to
medicines
Rationale
 Inefficient markets and poorly functioning supply chains
restrict the access to affordable, quality and appropriate
medicines.
 Lack of information and information asymmetries fuel
inefficiencies, distort competition, allow corrupt practice,
hinder effective management and encourage irrational use
of medicines.
 Medicines account for 3 of the 9 most common causes of
inefficiency in health expenditure.
– “[R]educing unnecessary expenditure on medicines and using them more
appropriately, and improving quality control, could save countries up to
5% of their health expenditure.” World Health Report 2010
4|
WHO Guiding Principles
 The importance of providing information transparently and
involving the public to develop health policies was recognized
as early as 60 years ago.
– “Informed opinion and active co-operation on the part of the public
are of the utmost importance in the improvement of the health of
the people.” (Constitution of the World Health Organization)
 Evidence and information on medicine policies is a priority area
of work. (WHO Medicines Strategy 2008-2013).
 WHA resolution on strengthening national policy dialogue to
build more robust health policies, strategies and plans
(WHA64.8)
5|
WHO DG Commitment
 WHO Director-General addresses the Executive Board Report by
the Director-General to the Executive Board at its 130th Session,16
January 2012
– “[P]ublic health breaks new ground by tackling a long-standing
need. That is: to build national capacity to generate and analyse
basic health data. Without information, at country level, we can
never have accountability. Without information, we can never
know what a “best” or a “wise” investment really means. Without
information, we are working in the dark, pouring money into a
black hole.”
6|
Global Commitments
 The United Kingdom will host the 2013 G8 Summit in
Lough Erne, Northern Ireland from 17 - 18 June.
– Prime Minister David Cameron wants discussions to focus on
ways in which G8 nations can support the development of open
economies, open governments and open societies, including:
• promote greater transparency.
7|
Universal Health Coverage
 Transparency and good governance are recognized as significant
factors for achieving universal health coverage.
– Communication is essential so that people are actually aware of their
entitlements. Information to enable transparent monitoring is key.
Background document to the Ministerial Meeting on UHC
8|
MeTA and GGM
GGM
MeTA
Voice
Transparency
Efficiency
Participation
Accountability
9|
Ethics/anticorruption
Rule of
law/regulation
About MeTA
 7 countries:
– Ghana, Jordan, Kyrgyzstan, Peru, Philippines, Uganda and Zambia.
 Pilot Phase from 2008-2010
– Established multi-stakeholder platforms
– Collected baseline data & capacity building for it;
– Initiated/tested transparency initiatives
 Phase 2 from 2011-2015
– Address information gaps
– Transparency and disclosure
– Convert dialogue into policy recommendations and interventions
10 |
MeTA structure
 WHO and Health Action International provide:
– Project coordination, administration
– Technical support through the provision of data collection,
analysis & dialogue methodologies, capacity building and policy
guidance.
 MeTA councils
– Public sector, private sector, civil society, academics
– WHO Country Office support
– Plan and implement MeTA workplan
11 |
MeTA process
Identifying
challenges or
gaps
Evidence
based
Policy
policy
dialogue
Assessing data
Dissemination
of data and
messages
Setting priorities
Multi-stakeholder
dialogue
Advocacy
Voice
Defining a
baseline
Gathering data
Agreeing the
process
12 |
Types of information
Medicines Registration and Quality Assurance
 Market registration procedures and registration status of all medicines
 Good Manufacturing Practice (GMP) outcomes
 Quality assurance processes in public and non-profit tenders
 Quality assurance data during registration or procurement
 Routine quality testing and adverse event monitoring
Medicines Availability
 Volume and value of medicines procured
 Availability of medicines to consumers
 Routine audits for public, private, and non-profit medicines outlets
13 |
Types of information
Medicines Prices
 Consumer and ex-manufacture prices of medicines in the public,
private, and non-profit sectors
 Public sector medicines procurement prices
 Medicines price components in the public, non-profit, and private
sectors
Medicines use and Promotion
 Standard treatment guidelines
 Essential medicines list
 Medicines promotion regulations, policies, and industry practices
14 |
Successes from the pilot
 The National Medicines Regulatory Authorities of Kyrgyzstan, Uganda
and Zambia created web-sites
– registered medicines list, list of authorized wholesalers, etc.
 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.
 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.
 MeTA supported the country to develop Standard Treatment
Guidelines for key diseases.
15 |
Lessons learned from the pilot
 Multi-stakeholder working is not easy – it takes patience, understanding,
diplomacy and tact;
 Identifying champions in each sector can greatly expedite the process of multistakeholder engagement and transparency;
 Each sector needs to give & take to build consensus;
 Conflict of Interest identification – transparency;
 The MeTA process needs to be country-led and with guidance.
16 |
Phase 2 targets
 Decrease mean price of essential medicines by 10%
 Increase average availability by 10%
 Improve efficiency
 Build on the foundations of the MeTA pilot
 Focus on policy dialogue in alignment with country
priorities
17 |
Main areas of technical work
Ghana
Monitoring price
and availability
Analysis and use
of phase 1 data
Jordan
National drugs
policy
Supply chain
management
Determinants of
availability
Kyrgyzstan
National drugs
policy
Public sector
procurement
RUM:antimicrobial
resistance
Peru
Monitoring price
and availability
Analysis and use
of phase 1 data
Public sector
procurement
Philippines
Monitoring price
and availability
Medicines
promotion
assessment
Quality
Uganda
Monitoring price
and availability
RUM: DTCs
Quality assurance
Zambia
Analysis and use
of existing data
Public sector
procurement
18 |
Quality assurance
Main areas of Civil Society activities
Ghana
Assessment capacity
Capacity building for
communications
Jordan
Capacity building for
communications
Campaigns to improve
knowledge on patient rights
Kyrgyzstan
Capacity building for
collection of data and
pilot data collection
Capacity building for
communications
Peru
Campaigns to promote
access to medicines
Involvement in development of methodologies and
policy recommendations
Philippines
Campaigns to improve
awareness of drug
entitlement programmes
Community monitoring
pilot
Uganda
Campaigns to empowe communities to own
services and holder duty bearers to account
Zambia
Capacity building for
community radio
19 |
Improve awareness of
regulatory issues
Communications
activities
Campaigns on patient
rights and antibiotic use
Factors for success
 Government commitment
 Country driven process
 True multi-stakeholder collaboration
20 |