CSO Report
Transcript of CSO Report
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Southern Arican Regional Programme
on Access to Medicines and Diagnostics
CIVIL SOCIETY MEETING REPORT
How can we work in partnership to improe access
to Medicines & Diagnostics in Sothern Arica?
21 22 March 2010, Nairobi, Kenya
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2TABLE OF CONTENTS
RECORD OF THE CONSuLTATION
1. Establishing a common agenda to improve access in Southern Arica 3
2. Objectives o the consultation 3
3. Who was there 3
4. The meeting proceedings 4
5. Record o small group discussions & recommendations 4
6. Dening potential Partnerships or Action PACTs 5
7. Key points o consensus 6
8. Actions or the next steps 6
9. Conclusions 6
ANNEXES
A. Overview o SARPAM 7
B. SADC Pharmaceutical Business Plan 2007 2013: Summary 9
C. Participants List 10
D. Record o Open Agenda Discussions 11
E. First Drat CSLed Partnership or Action PACT Framework 23
F. The SARPAM Civil Society Reerence Group 25
G. Maniesto For Civil Society Action on Access to Medicines in southern Arica 26
H. Case Study: Partnership In Action 28
I. Workshop Evaluation 38
SARPAM Contact details
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3RECORD OF THE CONSuLTATION
Through initial emailbased discussions, regional
and national CS representaties shared ideas on
how the cold potentiall contribte towards
improing access to medicines throgh more
intensie ocs on the sothern Arica region.
The subsequent consultation was called at short
notice to take advantage o the act that a number
o key Civil Society representatives would be
in Nairobi or other meetings. This oered an
opportunity or these individuals to engage in an
intensive process to:
MapouttheagendaforCivilSocietytoimprove
access to medicines and diagnostics in southern
Arica;
Learn about SARPAM and the possible
contributions it could make to the Access
agenda;
Interact with other CSOs working directly or
indirectly on pharmaceutical and treatment
access issues within the SADC region;
DeneaCivil-SocietyledPartnershipforAction
PACT in which each organizations potential
contributions are mapped out;
Engagewithaprocessforassessingthesupport
that each organization needs to make their
contributions as partners in the PACT;
Learn a methodology for developing further
Partnerships or Action.
1. ESTABLISHING A COMMON AGENDA TO IMPROvE ACCESS TO MEDICINES IN SOuTHERN AFRICA
3. WHO WAS THERE
2. OBjECTIvES OF THE CONSuLTATION
The Southern Arican Regional Programme on
Access to Medicines & Diagnostics SARPAM is
being designed through a process o consultation
and inormationgathering during an inception
phase that started in January 2010. During the
period, Partnerships or Action PACTs are
being explored to improe the aailabilit,
aordabilit and qalit o essential medicines
and diagnostics across the SADC region. These
PACTs should support implementation o the SADC
Pharmaceutical Business Plan to the end o 2013.
SARPAM oers the potential to strengthen thecapacity o regional institutions and civil society
to implement joint plans that will achieve agreed
results through multistakeholder action across
countries in the region.
The Responsible Action Consortium managing
SARPAM on behal o the U.K. Department
or International Development acilitated this
consultation or Civil Society in March 2010.
The meeting started with an open agenda or
participants to dene their own priorities to address
the challenge: How can we work in partnership to
improve access to medicines and diagnostics in the
Southern Arica region?.
Over 2 days, participants started the process o
engaging with each other as Arican Civil Society
to initiate a regionally ocused Civil Society Action
Networkthat will ocus on what Civil Society in the
SADC region can do to support implementation o
the SADC Pharmaceutical Business Plan.
Strong commitments to action were made by those
present to lead a Partnership or Action PACT
that will promote greater transparency in the
regional pharmaceutical marketplace and more
eective sharing and use o pharmaceutical market
inormation.
A Reerence Group o Civil Society ocal persons
was constituted to take this process urther with the
SARPAM programme management team.
The 25 participants Annex C represented a good crosssection o regional Civil Society Organizations CSO
and Faith Based Organizations FBO working on dierent Access issues, including: advocacy and campaigns;
legal and trade; research; service delivery; proessional standards and research.
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7. Qalit o Medicines
Supportforregionalstandardsandaccredited
quality control acilities.
InvolvementofCS in pharmacovigilanceand
raising prole o quality issues.
8. Priate Sector Engagement
CS platform can open debates on positive
engagement o the private sector including
participation in PACTs and other stakeholder
opportunities e.g. MeTA
CS advocate for increased Corporate Social
Responsibility CSR at country levels
9. Commnit Inolement
Studyandidentifybestwaystoworkwithand
support true community representation in the
dierent countries Link with and build capacity of Community
Based Organizations CBOs.
Advocate for sustainable nancing of
programmes that support communities e.g.
the WHO community care giver plan
10. Good Goernance
Promotedrugsupplysystemsthatarerobustand transparent and have measurable
indicators.
CSOs can act as critical watchdogs and
lobbyists.
11. Hman Rights and Access to Medicines
CSOscancarryoutevidence-basedadvocacy
CSbestrategicinaligningtheircompetencies
or maximum impact, including building
capacity or operational research.
On the second day, participants discussed possible
intervention areas in which CSOs/FBOs could take
more eective joint action with an intensied ocus
on southern Arica. They made the case or a range
o proposals or joint action through the PACT
mechanism, including to:
Establish a mechanism that will support pooled
and bulk procurement initiatives or essential
medicines. This would require: engagement o the
SADC Secretariat to recognize the role o FBOs
e.g. in service delivery; analysis o the reasons or
failuresofcrossborderbulk/pooledprocurement
attempts; and inclusion o FBOs in discussions on
a SADC pooled procurement market survey.
Strengthen the capacity o CSO/FBOs working
on access in the region to eectively support
implementation o SARPAM. Action areas
proposed could include: increasing capacity
of CSO/FBOs to handle medicines and access
issues; providing oversight through proessional
pharmacy networks/associations; harmonizing
the CS actions; targeting the maximization o the
utilization o the current TRIPS exibility to 2016
as provided or in WTO agreement.
Establish a collaboration platorm between SADC
and regional CSO/FBOs. Action areas proposed
could include: promotion o transparency and
accountability by applying the MeTA principles;
supporting at least 3 SADC countries to join MeTA
by 2011; and the reestablishment o the SADC
Pharmaceutical Task Force in which CSO are
members.
Establish a system or CS to continuously evaluate
Pharmaceutical Supply Management. Actions areas
could include: monitoring the supply chain as
well as the prices and availability o medicines at
acility level.
Advocate or development, harmonization and
implementation o treatment and diagnostic
guidelines in Southern Arica.
This process prodced consenss that the most
sel immediate PACT that Ciil Societ shold
lead is to promote greater transparenc in the
regional pharmacetical marketplace and more
eectie sharing and se o market inormation.
Initial mapping o the PACT Framework or this
identied the highest priority results that could be
jointly pursued, the range o partners that could work
together and some initial ideas o what each partner
organization might be able to specically contribute
towards achieving these results. This drat ramework
ollows in Annex E.
The group agreed that this ramework or the PACT
would need to be worked up urther and the SARPAM
programme management team was charged to
complete this task in collaboration with a Civil Society
Reerence Group see section 6 below.
6. DEFINING POTENTIAL PARTNERSHIPS FOR ACTION (PACTS)
RECORD OF THE CONSuLTATION continued
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Having the means to gather and disseminate
inormation, hold discussions and share documents
was considered a key requirement or successully
implementing this PACT. Participants agreed to use
o the Civil Society Action Network newsgroup and
online collaboration site in the SARPAM InoHub.
Use o short message service SMS was discussed as
a possible way o keeping everyone in the network
updated.
Participants agreed to:
1. Establish a regional Civil Society Reerence
Group, to which the ollowing individuals were
nomintated: Gichinga Ndirangu HAI; Donna
Kusemererwa EPN; Tapiwanashe Kujinga
PATAM; Franco Wandabwa ANECCA; and
Tasangana Matika (Seatini/Equinet). Terms
o Reerence or the group were discussed
immediately ater the meeting and adopted by
the Reerence Group members see Annex F.
2. All CS and aithbased organizations committed
to working through SARPAM should sign up to
a Maniesto or Civil Society Action on Access to
Medicines, based on principles o engagement that
were developed by a subgroup o participants
see Annex G.
3. Send 2 CS representatives Franco Wandabwa
and Cryson Miyoba to attend the Pharmaceutical
Market Analysis Study Readiness Retreat in Cape
Town.
7. KEy POINTS OF CONSENSuS
1. Complete the drating o a maniesto
responsibility o the SARPAM secretariat CS
Technical Lead and CS Coordinator that,ollowing consultation with the Reerence Group,
should be sent to all meeting participants to
present this to their organizations or signature.
2. Preliminary report o the consultation to be sent
to participants within a week o the meeting.
3. CS Technical Lead to communicate with the
participants and other CS who could not attend
the meeting on the next steps to take orward the
PACT.
4. CS Reerence Group to consider and recommend
how best to gather and disseminate inormation
between the CS, including pilot testing the SMS
methodology.
5. The SADC Pharmaceutical Business Plan and
SARPAMs one page summary to be sent to
all meeting participants by email SARPAMSecretariat.
6. The PACT methodology to be written up and sent
to all participants or use in their own meetings.
7. SARPAM Secretariat, in collaboration with the
Reerence Group, to complete the development
o the agreed PACT.
8. Assessments o what each Civil Society
organizations capacity needs are to eectively
contribute to the PACT will be carried out by the
SARPAM Secretariat. This will result in Enabling
Plans and resource requirements being scoped
out and presented to DFID or Implementation
Phase unding to be incorporated into the
SARPAM Inception Report.
8. ACTIONS FOR THE NEXT STEPS
The objectives o the consultation were achieved. However, as not all regional CS representatives were able
to attend, it will be important to share the report and to continue the conversations that were started. The
enthusiasm needs to be kept through regular communication and interactions, led by the SARPAM Civil
Society Lead Eva Ombaka, supported by a Civil Society Coordinator and in collaboration with the Civil Society
Reerence Group.
9. CONCLuSION
RECORD OF THE CONSuLTATION continued
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7ANNEX A | OVERVIEW OF SARPAM
The Southern Arica Regional Programme on Access to Medicines and Diagnostics SARPAM launched in January
2010. SARPAM is ounded on the belie that eective collective action and innovation will improve Access to
Medicines across the regional economic community. Working with member state governments, civil society,
regional institutions, international agencies, research networks and the private sector, SARPAM will support the
good work being done through existing partnerships and initiatives, as well as identiy new Partnerships or Action
that will achieve ambitious results.
The programme oers new resources in the orm o targeted unding, technical assistance, partnership building
and networking opportunities. As the primary sponsor o this new initiative, the UK Government hopes that
SARPAM will develop into a platorm or collaboration and partnership that will attract a broad support base over
the next 45 years. This will create signicant opportunities to substantially improve the marketplace or good
quality essential medicines.
SARPAM oers to support and strengthen the capacity o regional institutions to implement plans that will benet
rom multicountry action. The SADC Pharmaceutical Business Plan endorsed by regional Ministers o Health
in 2007 is the leading example o this. Civil Society Organizations within the region will be supported to lead
Partnerships or Action that have the potential to positively inuence the pharmaceutical market, including the
demand or medicines and their rational use.
A regional InoHub will be established to make transparent pharmaceutical market intelligence and evidence
or policy accessible to all stakeholders in the region. SARPAM will be undertaking an intensive Pharmaceutical
Sector Market Analysis during the rst 9 months o 2010 to provide a baseline data set. A regional Evidence or
Action Network will be supported as part o the Global Access to Medicines Research Network to set the agenda
or research and to make research ndings available as global public goods.
The Responsible Action Consortium, led by Re-Action! (Southern Arica) has been contracted by DFID to manage
implementation o SARPAM. This includes establishing a network o development proessionals to work with the UK
government southern Arica regional team so that priorities on Access to Medicines within SADC can be more eectively
responded to and local capacity can be built.
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8ANNEX B | SADC PHARMACEUTICAL BUSINESS PLAN 2007 - 2013: SUMMARY4
The Southern Arican Development Community SADC was ormally launched
on 17th August 2002 under a Treaty, and consists o 14 Member States with an
estimated total population o 200 million people. In its programmes and operations,
SADC is guided by a clear mission statement, which is To promote sustainable and
equitable economic growth and socioeconomic development through efcient
productive systems, deeper cooperation and integration, good governance,
and durable peace and security, so that the region emerges as a competitive and
eective player in international relations and the world economy.
SADC has identied the need to develop and implement a Pharmaceutical Programme in line with the SADC
Health Protocol and the SADC Health Policy. The purpose o the programme is to enhance the capacities o
Member States to eectively prevent and treat diseases that are o major concern to public health in the Region.The Programme mainly addresses issues that concern access to quality medicines in all Member States. The SADC
Pharmaceutical Business Plan has been developed within the context o global, continental and regional policy
rameworks, protocols and commitments. Based on a SWOT analysis, the Plan identies priority areas, objectives
and major activities that will be implemented both at regional and national levels to improve access to quality and
aordable essential medicines including Arican Traditional Medicines.
The overall goal o the SADC Pharmaceutical Business Plan is to ensure availability o essential medicines including
Arican Traditional Medicines to reduce disease burden in the region. Its main objective is to improve sustainable
availability and access to aordable, quality, sae, efcacious essential medicines including Arican Traditional
Medicines. In order to achieve the overall goal and the main objective, the ollowing strategies will be pursued:
i Harmonizing standard treatment guidelines and essential medicine lists;
ii Rationalizing and maximizing the research and production capacity o local and regional pharmaceutical
industry o generic essential medicines and Arican Traditional Medicines;
iii Strengthening regulatory capacity, supply and distribution o basic pharmaceutical products through
ensuring a ully unctional regulatory authority with an adequate enorcement inrastructure;
iv Promoting joint procurement o therapeutically benecial medicines o acceptable saety, proven efcacy
and quality to the people who need them most at aordable prices;
v Establishing a regional databank o traditional medicine, medicinal plants and procedures in order to
ensure their protection in accordance with regimes and related intellectual property rights governing
genetic resources, plant varieties and biotechnology;
vi Developing and retaining competent human resources or the pharmaceutical programme;
vii Developing mechanisms to respond to emergency pharmaceutical needs o the region; and
viii Facilitate the trade in pharmaceuticals within SADC.
In line with the SADC Protocol on Health, the Implementation Plan or the Protocol and the SADC Health Policy
Framework, the SADC Pharmaceutical Business Plan will be coordinated and implemented through the approved
SADC structure. The Business Plan has spelt out clear roles and responsibilities o all stakeholders that will
4. Adapted rom SADC PHARMACEUTICAL BUSINESS PLAN, SADC SECRETARIAT, 27 JUNE 2007, p. 35.
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9ANNEX B | SADC PHARMACEUTICAL BUSINESS PLAN 2007 - 2013: SUMMARY
be involved in the implementation process. At the political level, the implementation o the Plan will be
monitored through the established institutional ramework.
The implementation o the Plan will require substantial resources including human, material and nancial rom
dierent sources. The Plan is estimated to cost US$16 million. To ensure ownership and sustainability, Member
States will be required to budget or implementation o some o the interventions that need ongoing nancial
support. The SADC Secretariat will make all eorts to mobilize resources rom key stakeholders including
International Cooperating Partners.
A monitoring and evaluation ramework has been included in order to review activities during implementation
process. The Secretariat will acilitate capacity building on monitoring and evaluation. Appropriate technical
and nancial reports will be produced during and ater implementation o program specic activities outlined
in the Pharmaceutical Business Plan.
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11ANNEX D | RECORD OF OPEN AGENDA DISCUSSIONS
TOPIC
Ciil Societ Capacit bilding
PARTICIPANTS
Donna, Tapiwanashe, Aarti, Christa, Mike, Cryson
MAIN POINTS DISCuSSED
NeedinformationonSARPAMhowdoesSARPAMsupportcapacity?
DiscussiononSARPAMsowecanbuyintothebiggerpicture
Betterunderstandingofcapacity
Linkages between organizations e.g. management systems (JSI), sharing information lessons, even
opportunities or capacity building
Addressallissues:governance,infrastructure
CSrequirescapacitybuildingbutalsohascapacitytobuildinotherorganizationsincludinggoods
RECOMMENDATIONS
1. Consider internal opportunities
2. Involve CS in capacity building initiatives within the region as the actual implementers
3. CS needs inormation on SADC Pharmaceutical Business Plan PBP
4. Review maniestos vis a vis denition o Civil Society ensure capture dierent groups
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12ANNEX D | RECORD OF OPEN AGENDA DISCUSSIONS (continued
TOPIC
Commnit inolement in Access to Medicines
PARTICIPANTS
Redemptor, Mike, Aarti, Eva, Cryson, Nalishebo, Franco, Phillip, Donna
MAIN POINTS DISCuSSED
(DRC)organizethroughsocialinsurancesomemoney,makecontractswithhealthcentresandhospitals
get treatment or a year
Twoevaluations(June/December)communitiesareinvolved
Communityparticipationis throughchiefs.Oneissuebroughtto theattentionisthatmedicineswere
not ree. Issue is with representation through chies is like the government not true representation
o community e.g. in DRC the Chie is civil servant. In Zambia, the Chie is part o the community, has
headman who is responsible or smaller communities thereore true representation chie is community
thereore is representative o CS
Useofpublicforumsindierentcountriese.g.inKenyalocalCBOsusedtomobilizecommunitiesfor
stockout campaign managed to get inormation rom the ground.
CBOsneedassistancefortransportandastipendforlunch
Traditionalhealersarealsoimportantwithregardtoruralsettings(SA).Sickpeoplegothererst.
Communitycaregivers criticalformonitoringstockouts,toidentifypatientsinthehomeprovide
basic services these are volunteers
District/CommunityCliniccommitteeslinkcommunitytoformalhealthcaresystemsplayacritical
role in some settings Political orces aect those that are made strong ater capacity building
Useofcaregiversisdependentonthespecicpriorityofcountries.Needtobecarefule.g.SAcreateda
monsterrecruit caregivers NGOs provide better package than government unhelpul competition
thereore government and the NGO world need to agree
FBOsaspartofcommunity
Community caregiverprogramme isreceived/ recognizeddierently indierentcountries issueis
controversial.SchemeworkedwellinWHO/UNsupportedareasalsoworkswellinspecicprogrammes
which are supported by outside agencies.
RECOMMENDATIONS
1. Need to understand relationships or community mobilization in specic situations
2. CBOs are a major ally build their capacity
3. Provide capacity support to traditional healers regarding HIV symptoms, reerral systems get their
integration create a platorm or engaging traditional healers. Look at linkages with CBO capacity
building
4. Recognition o the impact and role o community caregivers who are volunteers provide support and
to integrate into the public health system
5. Advocate to implement the community caregivers policy. Also consider unding mobilization that is part
o the government or sustainability
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13ANNEX D | RECORD OF OPEN AGENDA DISCUSSIONS continued
TOPIC
Ciil Societ Networking
PARTICIPANTS
Tapiwanashe, Redemptor, Nalishebo, Orgenes, Phillip
MAIN POINTS DISCuSSED
1. Broadly there are a number o CSOs and networks that are working on access to medicine. Mapping
exercise needed
2. Regional networks identied are:
PATAM
HAI Arica
ANECCA
Enquinet
EPN
3. There are many others working at country level
4. Need to identiy key issues or advocacy
Stop Stockouts
CEPA
Anti Microbial Resistance AMR
RECOMMENDATIONS
1. ConductaCSO/networkmappingonATM
2. Come up with an umbrella campaign on ATM
3. Agree on various components or the campaign
4. Identifyleadorganization/networksforeachcomponent
5. DevelopacomprehensivemediastrategyforongoingCSO/networkcommunication
6. Network consumer society organization in this region
7. Ideal to have an umbrella campaign that encompasses the components and the SADC business plan
and the member organizations can link up to it
8. TheumbrellacampaigntohaveparticularcomponentsthatareledbyCSOs/networkswithcapacity
and experience9. LeadCSOs/networkstoorganizecapacitydevelopmentinordertofulllSARPAMobjectives
10.AcomprehensivemediastrategywillhelpmemberCSOs/networkstonetworkwithinthecampaign
11. Setting up an email list, website and development o campaign materials
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14ANNEX D | RECORD OF OPEN AGENDA DISCUSSIONS continued
TOPIC
Qalit o Medicines
PARTICIPANTS
Nalishebo, Orgenes, Cesar, Redemptor, Joseph, Phillip, Titus
MAIN POINTS DISCuSSED
Qualityisastandardnotaconcept
CSOstopromotetheavailabilityofqualityaordablemedicines
Needtodevelopregionalstandards
CSOstoassistinissuestodowithpharmaceuticalvigilance,counterfeitmedicineinimprovingquality
Capacitybuildingofregulatorsauthorizedtodierentiatebetweengenericsandcounterfeits
CSOstoworklikequalitywatchdogsindealingwithpharmaceuticalvigilanceissues
AdvocatingforCSOstobeinvolvedintheprocurementprocesses
Recognize,rewardandprotecttheachievementsoftheregionalpre-qualiedfactoriese.g.factoryin
Uganda
Anti-counterfeitActstobedevelopedbuttheseshouldnotaectaccess
CSOstogivesupporttotheregionalaccreditedlaboratories
RECOMMENDATIONS
1. Advocate or recognition, rewards and protection o the regional WHO accredited laboratories
2. Support the concept o regional quality control laboratories, und and supervise
3. Advocate or regional mini standards
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15ANNEX D | RECORD OF OPEN AGENDA DISCUSSIONS continued
TOPIC
Research & inormation on Access to Medicines
PARTICIPANTS
Aarti, Shaun, Franco, Albert, Eva, Christa, Joseph, Cesar
MAIN POINTS DISCuSSED
Whatdrivesevidenceisthequestionsweask.CouldwehaveaFAQestablishedasaknowledgebase?
Whatdowemeanbyresearch?CompilinginformationandevidenceonAEM,Advocatingforsharing
and transparency o inormation. Existence o correct inormation. As CS we should contribute to the
existence o accurate inormation we can also do research operational, actionoriented, etc. Use CS to
gather inormation to triangulate what already exists. e.g. L2 and L1 WHO surveys
Weneedadatabase(openaccess)whichgrowsacrossthe region,alsointernationally.Getcollective
evidence on what is going on.
What ino do we collect and how to get into the database?
How to create a community o users around it? How to get it out?
EPN ismapping pharmaceutical personnel in various (SADC) countries. Use thismethodology and
compare to public sector in SADC countries?
DFIDissponsoringtheATMResearchNetwork.WhatrolecanCShaveinthisformalizednetwork?Could
we inorm the agenda? Can we provide the relevant academic research questions? CS may be the subject
o or may implement the research. CS can assist each other: networking, training, identiying research
areas, getting unds or research etc.
Informationforadvocacypurposesinformationforpolicypurposes.Knowwhattodowiththeresultsto
impact ATM.
Domesticatetheresearchtomakeitusefulforcountrycontext
RoleofCSindisseminationofresearchndingsEvidencebriefsoronepagersordecisionbriefsetc.
Based on research: here are the ndings and here are the recommendations signed by those involved.
Use as basis or advocacy and decision making.
ImportanttohavelinksbetweenacademicinstituteandCS.
NationallevelpartnersonSARPAM:communications,links,dedicatedtime,etc.SARPAMevidencefor
Action network exists ensure it is linked to the SARPAM CS network
Usetheinternationalnetworksandtheirresources,funding,abilities,time,toanalyzedataandevidence
AEM access to essential medicine
L1, L2 Level 1, Level 2 Surveys ( WHO)
FAQ - Frequently Asked Questions
RECOMMENDATIONS
1. Set up the SARPAM observatory to include a clearing house on inormation on research, data studies,
reports,toolsinSADC(withaFAQcapability)
2. MechanismtoestablishaCSlinkingfacilitytotheATMResearchNetwork
3. CSdevelopone-pageevidence-baseddecisionpapers(foraction,dissemination,inuencepolicy,etc)
that will become widely recognized as having scientic, political and civic support4. EnsuretheSARPAMEvidenceforActionnetworkiswelllinkedtotheSARPAMCSNetwork
5. Advocate or transparency o inormation
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16ANNEX D | RECORD OF OPEN AGENDA DISCUSSIONS continued
TOPIC
Good Goernance
PARTICIPANTS
Titus, Michael, Tasangana, Cryson, Gichinga, JoAnne, Wilbert, Donna
MAIN POINTS DISCuSSED
What is good governance? We need denitions!
Corruption
Transparencyandaccountability
Regulation
Politicalenvironment
Eciency/eectiveness
Outcomes
CONCLuSION
CivilSocietyneedstoengageingoodgovernanceandcanplayanimportantroleasawatchdogand
lobbyist
STRATEGy
Insistonrobustdrugsupplysystemsthatarewellplanned,needsbasedandevidencebased Ensurethattherearemeasureable(SMART)andrelevantindicatorsthatcivilsocietycanmonitor
CSOthenshouldactasacriticalwatchdog
Insistongreatertransparency,whichwillleadtomoreaccountability
Theprocesswillreducevulnerabilityforcorruption,promotemoreandbetterregulation,leadingtomore
efcient systems and better access to better medication
RECOMMENDATIONS
1. Civil Society to involve itsel in governance o the supply chain
2. CSOs to act as a critical watchdog in procurement, quality, price and availability
3. Promote robust, transparent systems
impacting the
whole supplychain
Selection
ProcurementBudgets
Price
FinanceDistribution
UseofDrugs
Availability
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17ANNEX D | RECORD OF OPEN AGENDA DISCUSSIONS continued
TOPIC
Hman Rights & Access to Medicines
PARTICIPANTS
Rose, Cesar, Christa, Tapiwanashe, Wilbert
MAIN POINTS DISCuSSED
AssessingHumanRightsaccesstomedicineincountries
Accesstolife
Accesstomedicineasaright
Everyonehastherighttohealthandmedicine
Righttohealth
Accesstomedicineandhumanrights
SADCprotocolsandtoolstobeusedforadvocatingforaccesstomedicine
Countryconstitutionsasastartingpointforadvocatingforaccesstomedicines
RSAinequalitiesduetounequalopportunities,commercializationofhealth.Languageweuseand
how we communicate very important
Zimbabweneedourgovernmentstotakearights-basedapproachtohealthcareandneedingallthe
people TAC in SA an example o a success story
In-countrysystemsi.e.SADCtribunalnotbeingutilized
Howlitigationhasbeenusedtoensureaccesstomedicineandlegislation
Howcanweget2billionpeopleaccesstomedicinerighttohealthcare,includingrighttomedicine?
Rightsandresponsibilitiesmakingessentialmedicinesapublicgoodinvolvementofprivatesector
to consider medicines as public goods
Governmentshavesignedadeclarationofhumanrights
Thereisahierarchythatexistsintermsofholding
Healthhumanrightsandaccesstomedicines
RECOMMENDATIONS
1. Evidence based advocacy need to build capacity in operational research so that evidence is based
to hold governments accountable
2. Empowering users through capacity building3. Legal campaigns mobilize legal instruments
4. Being strategic, aligning and harmonizing all our competencies together and having a common
ground or our work
5. Document the evidence properly so that it can be shared across
6. Comparing the countries
9. LeadCSOs/networkstoorganizecapacitydevelopmentinordertofulllSARPAMobjectives
10. AcomprehensivemediastrategywillhelpmemberCSOs/networkstonetworkwithinthecampaign
11. Setting up an email list, website and development o campaign materials
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18ANNEX D | RECORD OF OPEN AGENDA DISCUSSIONS continued
TOPIC
Partnerships within SARPAM
PARTICIPANTS
Donna, Cryson, Phillip, Tasangana, Shaun, Aarti, Mike, Orgenes, Eva, Tapiwanashe
MAIN POINTS DISCuSSED
Anunderstandingoftermpartnership
Whoarepartners?
Denethe termpartnershipsinmorecleartermswithregardtopartnershipswithSARPAMwhatare
roles and the benets or partners?
RecognizethereareotherplayersinvolvedinATMandweneedtoincludethemsothereiscollaboration,
not competition
DiscussionofkeyareasoftheSADCPharmaceuticalBusinessPlan
RECOMMENDATIONS
1. Partnershipsareformal,structuredwithMoUsand/orCOMPACTS3
2. Ensure CS is always involved in all PACTs. SARPAM to provide platorm or building partnerships, especially
with governments.
3. Establish regional network and Reerence Group rom CS.
4. Establish a CSOled PACT.
5. Recognize a list o principles or engagement with SARPAM.
6. CS representatives to signup to a ormal commitment Maniesto.
7. Write up rom this meeting or representatives to share with their organizations.
8. SARPAM to provide overview o SADC PBP to wider group.
3. MoU/Compacts:AnMoUistypicallyabilateralagreementwherethepartiescanseekexternalarbitrationifeitherpartydefaultsontheagreement,
whereas a Compact is a multiparty agreement that needs to be enorced through mutual accountability.
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19ANNEX D | RECORD OF OPEN AGENDA DISCUSSIONS continued
TOPIC
Sppl Chain Management
PARTICIPANTS
Franco, Malishebo, Albert, Joseph, Cesar, Titus, Christa, Wilbert, Redemptor
MAIN POINTS DISCuSSED
Comparesupplychainsintheregion(countries)Similarities?Dierences?Bottlenecks?
Whatarethebarriers?
a No coordinated, national level policies poor implementation and procedures
b Weak institutions PSM, quality assessment, CMS, NMRAs
c Poor inrastructure to support medicine delivery roads, cold chain, storage
d Weak stock management procedures
e) Insucient/irrationalnancingforPSMactivities(prioritizing) Corruption
Civilstrife(politicalenvironment,war)
WhatistheroleofCS?CapacitybuildingonPSMissues?MandEofcoreindicators?
StrengtheningsupplychainsofMissionDSOs&GovernmentCMSs
UseofIT?
Transparency/disclosureofinformationanddata(e.g.quantication,etc)
ThinktankonPSM(regionallevel),sharinginformation/bestpractices
PrioritysettingalongPSMe.g.selectionofEMs
Pooled procurement quantication of needs, negotiations with suppliers (promote among
countries at regional level. 3 studies done 4th study ongoing by Arica development Bank in
SADC show it can be done. never implemented WHY? Possible reasons: Bureaucracies,
Procurement kingdoms, No shared dollars, No harmonised NMRA, No exchange o inormation
inormed buying
WhatcouldCSdo?Campaignagainstbureaucracy!Implementtherecommendationsoftheabove
studies
Stockouts-
Match disease patterns and stocks at any level
Promote local production
- DoweknowthemostappropriatePSMsystemtomeetrequirements/demands?Istherea
success story No.!
SAAB SA Access Barometer SSO Stop Stock Outs
FBO Faith Based Organizations (mission) PSM Procurement Supply Management
CMS Central Medicine Stores NMRA National Medicines Regulatory Authority
DSO Drug Supply Organization
RECOMMENDATIONS
1. CS coalition umbrella regional establish the SARPAM Coalition
2. M&E by CS o PSM e.g. SSO campaign extend to SADC SAAB report
3. CS Policy Audit annual report card
4. Study the barriers to implementation o the recommendations rom the PP studies and network
among those organizations working on governance: META, HAI Arica, NEPAD, and AU?
5. Involve/EngageCSintechnicalissues(withtechnicalsupportasnecessary)sharelessonsfrom
FBOse.g.Quanticationmethods/exerciseatnationallevel
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20ANNEX D | RECORD OF OPEN AGENDA DISCUSSIONS continued
TOPIC
TRIPS and Trade
PARTICIPANTS
Franco, Albert, Tasangana, Wilbert
MAIN POINTS DISCuSSED
Compulsorylicensingtocountriestoprovidecountriespatentpoolnegotiations
STATuS OF TRIPS
Middleincomecountrieshavetobecompliantby2000whilelowincomecountrieshavetobeby
2016. Arican countries are producing or are in the oreront o producing rst line. By 2016 LDCs will
be needed to be aligned with TRIPS. German government supporting countries that want to go or
complete licensing. Complete licensing is always point o patent laws. I old activists get involved it
could be watered down.
WhycountriesalwayssignandcomplainingHealthsystem/ministryisalwaysweakercomparedto
the trade ministry.
Activists have to be carefulwhen discussing issues ofTRIPS. Most countries areTRIPS compliant.
Correct and right inormation need to be given.
Need to have apaper (research) forthe14countries on the correct statein termsofcompliance.
In Europe there is a lot o case studies by pharmaceuticals but there is a need or comprehensive
inormation and acts rom Arica.
Makelinkswithlegislators/seminarsonTRIPS.Needtohavemeetingwithhealthandtradecommittees
at national and regional level. Need or inormation to be presented in a language or the lay people.
T.Matika(Seatini/Equinet)willshareadocumentpresentedtoSADConTRIPS.
PATENT POOL
TherewasameetinginGermanyandtherewasanagreementaboutthefactthatinformationneeded
to be claried about the process. Middle income and low income countries are already pressed to
enter the patent pool. Need more inormation on issues o patent pool
TRIPS
Move and encourage countries like South Africa for the adaptation and implementation of the
competition law. We need to analyze the scenario between now and 2016 to see how TRIPS roll out.
A question which we must also ollow is to see what will happen in 2017. Analysis results need to beproduced so it can be presented to CS Organizations.
RECOMMENDATIONS:
1. Arican civil societies need to take up advocacy and be a watchdog o maximum exibilities and
minimizing TRIPS + restrictions.
2. Need foranoverviewstudy/ research amongthe14countrieson thecurrentstateofTRIPS and
compliance(quick/rapidassessment).
3. More inormation needed to be provided on patent pool and how it is going to work and what benets
it provides to SARPAM beore moving orward.
4. Meetings with regional policy bodies and countries on TRIPS where bries are provided.
5. Brieng to health and trade ministry people on discussion o TRIPS.
6. Patent ree essential medicines or SARPAM members should be pushed or by CSOs in the region.
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21ANNEX D | RECORD OF OPEN AGENDA DISCUSSIONS continued
TOPIC
Priate Sector Engagement
PARTICIPANTS
Shaun, Orgenes, Tasangana, Gichinga, Titus, Joseph
MAIN POINTS DISCuSSED
Denitionofprivatesectordiersindierentcountries(e.g.Privateforprot,Privatenotforprot).
Privatesectorhasanimportantroletoplay,especiallyprivateprovidersofhealthservice.
Alotofsuspicionofprivateforprot.Tendstobeexcludedfrompublicsectorinitiatives.
Ecienciesandinnovationofprivatesector.Oftenmoreeectivegovernanceinprivatesector.
Goodexamplesofprivatesectorinitiativese.g.Accesstomalariaproductsinitiative(AMP),ADDO
accredited drug outlets MSH.
Whatistheevidenceforlackofprivatesectoraccountabilityordelivery?
Distinguish between prices of medication vs. cost of treatment. Private sector can be more cost
eective.
TrendistowardsNationalHealthInsurance,whichrequiresprivatesector.
PrivatesectorhasnottakenfulladvantageofTRIPSprovisionsbecauseoflackofgovernmentsupport
e.g. For comparison licensing. This impedes access.
Insomecountriesthereisoverregulationoftheprivatesector.Controlvs.collaboration.
Needpositiveengagement(ratherthannegativeengagement).
Denetheproblemstobesolved/challengedforinnovativeresponse.
Denerulesofengagementforethicalpractice.
CScanlobbymultinationalstodomoreanddelivermoresocialbenet.
Normaltenderingprocessdoesnotallowforblendedvalueoers(includingsocialcontribution).
RECOMMENDATIONS
1. Invite private sector in all SARPAM Partnerships or Action.
2. Assess to what extent private companies have taken advantage o TRIPS or better use o TRIPS
exibilities?
3. CSO Platorm or open debate and positive engagement on role o private sector with government
acilitation4. Play an honest broker role in a 3 party orum with Government and MNCs. Possible link to MeTA.
5. Advocate or delegated corporate social responsibility by MNCs to country level.
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22ANNEX D | RECORD OF OPEN AGENDA DISCUSSIONS continued
TOPIC
Drat Maniesto or Ciil Societ Action on Access to Medicines in Sothern Arica
(Developed through a meeting o: Gichinga, Shaun, Eva, Phillip, Titus)
PuRPOSE
A document that denes how we collaborate, as CSOs, in the context o SARPAM. Obligations, responsibilities
o CSOs and o SARPAM and commits partner to SARPAM
PRINCIPLES
Participateinpartnershipsforactionwherecontributionswilladdvalue
Commitment to thepurposeandobjectivesof SARPAM (plusprinciples)of SADC pharmaceutical
business plan.
Sharinginformationandresourcestoassistothers(growtogether)opencollaboration
Activeparticipation
Acceptingandaccountabilitycontributionsfromeveryone
Allowleadershipoftheorganization/swiththebestcompositiononspecicissues
Mutualrespectandrecognitionofrolesandcontributions,sharedbenets
OBLIGATIONS
Participateintheplatform(CSActionNetwork).Openconsultation
Inviteinparticipatingbyotherregionalandnationalstakeholders
Allowcontributionbyalltoacommonagenda
SignuptothecommitmenttoeachPACTthattheorganizationparticipatesin.
RESPONSIBILITIES
Sharedresponsibility
Acceptabilityagainstagreedcommitments
Workwithinnationallegalframeworks
Consultmembers
ELIGIBILITy
RegionalCSOoraliateofaregionalCSO(butnotbeexclusive)
AgreecriteriasuchasworkingonATM,membershipbase,fundingsource,etc
RECOMMENDATIONS:
1. Use MeTA denition o CSO
2. Establishadvisory/ReferenceGrouptoco-ordinate
3. Include statement o recognition o reason or CSO participation in maniest
4. Drat maniesto taken back to organizations by meeting representatives
5. Signatories will be listed as partners o SARPAM
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23
RES
uLTS
(To-BeAchieved)
ANECA
EPN
FIP
HAIAFRICA
META
P
ATAM
SEATINI
(EQuINET)
TAC
a
Imp
roved
Regional
Organization
o
CS
Internal
Organization
Weca
nassistwith
theor
ganizationo
SARPA
Masavibrant
s
tructure
b
Inormation
Sorces
Identifed
Provide
inormationonthe
competenciesthat
areavailablewithin
themembership
So
meoour
me
mbersare
invo
lvedinATM
wo
rkandcan
prov
idebaseline
inormation
SEATINIcanidentiy
inormation
(existing)on
essentialdrugslist
andmarketpricing
including
availability
c
D
ata
Collection
Workthroughour
technicalteamto
carryoutdata
gathering/research
atregionallevel
withemphasis
onPeadiatric
medicines
EP
Ncan
provid
erelevant
inorm
ationrom
then
etworkto
supportsetupo
monito
ringsystem
Su
pervise
nation
allevelsur-
vey,manager
ordatacollection
3prospective
METAcountries
unitedorMETA
GlobalForum
London
29June-1July
So
meoour
countrymembers
cancollectdataas
they
arealready
workingonthat
SEATINIcan
collectdatarelated
essentialdrugslist
andmarket
pricingincluding
availability
d
Inormation
Sh
aring
EPNcansupport
Datacollectionrom
membercountries
specif
callyrom
FBO
sector
SADCcountries
andCSOmeetat
ZambiaForum
1stweekJune
Wecansharethe
inor
mationthat
PATAMhasbased
on
ongoing
a
ctivities
SEATINIcanshare
inormationon
essentialdrugslist
Sha
reevidence
orca
sestudiesvia
M
SF/ARASA
e
Advocac
based
onIno
Spearheada
regionaladvocacy
campaignonaccess
tomedicinesin
SADCregion
Beingamember-
shiporganization
withm
embersin
anumb
eroSADC
countriesEPNcan
provideinormation
onPSM/supply
syste
msinthe
countries
N
etwork
sto
ck-outs,
ca
mpaign
pa
rtnersin
SADC
PATAM
s7strengths
liesinadvocacy
SEATINIcancarry
outadvocacy
workthrough
Parliamentary
Portolio
Committees
Regional
mo
bilisationin
a
ddressing
advo
cacygapson
stock-out,drug
p
ricesand
a
vailability
(TAC/??)
ANNEX E | FIRST DRAFT CS-Led PARTNERSHIP FOR ACTION (PACT) FRAMEWORK
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RES
uLTS
(To-BeAchieved)
ANECA
EPN
FIP
HAIAFRICA
META
P
ATAM
SEATINI
(EQuINET)
TAC
Tra
ining
Buildcapacityo
ANECCAmembers
onpaediatric
ormulationsand
medicines
1.Auditoexisting
technical
personnel
2.Inormation
sharingthrough
member
organization.
3.Examinationo
levelotraining
onaccessmatter.
4.Advocacyon
thoseintraining
onaccessmatter.
5.Examine
relevanceo
existingtraining
toaccessissues
Trainin
g
1.Age
nda
2.Met
hods
3.Tools
4.Training
Materials
5.Prov
ideTrainer
PA
TAMcan
help
withpolicy
develo
pmentaswe
havem
emberswith
techn
icalcapacity
g
Polic
Development
Usecurrentand
availableevidence
todevelop/review
policieson
medicines
Policy/strategy
development
Pushorpolicy
review/develop-
mentviaARASA
h
Stakeholder
Enga
gement
i
Dissemination
j
RegionalData-
bases/InoHb
ANNEX E | FIRST DRAFT CS-Led PARTNERSHIP FOR ACTION (PACT) FRAMEWORK
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26ANNEX G
FOR CIVIL SOCIETY ACTION ON ACCESS TO MEDICINES IN SOUTHERN AFRICA
PREAMBLE
The Southern Arica Regional Programme on Access to Medicines and Diagnostics SARPAM provides an
opportunity to make a critical dierence to peoples lives within the Southern Arican Development Community
SADC region and to encourage and support change that will address the complex issues relating to access
to medicines and diagnostics. One o the key outputs o the programme is an increased voice and inuence o
civil society reected in policies on access to medicines and diagnostics in Southern Arica.
Experience rom the Medicines Transparency Alliance MeTA countries has shown that Civil Society CS has
a vital role in keeping pharmaceutical companies, health proessionals and government civil servants and
organizations transparent, honest and accountable and CS organizations, along with the private sector and
governments as equal partners, are key actors to jointly seek solutions.
We, representing the Ciil Societ with interest in increasing access to medicines in the Sothern Arica
region are signatories to this maniesto as ollows:
PuRPOSE:
This document denes how we, the partaking civil society and aith based organizations CSOs and FBOs
collaborate, in the context o SARPAM. It species the intent, obligations, responsibilities and expectations o
SARPAM and our commitments as partners in SARPAM.
COMMITMENTS:
We commit to:
Participateinpartnershipsor action PACT where our contributions will add value SupportthepurposeandactivelyparticipateinpursuitoftheobjectivesofSARPAMandtheprinciplesof
the SADC Pharmaceutical Business Plan.
Shareinformation,expertise and resources,and fosteropencollaborationand consultation inorder to
assist each other towards mutual growth and success.
BeaccountabletoourCSpartnersonissuesthatwecommittocarryout.
AllowthepartnerCSorganization(s)withthebestexperienceandmostappropriatemandatetoleadothers
when working jointly on specic issues.
Mutuallyrespectandrecognizerolesandcontributionsofeachpartnertoacommonagendaandtoshare
benets.
Participatein theplatform,Civil Society ActionNetwork,by contributing ideas, comments, advice and
documents as may be appropriate or requested.
Inviteandsupporttheparticipationofotherregionalstakeholdersinordertoincreasecapacitytoachieve
our objectives
SignupandadheretothecommitmenttoeachPACTthatourorganization(s)participatesin.
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RESPONSIBILITIES:
We accept shared responsibility, acceptability and accountability against these agreed commitments. We
urther accept to work within national legal rameworks and to consult members regularly.
ELIGIBILITy:
We commit to the acknowledgement o diersit, broad representation and inclsiit. Thereore
initation or signatories are extended bt not limited to:
EstablishedandrecognizedregionalCSOsandFBOsoraliatesofsuchorganizations.
Anyorganizationwhichmeetsminimumcriteriaformembershipsuchasworkingonorinterestinaccess
to medicines ATM, membership base, unding source, etc.
EXPECTATIONS
We expect the Responsible Action Consortim managing the Sothern Arica Regional Programme to:
UseMeTAdenitionofCivilSocietyinthisrelationship.
FacilitatetheworkoftheReferenceGroupthathasbeenestablishedbytheCS.
SupporttheCSinimplementingtheagreedprogrammeofworkasmaybenecessary.
Facilitaterelationship-buildingbetweentheCSandtheSADCsecretariat,governments,privatesector,
donors and other partners committed to increasing access to medicines in the region.
KeepanaccuraterecordofsignatoriestothismanifestoandtolistthemaspartnersofSARPAM
Name and Stamp o CS Organization Responsible Action Consortium Stamp
Signature Signature
Date Date
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28ANNEX H | CASE STUDY: PARTNERSHIP IN ACTION
PuRPOSE
The purpose o this case study is to illustrate how the PACT approach was applied to achieve the ollowing
purpose:
TO FORGE A CIvIL SOCIETy PARTNERSHIP TO IMPROvE ACCESS TO MEDICINES INSOuTHERN AFRICA
A key principle o the PACT approach is that the participants take ownership o the PACT content and
conversations. Although there is a ramework that the PACT ollows, the agenda, the conversations and
agreements are incubated and driven by the participants. The ollowing diagram illustrates the process:
1
2
3
4
5
6
7
8
9
10
PREPARING THE
ENvIRONMENT
INTRODuCING THE
APPROACHArrival Opening
Reection ClosingExercise
Purpose
Proposals oraction
PACTMatrix
Agreementon results& partners
Denitiono PACTs
How?
Summary Clariy nextsteps
ClosingExercise
Finalreections byparticipants
Marketplaceo topics
List openagenda
discussiontopics
List openagenda
discussiontopics
Relate to
SARPAM and
SADC PBP
DEFINING THE OPEN
AGENDA
PACT
CONvERSATIONS
RE-FOCuS AGENDA
FOR 2ND SESSION
REvIEW
PROGRESS
PACT
CONvERSATIONS
PLANNING
FOR ACTION
DEFINE RESuLTS AND
PARTNER CONTRIBuTIONSS
CLOSE
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29ANNEX H | CASE STUDY: PARTNERSHIP IN ACTION continued
THE SCENE
A large meeting room and in the centre a circle o empty chairs.
On the periphery, ve tables each with seating or 10 people, a rereshment station and a stationery
desk.
On the walls, some posters and a banner bearing the SARPAM logo with the words: How can
we work in partnership to improve access to medicines in southern Arica?
When participants arrive, they move in and seat themselves at random in the main seating area.
The Civil Society Technical Lead, SARPAM members and
head o the civil society programme, briey welcomes
everyone to the workshop, describing it as the rst step
in a process that aims to change the situation or the
people o southern Arica through improved access
to essential medicines. The SARPAM director and
the acilitator rom ReAction!, the lead company in a
consortium responsible or implementing SARPAM, areintroduced.
In a short introduction to SARPAM, the SARPAM Director
covers DFIDs central role in SARPAM, explaining the
thinking behind the ninemonth inception phase or
SARPAM a pregnancy that we hope will deliver a live
born child and the dual nature o SARPAM working
with the SADC Secretariat and SADC member states on
the one hand, and with civil society structures on the
other. The Director emphasises the regional nature o
SARPAM and how this mandate could be taken up byCSOs. The rules o the game are not ocusing at the
individual country level.
The workshop acilitator takes the lead and highlights
the central question: How can we work in partnership
to improve access to medicines in southern Arica? She
gestures to a blank wall and says: This is our agenda or
the next two days . . . this is your journey, your process
and you set the agenda.
1
2
PREPARING THE ENvIRONMENT
INTRODuCING THE APPROACH
Poster describing the purpose o the meeting
Facilitator illustrating the agenda
Facilitator beginning the open space
acilitation process
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Ticket to ride . . . openness, choice, new beginnings.
The acilitator gives each person in the circle a ticket or
the twoday journey a card containing an afrmation
in the rst person. My intuition is powerul, I have thereedom to choose, I let go o the past. Participants are
invited to read out the message on the ticket.
With the mood set, the acilitator outlines the our principles o the workshop:
Showupandchoosetobepresent.
Beopentotheoutcomenotattachedtoit.
Payattentiontowhathasheartandmeaning.
Tellthetruthwithoutblameorjudgment.
Thefacilitatorrequestseveryparticipanttoidentifyanyissuesoropportunitiesthats/hewouldlike
to discuss during the course o the workshop, to write each item on an individual sheet o A4 paper
and to put his or her name on it.
A RuSH OF IDEAS
Participants duly take sheets o paper, write down their subjects, and read them out loudly.
Iminterestedin the supply chain howdowegetdrugsoutof the storeroomsand into
communities.
Myinterestissharingadvocacystrategiesforaccesstoessentialmedicines.
Iproposetalkingaboutacoalitiontoinuencepolicyontheaordabilityofmedicines.
IminterestedinTRIPSandmedicinesandtheimpactoffreetradeagreements.
. . . and so on.
They then stick their suggestions on the blank wall
indicated earlier which now carries a sign reading
Community Notice Board.
The acilitator explains that each one o thesesubjects will be the ocus o a meeting, which will
be chaired and run by the originator o the topic.
Participants can sign up or any meeting they are
interested in.
Two laws or participation in meetings are explained to the group:
The LawoftheBumbleBeeandtheButterywhichsanctionspeople ittingdiscussion
between groups to pollinate or add value.
TheLawoftheTwoFeetwhichencouragesparticipantstomoveoutofadiscussiongroup
where they are not engaged and join another.
Posters describing the workshop principles
A rush o ideas rom the participants
3 CONSTRuCTING THE AGENDA
ANNEX H | CASE STUDY: PARTNERSHIP IN ACTION continued
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31ANNEX H | CASE STUDY: PARTNERSHIP IN ACTION continued
Everyone goes to inspect the Community Notice Board,
with a view to merge topics or add new ones where there
are gaps. Participants begin to identiy common ground
between their own proposals and those o others. They
move individual sheets o paper so that clusters or lists o
related topics emerge and in this way, meeting themes
are dened.
10 CENTRAL DISCuSSION THEMES EMERGE:
Capacitybuilding
NetworkingamongCSOs(Partnershipislater
extracted as a dierent topic
TRIPSandtradeissues
Good governance and research (Research is
later dened as a separate topic
Supplychain
Medicinesquality
Communityinvolvement
Privatesectorengagement.
The agenda is now nalised and trading or time and venue begins. With the groups permission, the
acilitator helps rationalise the process o allocating time slots and meeting venues.
Four time slots are carved out or meetings, with between two and our meetings running at the same
time.
For the remainder o the rst day and the rst hour on Day 2, the meetings on participants sel
selected themes continue. Each group is chaired by an individual who proposed one o the original
topics that was collapsed into the theme. Main discussion points and recommendations are captured
on a standard reporting orm. These orms are posted on the Community Notice Board and, romtime to time, the acilitator reminds participants to consult the board to see what other groups have
debated and concluded.
The groups are very stable and participants intensely involved. The meetings are small enough or
everyone to have a say and hardly anyone makes use o the Law o the Two Feet.
The Community Notice Board
Trading or time and venue begins
4 PACT CONvERSATIONS
Engaging the issues . . . and each other
Participants engage in discussion at meetings around sel-selected themes
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The rst day concludes with a game a modied version o charades and reection on the day. Asked
to describe their experiences, participants venture:
Itwasdierent.
Fast.
Wesaidatthebeginningthiswouldtakeustwoweeks.Ittookusoneday.
At the beginning therewasmoreopportunity for our voiceto beheard.Thistimewe felt the
workshop was owned by us.
Peoplefelt alittlebitmoreinformationwasneededaboutSARPAM.Whoweareandwhatwill
happen when we leave this room.
The acilitator comments on how things appeared through her lens:
Theagenda-settingwasextremelyrapidandamazinglyrich.
Peoplewereintenselyengagedindiscussion;almostnousewasmadeoftheLawoftheTwoFeet.
The acilitator touches on aspects o a number o discussions and mentions that the meeting on
partnership had come up with the idea o a maniesto that would be the oundation o the civil
society CS partnership within SARPAM.
A discussion on how the process should unold, ollows. Participants express a need to ocus and move
towards an action plan:
IhavefearswecouldbeasinactiveastheSADCPharmaceuticalBusinessPlan.
Weneedabitmorestructure,alittlebetterideaofwherethedestinationlies.
The acilitator conrms that most o Session 2 will be devoted mostly to prioritisation and action
planning.
A game o charades and reections toconclude Day 1
The acilitator reects on the learning rom theday rom her lens
5 REvIEW PROGRESS
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6
7
8
RE-FOCuS AGENDA FOR 2ND SESSION
The Facilitator opens the next session. She creates a space or participants to reect on the previoussession and give eedback on their thoughts or the progress o this session.
Ater that, seated in the central circle, they receive a
detailed outline o SARPAM which DFID has initiated and
unded as a partnership venture, not a new entity. The
inormal presentation covers the broad objectives o the
programme, the specic work o the inception phase, the
rationale or the inception phase, the main players in the
Responsible Action Consortium, the budget allocation by
DFID, and the respective collaborations with civil society,
the SADC Secretariat, and governments in the region.
Participants gather in three discussion groups to complete the PACT meeting schedule rom Session 1.
The participants response is positive, captured in the comment: I want to suggest we look at ourselves
as the drivers o this agenda. We must own the platorm.
The acilitator invites participants to examine the
recommendations o the various meetings posted on
the walls and to rame those that appeal most to them
as proposals or joint action. This proposal can be an
individual or joint eort, but the proposers should
canvas support or the idea. Every participant has ten
votes represented by red stickerdots which they can
use as they like to indicate support or various proposals.
Some participants are active in canvassing support or their proposals while others simply pastethem on the notice board and hope the ideas will speak or themselves. Ater all proposals have been
pasted up the process o discussing their merits begins.
The SARPAM Director chairs this session, where necessary providing inormation about how the
proposal relates to other actions that SARPAM will undertake in the inception phase.
PACT CONvERSATIONS
PLANNING FOR ACTION
SARPAM Director outlines the partnership
venture
Support or various proposals indicates by redstickers or votes
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A TASTE OF THE PROPOSALS
DevelopaframeworkforcollaborativeworkwithSADC(becauseitismoreproductivetobeatthe
table than to shout rom the sidelines.
Conductahumanresourcesmappingexercise,focusingonpharmacists.
Advocatefortheharmonisationofdiagnosticprocessesandtreatmentguidelinesforselectedhealth
conditions.
Establishasystemforcivilsocietydatacollectionandwatch-doggingofprices,supplychainsand
availability o medicines in acilities.
As the discussion proceeds, some proposals are combined
and others are eliminated. The wording o some o the
rontrunners is changed to make proposals more inclusive
and suited to the dierent cultures o various civil society
groupings.
In the end, the rst CS Partnership or Action is dened as
ollows:
To establish a joint civil society system or gathering inormation on pricing o selected medicines,
supply chain eectiveness and availability o these medicines at acility level.
The Director indicates that this will strengthen one o the main deliverables o SARPAM during the
inception stage: an analysis o pharmaceutical markets across the SADC region.
ACTIvITIES AND RESPONSIBILITIES
At this point a giant matrix on the wall behind the
chairperson becomes the ocus o attention. Participants
are asked to:
Completethelefthandcolumnbyproposingcategories
o key activities needed or the partnership project
that they have adopted. These are then put into time
sequence.
Identifyappropriateorganizations inside and outside
the room who could be valuable contributors to this
partnership or action PACT, and spread these across
the top row.
Each o the activities and potential partner organizations is
written on a large Postit note and slotted into the matrix
in the relevant cell. Each organization is given a dierent
colour code.
Those organizations in the room are then asked to outline more specically what they mightbe able to contribute in terms o the various categories o activity. These details are written on Postit
notes in the organizations colour and posted into the relevant cell on the matrix.
Participants identiy proposals or joint action
Matrix on the wall to denote key activities andresponsibilities
Participants discussing contributions to thefrst CS partnership
9 DEFINE RESuLTS AND PARTNER CONTRIBuTIONSS
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The eect is illustrated below. An organization that posts a note under training, or example, might say:
Produce training materials and supply trainers.
The column or organizations not represented at the workshop, obviously, remains blank and their
commitments will be established at a later stage.
Activities EPN HAI Patam Aneca Seatini etc . . .
Internal organization
Identiy existing ino
Data collection
Inormation sharing
Advocacy
Training
Policy development
The matrix has eectively become the oundation o a plan o action and two months o planning have,
indeed, been accomplished in two days.
The CS Technical Lead acilitates the closing discussion
and directs attention to three key tasks:
Organising the partner organizations so that theprocess can move orward.
Framingthepurposeandobjectivesofthepartnership
in language that is clear and acceptable to all.
Creatingchannelsforcontinuedcommunication.
ORGANIzING THE CS PACT
The CS Technical Lead appeals to the group or assistance with organizing the partnership internally. A
task team is created with our key regional organizations HAI Arica, EPN, Patam and Aneca identied
as its core members. Each organization will determine who will represent it.
It is urther agreed that one person rom these organizations or one o their member organizations will
representtheCSPACTatameetinginCapeTownon29/30MarchwherethebroaderSARPAMmarket
analysis process will be discussed in detail.
FRAMING THE PACTS PuRPOSE AND MEMBER RESPONSIBILITIES
Apart rom attending to the objectives o the CS Pact, the task team would consider and strengthen
the recommendations o the workshop group on partnerships. They would revise, complete and
circulate the drat maniesto or PACT members, a document intended to be mutually binding
among partners.
CS Technical Lead acilitates closing discussion
10 CLOSE
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COMMuNICATION
Participants suggest that SARPAM needs a dedicated, wellunctioning website as a channel or communication.
The SARPAM Director explains the acility o the Frontline SMS system which will eventually be tollree orusers. Participants with mobile phones that are unctional in Kenya are invited to register immediately on the
SMS system.
CLARIFy NEXT STEPS
IMMEDIATE NEXT STEPS
Thetaskteamwillmeetsoon.
Thedraftmanifestoandstatementofresponsibilitieswillbecirculatedtoallparticipantstogetherwitha
summary o the meeting.
Eachparticipantshouldmeetwithhis/herorganizationtodiscussitscommitments tothePACTand
prepare a detailed description o the role it could play within the planning ramework developed. TheSARPAMsecretariatwilltalkone-on-onewitheachorganizationtoestablishresourcerequirements
in the inception phase and beyond.
CLOSING EXERCISE
Completing the pictre
The acilitator resumes acilitation and invites everyone to reect on the twoday experience and the amount
ofworkachieved.Sheaskseachparticipanttotakethejigsawpieces/hewasgivenatthestartofthedayand
to help build a puzzle on the table in the middle o the circle.
The jigsaw gradually takes shape and resembles the SARPAM banner: How can we work in partnership to
improve access to medicines in southern Arica?
Asked to comment on the jigsaw, people note there are pieces missing, and its a bit uneven and insecure,
but the image and the words are quite recognisable. As they speak they realise this is a metaphor or the
partnershipbuilding and projectplanning process they have just undertaken.
In a nal symbolic act, individuals close the circle by shaking hands with the person on either side.
Closing Jigsaw game The puzzle takes shape
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38ANNEX I | WORKSHOP EVALUATION
CSO Workshop: 2122 March 2010How can we as Ciil Societ improe Access to Medicines in Sothern Arica?
WORKS
HOP
WAyFORWARD
FACILITIES
1 2 3 4
1. Understanding o purpose 2 6
2. Achievement o workshop objective 1 10 6
3. Methodology and approach 1 7 11
4. Facilitation process and support 8 11
5. Level o participation o all delegates 1 5 13
6. Handling o questions and concerns 2 9 8
7. Building o relationships and networks 12 7
GENERAL REFLECTIONS AND SuGGESTIONS FOR FuTuRE CSO WORKSHOPS:
Good keep it up. Ensure that we all have the necessary background ino needed to be more resourceul in terms o partici
pation e.g. ino about SARPAM, your expectations and why you need CSO engagement should have beenclear upront.
I like the open agenda as a concept but or a group with no real connection beore hand I think a bit morestructure would have helped.
Advance planning. InitiallyIfearedthenoagendaapproachbutnowIappreciateit.Thankyou!
Involve more networks The workshop achieved a lot in two days the achievements exceeded my expectations. A new methodology thereore may take time to get ully knowledgeable. Perhaps an understanding o the key aims, expected results and the methodology. Also need more clarity
at the beginning
8. Clarity on individual role and accountability 4 11 4
9. Idea o uture communication through sms technology 1 2 11 5
GENERAL REFLECTIONS AND COMMENTS ON AGREED WAy FORWARD:
I liked the idea o participants coming up with the agenda. It looks realistic. I hope we shall adhere to it. It was a good beginning. Obviously it sets the basis or moving orward. More clarity needed but that is
within sight. Notfullysatisedwiththeaction/pactareaagreedbutwillsupportit.
Need or better clarity on dierence between individual role and tting into a bigger picture. Very good because cellphones are now available everywhere. Better more use o emails or record keeping purposes. Lesser use o SMS. Acceptable, can be improved.
Will become more clear as next steps report, communications evolve
9. Workshop venue and resources 6 13
10. Accommodation and meals 8 10
11. Travel logistics and arrangements 3 11 3
GENERAL REFLECTIONS AND COMMENTS:
Great organization. Well organized, good approach, results have been achieved rom nothing no agenda. Good start. SARPAM must sustain the interest, share ino and ensure that the momentum is not lost. The methodology and vision or the meeting was quite interesting and opened more opportunities o
ownership. Good.
The methodology and the principles o this workshop need to be tried elsewhere in Arica. Great meeting, the approach was completely innovative but idea in allowing participants to see the
agenda. Keep it up Sharon and Shaun. This was a really great. Good venture. This has proved that an agenda put up by participants enable them. To discuss broadly and in deep the
contents, since they are issues being encountered daily
SCORE KEy:
1 POOR; 2 SATISFACTORY; 3 GOOD; 4 EXCELLENT
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