Medicines Transparency Alliance

Presented by Gilles Forte

Department of Essential Medicines and Health Products, WHO

On behalf of WHO and HAI

Technical Briefing Seminar

29 Oct - 2 Nov 2012, Geneva

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MeTA hypothesisMeTA hypothesis

Reliable information on medicines policies

Improved accountability

Improved governance

Improved efficiency

Improved Policies

Transparency

Access to medicines improved

Multi-stakeholder approach

Improved accountability

Improved governance

Improved efficiency

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MeTA aimMeTA aim

MeTA aims at improving access to and use of quality medicines by increasing transparency of the pharmaceutical sector through collection of reliable data, valid analysis, and then disclosure for advocacy, accountability and policy dialogue among stakeholders e.g. private sector/public sector/civil society.

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About MeTAAbout MeTA

7 countries: – Ghana, Jordan, Kyrgyzstan, Peru, Philippines, Uganda and Zambia.

Pilot Phase from 2008-2010– Established multi-stakeholder platforms with MoH, CSOs; private sector etc. – Collected baseline data & capacity building for it;– Initiated/tested transparency initiatives: e.g. Peru; – External evaluation

Phase 2 from 2011-2015– Address information gap from Pilot Phase– Support countries transparency and disclosure strategy – Convert dialogue into policy recommendations and interventions

  WHO and Health Action International provide:– Project coordination – Technical support through the provision of data collection, analysis & dialogue methodologies,

capacity building and policy guidance.

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MeTA Core PrinciplesMeTA Core Principles

MeTA priorities are aligned with country priorities for improving access to medicines;

Governments perceive it as “a catalyst for evidence-based policy change and implementation”;

MeTA priority interventions will be implemented and monitored through an agreed workplan in line with national health and pharmaceutical workplans;

MeTA builds bridges, stimulates dialogue among stakeholders in countries, helps identify areas of common interest, facilitates alignment of goals between stakeholders;

MeTA facilitates countries sharing of experience and evidence to accelerate improvement;

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Private sector at country levelPrivate sector at country level Multinationals and Innovators

Generic importers

Local Manufacturers

Wholesalers, distributors

Retail pharmacies

Drug shops

Private health care providers

Mission Sector

Insurance companies

et al …

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Civil Society at country levelCivil Society at country level

Health NGOs/CSOs (domestic & international)

Medicines NGOs/CSOs

Transparency NGOs

Patient Groups

Consumer Groups

et al …

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Government at country levelGovernment at country level

Ministries of Health

Medicines Regulators

Government Insurance Funds

Government Procurement

Chief Pharmacists/Medical Officers

et al …

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What could be disclosed?What could be disclosed?

Medicines Registration and Quality Assurance

Market registration procedures and 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

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What could be disclosed?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

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What could be disclosed?What could be disclosed?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

Pharmaceutical patents held in the country

Medicines use and Promotion

Standard treatment guidelines

Essential medicines list

Medicines promotion regulations, policies, and industry practices

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MeTA "Success stories" from the Pilot (2008-2010)

MeTA "Success stories" from the Pilot (2008-2010)

The National Medicines Regulatory Authorities of Kyrgyzstan, Uganda and Zambia have created web-sites on which they make available key information like list of registered medicines, 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 competion is meant to reduce prices of medicines.

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.

In the Philippines MeTA contributed to the enactement of the "Cheaper Medicines Act" 2008 and to the establishment of an e-procurement system for medicines.

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Lessons learned from the pilotLessons learned from the pilot

Multi-stakeholder working is a new concept – not easy – it takes patience, understanding, diplomacy and tact;

Identifying champions in each sector can greatly expedite the process of multi-stakeholder 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;

Gaining consensus and understanding requires a constant and frank exchange of views;

Tools for gathering baseline data on access do already exist; new innovative ‘user-friendly’ and cost effective tools required for M & E of progress.

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MeTA 2011-2015 targetsMeTA 2011-2015 targets

Median consumer price ratio for EM decreased by10%;

Mean availability of EM increased by up to 10%;

Estimate efficiency savings through reduced prices, efficient procurement and appropriate use of medicines;

Transparency, accountability improved;

Multi-stakeholders policy dialogue effective and address country priorities;

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Main areas of technical work 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

RUM: antimicrobial resistance

Public sector procurement

Peru Monitoring price and availability

Analysis and use of existing data

Public sector procurement

Quality assurance

Philippines Monitoring price and availability

Medicines promotionassessment

Quality assurance

Uganda Monitoring price and availability

RUM: DTCs Quality assurance

Zambia Analysis and use of existing data

Development of tools

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Main areas of Civil Society activitiesMain areas of Civil Society activities

Ghana Assessment of CSO capacity

Capacity building for communications

Involvement of CSO in communications activities

Jordan Capacity building for communications

CSO campaigns to improve knowledge on patient rights

Kyrgyzstan Capacity building for collection of data and pilot data collection

Capacity building for communications

CSO campaigns on patient rights and antibiotic use

Peru Expand involvement of CSO in promoting access to medicines

Expand involvement of CSO in development of methodologies and policy recommendations

Philippines Awareness of drug entitlement programmes

Community monitoring pilot

Uganda Empowerment of communities to own services and holder duty bearers to account

Zambia Capacity building for community radio

Improve awareness of regulatory issues