Medicines Transparency Alliance13/09/2015 1 MeTA Uganda Country Overview Public Sector Private...

Medicines Transparency Alliance19/04/23 1

MeTA Uganda

Country OverviewPublic SectorPrivate SectorCivil Society


Country Overview

Jacqueline IdussoSecretariat Coordinator


Multi-stakeholder process

Milestones:

Multi-stakeholder collaboration: first time in the pharmaceutical sector

Capacity building and formation of an umbrella organization for CSOs

Participation of private sector and CSOs in the development of the NPSSP II

Amendment of the counterfeit goods bill: a CSO-led process in which NDA and private sector were invited

Input of MeTA Council was crucial to success of the “STOP STOCK OUT” campaign

Medicines Transparency Alliance

Major achievements and successes

NDA database of registered drugs is now searchable online www.nda.or.ug

Improved intra-government efficiency as NDA verification information will be available to MoH

Improved access to information by the private sector e.g. MoH procurement plan, medicines price monitor

Increased public debate and reporting on medicines-related issues such as stock outs

Resolutions from the forum on NMS/JMS/NDA improving efficiencies re sharing information on quality assurance data

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Overall challenges

Slow start

Variable participation in the process (competing priorities, no direct incentives)

High member expectations of funding esp. CSOs

Disclosure is still a challenge, still in the process of making an inventory, modalities unclear

Insufficient visibility for MeTA (esp. in MoH structures)

Dissemination of available information from stakeholders is still not effective

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Overall challenges 2

The need for “Patience” in working as a multi-sector team!

Acceptance that the different sectors work in different ways, e.g. Private sector appears to have more sense of urgency - deadline driven!

Involve the “full” private sector in the discussions and get commitment for actions

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Lessons Learned

It takes time for such initiatives to take off: pilot phase too short to expect meaningful results

The disclosure survey unleashed gaps in pharmaceutical sector which MeTA is working to prioritize

Better planning needful at onset of initiative to prevent delays in take off, ownership of activities.

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WHAT NEXT?


Thank you

Jacqueline Idusso Email: [email protected]

Mobile number: +256-752-656380

Skype: metauganda

Website: www.MedicinesTransparency.org


Public Sector

Presenter: Oteba Olowo MartinJob Title: Assistant Commissioner health

Services (pharmacy)


Multi-stakeholder process - milestones

Establishment of the MeTA country chapter with a secretariat facilitated by a national coordinator

CSO – Government – Private sector multistakeholder national MeTA council established

the National Pharmaceutical Sector Strategic Plan (NPSSP) supported – draft NPSSP produced

Facilitating transparency in the medicines registration process – register of medicines regularly updated and accessible on website free of charge


Multi-stakeholder process - milestones

The three year procurement plan evaluated, updated and shared among stakeholders in the health sector

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Major achievements and successes – MeTA Uganda

Joint action in areas hitherto of mutual suspicion achieved

Understanding diversity, taking advantage of the opportunities therein for collective and effective policy development and implementation

Medicines price monitoring conducted on a quarterly basis

Process of computerizing medicines import data started and dialogue for continued support by other partners initiated

The NPSSP reviewed through a wider stakeholder process – Document available in draft form (Yet to be costed)

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Overall challenges during the pilot – MeTa Uganda

Appreciating the MeTA core values and value add to the various stakeholders

Breaking barriers between stakeholders and opening up opportunities for synergistic actions – time waste

Building trust and confidence among the stakeholders

Time waste in addressing the individual stakeholder interests and concerns

\Most project outcomes yet to be evaluated for broader impact

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Lessons Learned – MeTA Uganda

Soliciting goodwill and support by stakeholders should not be taken for granted

Stakeholder prior understanding of new initiatives provides good grounds for buy in

The pilot phase as a consequence of the lag phase has been ultimately shorter than was expected creating pressure in the implementation of agreed on programmes at country

Stakeholder engagement provides requisite grounds for mitigating and or eliminating potential conflict and allows for progressive synergy in moving forward agenda in medicines transparency programmes

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Lessons Learnt

Understanding each others interests, mandates and responsibilities and positively sharing the concerns of the other parties.

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Thank you

Name of presenter: Oteba Olowo Martin Email: [email protected]

Mobile number: +256 772 512 975

Skype:

Website:


Private Sector

Nazeem MohamedC.E.O. Kampala Pharmaceutical Industries (1996) Ltd


Summary Analysis at start of MeTA

Issues– Market dominated by subsidised imports from India and China

• Prices are cheap,

• Huge variability in stocks

• Subsidised imports impact on competitiveness of local manufacturers

– Perceived lack of clear policies to support local manufacturing

– Lack of adequate Government support for local manufacturing


Issues 2

– Relatively strong regulations and enforcement in place

– Increasing commercialization of health care provision

– Weak infrastructure which increases the cost of distribution and availability of essential drugs.

– Poor and inadequate patient and customer service

– Lack of knowledge and dissemination of patient rights – Wide spread corruption in areas of health service delivery, procurement,

leakage of products etc...

– No point of reference to access data on pricing, margins, or availability of essential drugs

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Major milestones

Private sector has been provided a seat on the table!!

Private sector recognized as a significant and growing player in health care service delivery

Opportunities created for dialogue with the Government, CSO’s and development partners

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Successes

Invited to participate in development of Government’s Pharmaceutical Strategic Plan (NPSSP) for 2010-2015

Worked with CSO’s on “Counterfeit Bill” and submitted a common position to the Government

Initiated discussion with Academia to improve technical skill base among graduates and company staff

Initiation of a project to promote the value of “generics” and local manufacturing

Identified need to collect and disseminate data on the market, e.g. Importation, use of different medicines, trends in usage, etc

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Challenges

The need for “patience for results” in working as part of a multi-sector team!

Understanding that sectors have varying objectives and work in different ways, e.g. private sector tends to act with more sense of urgency

Involving the “full breadth/spectrum” of private sector in the discussions and getting commitment for actions

Lack of empirical information on characteristics, extent, growth and consequences of unregulated commercial health care provision

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Lessons Learned

Most issues of concern are common to different stakeholder groups

Understanding and appreciating the role each sector can play in making multi stakeholder initiatives/processes work

Identifying and involving all stakeholders that will contribute to the success of the multi stakeholder process

The role of advocacy/lobbying in ensuring that private sector concerns are considered during policy formulation

The need for strengthening the capacity of government to constructively engage the private sector

Building trust and constructive policy dialogue are vital for successful engagement

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Civil Society

Rosette MutambiCSO Coordinator


Summary Analysis at start of MeTA

What were the needs and issues in your specific sector at the start of MeTA?

Access to medicines:- Availability of medicines; Medicine prices; Monitoring and accountability; Rational use

Create public awareness; increase transparency in medicine supply chain (policy and practice), roles of key medicine sector institutions (NDA,NMS etc)

CSO coordination and communication

Capacity building of CSOs for effective participation in medicine sector

Representation of CSOs on the different decision making structures


Major milestones

What milestones have been achieved during the MeTA pilot phase?

Two CSOs HEPS and Uganda National Health Consumers Organization (UNHCO) were selected to sit on MeTA Council

Rosette Mutambi (Executive Director HEPS) was chosen as first rotating Co-Chair of MeTA Uganda Council.

At inception of MeTA in early 2008, HEPS was chosen to present CSOs on Ministry of Health Technical Working Group on Medicines Procurement and Management

CSOs empowered to meaningfully participate in the planned multi-stakeholder activities in Uganda and feel more comfortable to engage with national policy processes

MeTA has provided CSOs with access to government bodies

Work plan on track

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Successes

What were the successes for your sector during the MeTA pilot phase?

For the first time ever, the Ministry of Health invited CSOs to the National Pharmaceutical Sector Strategizing Workshop in July/ August 2009

Increased public debate and reporting on medicine issues for example stock outs

Increased collaboration between government bodies, private sector to improve access to medicine

MeTA council provided useful input into materials used for the Stop Stock outs campaign

Shared responsibility among CSOs in implementing work plan

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Challenges

What challenges has your sector endured during the MeTA pilot phase?

Constant communication which is required to maintain interest and to keep members updated on MeTA issues is a challenge

High member expectations of funding

District CBOs not yet aware of MeTA

Increased pressure from public to CSOs to demand/cause change

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Lessons Learned

What are the lessons that your sector has learned from MeTA?

There is shared responsibility by all stakeholders to increase access to medicines and all sectors have a contribution

MSP helps sectors to understand role of others and their key competencies in improving access to medicines

MSP important in increasing transparency and accountability

An enlightened Civil Society is crucial to advocacy

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Capacity Building Workshop

CSO participants of Capacity Building Workshop


Thank you

Rostte Mutambi

Executive Director HEPS Uganda/ Co-chair MeTA Uganda Email: [email protected]; [email protected]

Mobile number: +256 782 371401

Skype:

Website: www.heps.or.ug

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