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
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