Summary

1. WHO/UNICEF Technical Briefing Seminar Geneva 16-20 November 2009.WHO Collaboration with Countries on Pharmaceutical PoliciesMrs. Helen TataEssential Medicines and Pharmaceutical Policies

2. Summary • WHO Presence in Region and Countries • Collaboration structure • Collaboration Framework • Partnerships • DFID/WHO/HAI-A Collaboration • EC/ACP/WHO Partnership on Pharmaceutical Policies • MeTA • Outcome of Collaboration

3. 193 Member States 6 Regional Offices • Regional Office AFRO Regional Office EMRO Regional Office EURORegional Office WPRO Regional Office SEARO Regional Office AMRO WHO HQ Geneva (Source: http://www.who.int/about/regions/en/index.html)

4. Coordination mechanisms for a sustainable collaboration with countries AFRO WHO AMRO HSS EMRO EMP EURO SEARO WPRO

5. Collaborating Centres for Medicines • Over 30 collaborating centres in 21 countries

6. A network of advisors for pharmaceutical policies in countries • Medicines Advisers in over 40 countries (16 en Africa) and in regional and sub-regional offices for: • Assessing needs and priorities. • Planning, implementing, following up and evaluating interventions. • Coordination of partners. UEMOA Burundi Cameroon Central African Rep. Chad Congo Democratic Rep. of the Congo Ethiopia Ghana Kenya Mali Nigeria Rwanda Senegal Uganda United Rep. of Tanzania Zambia EAC

7. Sub-Regional CollaborationPotential Gains Exchange of information and experiences on pharmaceutical policies Exchange of information on quality of medicines, prices and on suppliers. Promote Transparency and Good Governance Stronger Negotiating Power. Alignment and Harmonization of legislations to improve access to quality medicines. Harmonization of Essential Medicines Lists and Standard Treatment Guidelines.

8. Collaboration framework (1) • WHO Medicines Strategy: 2004-07 et 2008-13 • WHO Medium Term Strategic Plan 2008-2013 • Strategic Objective 11 (SO-11) • Results are measured against the goals of the organization (OWERs 11.1, 11.2, 11.3) • Recent Resolutions of the EB and World Health Assembly. • Priorities set by the Director General. • Regional Declarations and priorities identified by member states. • Millennium Development Goals 2000-2015– Goal 8 • World Health Report on PHC 2008

9. Collaboration framework (2) • WMS 2004-2007- Countries at the core: • Medicines Policy • Access • Quality and Safety • Rational Use • EC 8 results areas: • National medicines policies • International trade agreements • Affordability and financing • Drug supply management • Norms and standards • Effective drug regulation • Rational use by health professionals and control of antimicrobial resistance • Rational drug use by consumers

10. Bottom-up approach Head Quarters Keep contacts with partners for resources mobilization and provision of expertise WHO Regional Office Support the country office and coordinate with HQ WHO Country Office Support the the MoH to idenfity needs and priorities, to develop plans and to implement them Ministry of Health Identify needs and priorities

11. Partnerships

12. Relations with partners WHO Countries HQ Regional Offices Country Offices Ministries of Health Partners Operational Partners UN Agencies e.g. UNICEF; NGOs Scientific Partners Collaborating Centres; Research Universities; Professional Associations (e.g. FIP). Strategic Partners World Bank; Donors e.g. European Union, DFID, Global Fund, UNITAID

13. DFID Partnership Example • WHO-HAI Africa Regional Collaboration for Action on Essential Medicines in Africa 2002 – 2008: DFID funding 75% to WHO and 25% to HAI Africa • The birth of WHO Medicines National Professional Officers (NPO) in selected African countries. • Intensified support in medicines work to 15 countries, RO and HQ • Capacity building for HAI Africa and its network • Collaborative activities in 3 countries

14. DFID/WHO/HAI-A Regional Collaboration MoH Pharm Dept Ghana, Kenya, Uganda Collaboration to improve policies and practices for access to medicines WHO Country Medicines Adviser HAI Africa

15. The EC/ACP/WHO Partnership • Focus on country and regional needs and priorities • Assess, taking into account capacities and existing support, and then plan interventions. • Technical collaboration with countries: • for influencing policies and advocacy; • for strengthening pharmaceutical systems & improve access to quality services; • for building capacity • Consolidate the work done, build on it and make it sustainable. • Promote stable collaborations and seek synergies with other key partners (UNITAID, TGF etc.) • Promote Regional and Sub-Regional Collaboration.

16. Medicines Transparency Alliance (MeTA) • A global multi-stakeholder alliance • DFID • WHO • World Bank • Private Sector (pharmaceutical Industry, generic and local manufacturers, wholesalers, retailers etc.) • Civil Society (public health, transparency and rights NGOs, grassroots networks, patients/consumer organisations, academia) • Other bilateral institutions and partners

17. MeTA (2) Expected Outputs: • Establishment of a multi stakeholders approach • Collection, generation of data on availability, price, quality and promotion of medicines • Disclosure and dissemination of data • Analysis & use of data to improve policies, advocacy & practices • Strengthening country capacity to collect, analyse, disseminate and use data on medicines • Strengthening partnerships and promote a participatory approach to policy development

18. Collaboration Outcome:The case of Tanzania • Tanzania Mainland and Zanzibar have both developed a National Medicines Policy and an implementation plan (still draft for mainland). • The Tanzania patent law has been revised to allow the use of TRIPS flexibilities that could impact on improving access to medicines. • Medicines prices and availability are currently regularly monitored in public and private sectors institutions. As a result, advocacy work for more prices transparency has been carried out. In the Eastern Africa Community countries, of which Tanzania is a member, similar findings have been recorded and duties and taxes on medicines have been reduced by 10%. • A study on medicines coverage for ongoing health insurance programs has been carried out in 2008 with the objectives of setting appropriate schemes for achieving universal medicine access. • An in-depth assessment of procurement and supply systems has been carried out in 2007 and training in drugs management has been provided in both Tanzania Mainland and Zanzibar. • Data on human resources for the pharmaceutical sector has been collected and report produced. • The Tanzania Food and Drug Administration has been supported for the development of regulatory guidelines such as for Good Manufacturing Practices, medicines donations, inspections, etc. and its staff trained. The Zanzibar Drug Act was endorsed in 2006. • Rational use of medicines has been promoted with the revision and dissemination of the Essential Medicines List and Standard Treatment Guidelines (STGs) for Mainland in 2007. The STGs for Zanzibar have been revised in 2009.

19. Qualitative Analysis WHO/HAI-A collaboration Results highlighted the following added value: Provided an Opportunity for synergies between partners with different expertise and approaches. Mechanism to improve trust and mutual respect between the Ministry of Health and Civil Society; and to allow them to work as partners in the medicines policy area. Dynamic process of consultations and exchange of information and experiences to better respond to country needs for the implementation of national medicines policies.

20. DFID Evaluation 2009 • Increased profile for essential medicines and evidence based medicines policy across programmes and partners • Increased capacity and recognition for the regulatory, procurement and supply system • Funding leveraged (domestic and external) • Enhanced regional linkages and initiatives • Improved co-ordination among government programmes, development partners, civil society and others • HAI Africa has convened and enabled a respected and credible consumer voice in medicines policy • Substantive results achieved in collaborative work – joint research, policy and well co-ordinated advocacy

21. THANK YOU FOR YOUR COLLABORATION 21