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EMP Technical Briefing Seminar Good Governance for Medicines programme EMRO Regional Perspective

EMP Technical Briefing Seminar Good Governance for Medicines programme EMRO Regional Perspective November 2009, Geneva, Switzerland. Essential Medicines and Pharmaceutical Policies Unit November 2009 – Good Governance for Medicines 1. WHO Eastern Mediterranean Region 22 countries.

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EMP Technical Briefing Seminar Good Governance for Medicines programme EMRO Regional Perspective

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  1. EMP Technical Briefing Seminar Good Governance for Medicines programme EMRO Regional Perspective November 2009, Geneva, Switzerland Essential Medicines and Pharmaceutical Policies Unit November 2009 – Good Governance for Medicines 1

  2. WHO Eastern Mediterranean Region22 countries

  3. Classification of EMR countries by income(World bank 2009)

  4. Observations • Global supplier of crude oil and natural gas • Suffers from numerous wars and emergency situations • Comprises a mix of richest and poorest countries

  5. Life expectancy increasing

  6. Infant mortality decreasing

  7. Health expenditures

  8. Out-of-pocket expenditures

  9. Medicines • 40% of total health expenditures • Up to 30% of MOH budgets • Out-of-pocket expenditure high (up to 74%)

  10. Diversity in medicines situation: examples • Lower middle income country (Pakistan) with large number of medicines manufacturers • High income country (Qatar) no medicines producers • Lower middle income country (Jordan) has FDA with over 400 staff • Upper middle income country (Libya) with limited regulatory capacity

  11. GGM Progress Other EOI

  12. Transparency assessments Jordan GGM Framework Lebanon GGM Framework

  13. Common strengths • Political commitment to increasing access to medicines • Presence of medicines laws in all countries • Active technical committees in various functions • Registration systems • Essential medicines lists • Qualified human resources

  14. Common gaps • Policy on conflict of interest • Declaration • Management • Sanctions on violation • Written guidelines on membership in committees (including rotation policies) • Standard operating procedures (especially for decision making process) • Public availability of information

  15. Common gaps (cont’d) • Control of medicines promotion • Direct to consumer • Medical professionals • Civil society engagement • Presence of suitable codes of conduct • Civil service • Professional association • Manufacturers association • Socialization of codes of conduct

  16. Common gaps (cont’d) • Sanctions on reprehensible acts • Enforcement mechanisms • Guidelines on interaction between public officials and private sector • Independent complaints mechanism • Protection of whistle blowers • Limited resources

  17. Complimentarity with other programmes • Medicines Transparency Alliance (MeTA) • MRA support • Health system strengthening • Country Cooperation Strategies

  18. EMRO GGM country support • New and experimental field • Not limited to developing countries • Is not isolated from overall governance system • Encourages sharing views and experiences across countries • Growing roster of human resources • Technical documents in Arabic • Stakeholder involvement from outside the medicines sector • Sum of WHO technical support ≈ sum of lessons learned in countries

  19. More information • On EMR medicines situation • www.emro.who.int/emp • On GGM programme • www.who.int/medicines/ggm

  20. Thank you وشكراً

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