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This technical briefing seminar in November 2009 in Geneva focused on the Good Governance for Medicines program in the Eastern Mediterranean Region. It highlighted observations, progress, common strengths, gaps, and complementarity with other programs. The seminar emphasized transparency, framework, country support, and stakeholder involvement.
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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
Observations • Global supplier of crude oil and natural gas • Suffers from numerous wars and emergency situations • Comprises a mix of richest and poorest countries
Medicines • 40% of total health expenditures • Up to 30% of MOH budgets • Out-of-pocket expenditure high (up to 74%)
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
GGM Progress Other EOI
Transparency assessments Jordan GGM Framework Lebanon GGM Framework
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
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
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
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
Complimentarity with other programmes • Medicines Transparency Alliance (MeTA) • MRA support • Health system strengthening • Country Cooperation Strategies
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
More information • On EMR medicines situation • www.emro.who.int/emp • On GGM programme • www.who.int/medicines/ggm
Thank you وشكراً