L’ALLIANCE DE LA TRANSPARENCE DES MEDICAMENTS ( MeTA )

1. L’ALLIANCE DE LA TRANSPARENCE DES MEDICAMENTS (MeTA) Présentée par Mme Deirdre DIMANCESCO Département Médicaments essentiels et produits de santé, OMS Séminaire sur les Politiques Pharmaceutiques à l’attention d’Experts francophones. 15 avril, 2013

2. MeTAobjectif • MeTA a pour objectif d’améliorer l'accès aux médicaments de qualité en augmentant la transparence du secteur pharmaceutique par la collecte de données fiables, puis d’une analyse solide, et enfin en divulguant pour le plaidoyer, le dialogue politique entre les parties prenantes.

3. L’hypothèseMeTA Informations recueillies, pertinentes et robustes Informations mise à disposition des acteurs concernés Le partage et l’analyse des données des différents secteurs. Les politiques et la mise en œuvre fondées sur des preuves Améliorer l’accès aux médicaments.

4. Raisonnement • Le disfonctionnement des marchés et des chaînes d’approvisionnement, restreint l’accès à des médicaments abordables, de qualité et approprié. • Le manque d’informations et ?…, fausser la concurrence, permet la pratique de la corruption, entrave la gestion appropriée and encourage l’usage irrationnel des médicaments. • Medicinesaccount for 3 of the 9 mostcommon causes of inefficiency in healthexpenditure. • “[R]éduire les dépenses inutiles sur les médicaments, les utiliser de manière plus appropriée et améliorer le contrôle de la qualité, pourrait sauver 5% des dépenses accordées à la santé de chaque pays” Rapport Mondial de la santé 2010

5. Les principesdirecteurs de l’OMS • Il y a plus de 60 ans, qu’il a été prouvé que fournir une information transparente ainsi que la participation du public à l’élaboration des politiques de santé sont essentiels. • “L’’opinion publique éclairée et une coopération active de la part du public sont d’une importance capitale dans l’amélioration de la santé des personnes”. (Constitution de l’Organisation Mondiale de la Santé). • Les preuves et les informations sur les politiques pharmaceutiques sont des domaines d’activité prioritaire. (Stratégie pharmaceutique de l’OMS 2008-2013). • La résolution de l’Assemblée mondiale de la santé sur le renforcment du dialogue national afin d’instaurer des politiques de santé, des statégies et des plans d’action plus solides. (WHA64.8)

6. L’engagement de la DG de l’OMS • Le 16 janvier 2012 lors de la 130 ème session du ConseilExécutifDirectriceGénéraldel’OrganisationMondiale de la Santé HO Director-General addresses the Executive Board Report by the Director-General to the Executive Board at its 130th Session,16 January 2012 • “[P]ublichealth breaks new ground by tackling a long-standing need. That is: to build national capacity to generate and analyse basic health data. Without information, at country level, we can never have accountability. Without information, we can never know what a “best” or a “wise” investment really means. Without information, we are working in the dark, pouring money into a black hole.”

7. Global Commitments • The United Kingdom will host the 2013 G8 Summit in Lough Erne, Northern Ireland from 17 - 18 June. • Prime Minister David Cameron wants discussions to focus on ways in which G8 nations can support the development of open economies, open governments and open societies, including: • promote greater transparency.

8. Universal Health Coverage • Transparency and good governance are recognized as significant factors for achieving universal health coverage. • Communication is essential so that people are actually aware of their entitlements. Information to enable transparent monitoring is key. Background document to the Ministerial Meeting on UHC

9. MeTA and GGM GGM MeTA Ethics/anti-corruption Rule of law/regulation Transparency Participation Accountability Voice Efficiency

10. About MeTA • 7 countries: • Ghana, Jordan, Kyrgyzstan, Peru, Philippines, Uganda and Zambia. • Pilot Phase from 2008-2010 • Established multi-stakeholder platforms • Collected baseline data & capacity building for it; • Initiated/tested transparency initiatives • Phase 2 from 2011-2015 • Address information gaps • Transparency and disclosure • Convert dialogue into policy recommendations and interventions

11. MeTA structure • WHO and Health Action International provide: • Project coordination, administration • Technical support through the provision of data collection, analysis & dialogue methodologies, capacity building and policy guidance. • MeTA councils • Public sector, private sector, civil society, academics • WHO Country Office support • Plan and implement MeTA workplan

12. MeTA process Evidence based policy Policy dialogue Dissemination of data and messages Multi-stakeholder dialogue Advocacy Voice

13. Types of information Medicines Registration and Quality Assurance • Market registration procedures and registration status of all medicines • Good Manufacturing Practice (GMP) outcomes • Quality assurance processes in public and non-profit tenders • Quality assurance data during registration or procurement • Routine quality testing and adverse event monitoring Medicines Availability • Volume and value of medicines procured • Availability of medicines to consumers • Routine audits for public, private, and non-profit medicines outlets

14. Types of information 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 Medicines use and Promotion • Standard treatment guidelines • Essential medicines list • Medicines promotion regulations, policies, and industry practices

15. Successes from the pilot • The National Medicines Regulatory Authorities of Kyrgyzstan, Uganda and Zambia created web-sites • registered medicines list, 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 competition is meant to reduce prices of medicines. • In the Philippines MeTA contributed to the enactment of the "Cheaper Medicines Act" 2008 and to the establishment of an e-procurement system for medicines. • MeTA supportedthe country to develop Standard Treatment Guidelines for key diseases.

16. Lessons learned from the pilot • Multi-stakeholder working is 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.

17. Phase 2 targets • Decrease mean price of essential medicines by 10% • Increase average availability by 10% • Improve efficiency • Build on the foundations of the MeTA pilot • Focus on policy dialogue in alignment with country priorities

18. Main areas of technical work

19. Main areas of Civil Society activities

20. Factors for success • Government commitment • Country driven process • True multi-stakeholder collaboration