Medicines Transparency Alliance

1. 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

2. MeTA hypothesis Transparency Access to medicines improved Improved accountability Improved accountability Reliable information on medicines policies Improved governance Improved governance Multi-stakeholder approach Improved efficiency Improved Policies Improved efficiency

3. MeTA 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.

4. About 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. • .

5. MeTA 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;

6. Private 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 …

7. Civil Society at country level Health NGOs/CSOs (domestic & international) Medicines NGOs/CSOs Transparency NGOs Patient Groups Consumer Groups et al …

8. Government at country level Ministries of Health Medicines Regulators Government Insurance Funds Government Procurement Chief Pharmacists/Medical Officers et al …

9. 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

10. 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

11. 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

12. 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.

13. Lessons 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.

14. MeTA 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;

15. Main areas of technical work

16. Main areas of Civil Society activities