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Saul Walker

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Globally, evidence shows that: Poor people lack access to essential medicines ... Globally, evidence shows, Efficiency of public procurement variable ... – PowerPoint PPT presentation

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Title: Saul Walker


1
Medicines Transparency Alliance (MeTA)
  • Saul Walker
  • Policy and Research Division, DFID
  • Jordan 4 December, 2007

2
What is the problem?
  • Globally, evidence shows that
  • Poor people lack access to essential medicines
  • Prices are too high (private sector)
  • Products are not available (public sector)
  • Quality of products variable (public and private)
  • Need to focus on distribution from port to
    patient.

3
Port to patient
  • Globally, evidence shows,
  • Efficiency of public procurement variable
  • Price mark-ups along supply chains
  • Cumulative increase of 300 not uncommon
  • Diversion and leakage
  • Counterfeits
  • 10 30 of the market in many countries

4
What are we proposing in MeTA?
  • An alliance of countries, companies, civil
    society and others to
  • Increase transparency over key price, quality,
    procurement and availability data
  • Build accountability to address inefficiencies
    and reduce excessive pricing

5
Meta Principles
  • Commitment to improving health
  • Comprehensive approach to health systems,
    including pharmaceuticals
  • Weak pharmaceutical systems result in poor
    access, quality, affordability and health
    outcomes
  • Transparency and accountability can
  • Improve system performance
  • Build confidence
  • Support equity and social justice
  • Multi-stakeholder approach needed

6
MeTA Model
  • Three levels
  • Country level secure political commitment, form
    multistakeholder group, disclose data into the
    public domain, support reform efforts
  • International level multistakeholder group
    (countries, civil society, companies and other
    private sector, donors and others) plus
    international secretariat
  • Research Network repository for key data and
    analysis, active research agenda, monitoring and
    evaluation

7
Common dimensions
MeTA countries will
  • Make a high level political commitment to MeTA
  • Form a multi-stakeholder group
  • Support civil society and others to engage
  • Progressively disclose common data on
  • Core
  • Price
  • Quality
  • Availability
  • Context
  • Supply chain
  • Affordability
  • Equity of access
  • Rational use of medicines

8
Country level
Draw on existing data, including e.g. WHO / HAI
survey, Global Fund data
Review existing data / research
Agree key deliverables - identify blocks
Disclosure and report production
Disclosure of data
Establish multistakeholder group (MSG)
Identify needs for technical assistance procurem
ent, regulation, medicines policy etc
Political Commitment
Analyse, discuss, develop recs
Disseminate, debate, act
Release MeTA report
Diagnostic work e.g Full market analysis Drivers
of change
9
Phase I pilot countries for MeTA
  • Covering all regions
  • Latin America Peru
  • East Asia Philippines
  • EE/fSU Kyrgyzstan
  • Middle East Jordan
  • South Asia India
  • Africa Uganda, Ghana
  • 24 month duration
  • Share learning across countries
  • Fine tune approach and aspirations

10
Incrementalism
  • MeTA isnt big bang
  • Model seeks common commitments from countries
    wont be achieved overnight
  • Ongoing iterations as learn from pilots

11
JORDAN- Main Findings (I)
  • Low medicines availability in public sector
    (HAI/WHO)
  • Over prescribing of brand medicines, antibiotics
    and NSAIDs prevalent
  • Need for ethical prescribing and dispensing
    guidelines and training
  • No conflict of interest statements required from
    members of procurement selection committee
  • No supervision of pharmaceutical marketing and
    promotion practices JFDA has recently launched
    guidelines

12
JORDAN-Main Findings (II)
  • Poor counterfeit statistics and lenient legal
    penalties
  • Need to improve coordination among public
    institutions through shared SOPs
  • Local Industry supportive of MeTA
  • tackle unethical promotion by multinationals
    during procurement tenders

13
Possible Activities Under MeTA
  • Increase transparency, disclosure and
    dissemination of price information
  • Civil society capacity building to support
    disclosure and accountability
  • Support ethical medicines promotion
  • by multinationals,
  • by committees during procurement tenders
  • by local manufacturers selling in the Jordanian
    private sector

14
Possible Activities Under MeTA
  • Improve acceptability of generics to public and
    physicians
  • Improved rational use of medicines led by the
    newly formed RDU at the JFDA,
  • physician prescribing behavior and standard
    treatment guidelines

15
EXISTING INITIATIVES RELEVANT TO MeTA
  • Independent JFDA established 2003
  • Pricing regulations and prices available on
    website and JFDA mobile.
  • Rational Drug Unit recently formed
  • HAI/WHO medicines survey 2004
  • National Society for Consumer Protection MOU with
    JFDA (March 2007)
  • Joint Govt. Procurement agency operational 2006.
  • Tender conditions and results on website

16
EXISTING INITIATIVES RELEVANT TO MeTA (II)
  • World Bank MENA Region interested in being MeTA
    partner (has previously supported pharmaceuticals
    reform)
  • Significant international donor financing in
    health sector
  • USAID Health Systems Strengthening Project (45
    million 2005-2009)
  • Jordan recipient of GFTAM grants for TB and
    HIV/AIDS
  • JFDA is developing a code of ethics for marketing
    and promotion
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