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Pilot Countries View from the Civil Society. MeTA GhanaMeTA Philippines MeTA JordanMeTA Uganda MeTA KyrgyzstanMeTA Zambia MeTA Peru. MeTA Ghana. Presenter: Charles Allotey Executive Director-Health Access Network Ralph Ahiabu - PowerPoint PPT Presentation
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Medicines Transparency Alliance
MeTA Ghana MeTA Philippines
MeTA Jordan MeTA Uganda
MeTA Kyrgyzstan MeTA Zambia
MeTA Peru
Pilot CountriesView from the Civil Society
21/04/23 1
Medicines Transparency Alliance21/04/23 2
MeTA Ghana
Presenter: Charles Allotey Executive Director-Health Access Network
Ralph Ahiabu Director of Programs - DeSMAS
Medicines Transparency Alliance21/04/23 3
Summary Analysis at start of MeTA
What were the needs and issues in your specific sector at the start of MeTA?Lack of organized civil society coalition directly involved in issues related to access to medicines.Lack of capacity among civil society organizations to deal with medicines issues, especially where technical in nature.Ignorance among community members on issues surrounding medicine prices, quality, availability and access in general.Patients and consumers lacked information and power to realize their rights to healthcare and medicines - e.g. rights in Patient’s Charter, benefits and quality of care under National Health Insurance Scheme. Inadequate linkages and collaboration between the public, private and civil society sectors.
Medicines Transparency Alliance
Major milestonesWhat milestones have been achieved during the MeTA pilot phase?Built network and made linkages amongst civil society organizations across all 10 regions of Ghana.
Enhanced capacity of network members on access to medicines and transparency issues - e.g. workshops at various levels.
Established online social network (NING Group) to facilitate communication and mutual visibility of network members.
Launch of Ghana MeTA Civil Society Group by the Deputy Minister of Health.
Developed 4 educational posters targeted at consumers on relevant medicines issues in Ghana – translated into 7 major local dialects.
Undertook community awareness-raising activities, including public fora and radio programs.
Held a detailed mid-term review; developed forward plans for 2010-11.
In sum: We have achieved a lot, with limited resources. And more is planned!21/04/23 4
Medicines Transparency Alliance
Successes
What were the successes for your sector during the MeTA pilot phase?Enthusiasm has been created among community groups who are now able to engage in discussions on medicines issues.
Trust and collaboration are emerging between CSOs and public sector agencies on transparency and access to medicine issues.
We have enhanced awareness among consumers on patients responsibilities, counterfeit and substandard medicines, and the rational use of medicines.
We have a database and linkages at national, regional, district and community levels that will facilitate information sharing and joint advocacy, right across the country.
21/04/23 5
Medicines Transparency Alliance
Challenges
What challenges has your sector endured during the MeTA pilot phase?Sustaining interest of network members to engage actively in the MeTA process following the establishment of the network.
Aligning individual and organizational interests of network members to the core objectives of MeTA.
Demands made on members engaged in the organizational process were very high due to the sacrificial nature of the work.
Limited resources constrained the creative and innovative ideas that would have enriched the overall outcome. For example, we had hoped to engage in some operational research on medicine related issues in communities nationwide. This would have engaged network members proactively, resulting in (bottom up) data to complement that at policy level (top down).
21/04/23 6
Medicines Transparency Alliance
Lessons Learned
What are the lessons that your sector has learned from MeTA?Non-health professionals within the CSO network are able to engage with a wide range of stakeholders and the media on issues relating to transparency and access to medicines – The CSO network includes those working on governance, corruption, women’s rights, children’s rights, community health, etc.
The CSO sector is gaining valuable knowledge and experience through participation in the MeTA multi-stakeholder process.
Working with different stakeholders is possible and offers a better opportunity to address challenges than one stakeholder group acting alone. **For example, on [issue x]**
Opportunity created through the MeTA process to work with people with diverse professional backgrounds, skills and expertise resulted in achieving better outcomes. **For example…we achieved…**
21/04/23 7
Medicines Transparency Alliance21/04/23 8
Thank you Name of presenter Charles Allotey
Job Title Ghana MeTA CSO Group Coordinator Email: kallotey@gmail.com, han.ghana@gmail.com
Mobile number: +233 (0)244280284
Skype: kallotey
Website: www.hanghana.org
Medicines Transparency Alliance21/04/23 9
MeTA Jordan
Dr Abdel Fattah Al KilaniMeTA Council Member
Medicines Transparency Alliance
CSO Sector overview
A total of 240 societies are registered officially in the ministry of social development, yet not all are active neither represents patient groups
The history in working with the Civil Society Organizations in Jordan started in March 2008 when (HAI) facilitated a meeting/workshop for the CSO with the objective of bringing civil society groups together to take a decision as a group to form an independent alliance that will work effectively to enhance its role in policy planning and presenting the WHO/HAI survey results to them
21/04/23 MeTA 10
Medicines Transparency Alliance
Summary Analysis at start of MeTA
Limited CSO role in influencing healthcare strategies and policies in Jordan
Limited effectiveness and authority in solving patients’ problems regarding availability and affordability of medicines
Major limitation on the CSO’s fundraising ability due to restriction by the Ministry of Social Development on the number of fundraising events (only two annually)
There is an absence of coordination or sharing of expertise and experiences among the various CSOs
21/04/23 11
Medicines Transparency Alliance
Summary Analysis at start of MeTA Cont.
At the early stage of MeTA, the MeTA/ CSO committee has identified the following areas to include in the CSO workplan:
Priority Area 1: Engaging Civil Society Organizations (CSOs) to work together on promoting Transparency in the Medicines Supply Chain and improve Access to Medicines
Priority Area 2: To continue to build capacity among CSOs to analyze data and explore and recommend policy options around medicines availability and affordability, promotion and prescribing practices, RDU and the use of generics
Priority Area 3: Communication and Coordination
21/04/23 12
Medicines Transparency Alliance
Major milestones
The very first activity was conducted to map and identify CSOs to assess their ability and willingness to work together and to engage them with the MeTA council, this activity has set the baseline work for the CSOs in Jordan
Workshop on building capacity of CSOs in order to strengthen their ability to monitor and increase accountability of all stakeholders regarding medicines prices, availability, selection
and quality of medicines in the public and private sectors . The main objective of the workshop was to introduce CSOs to medicines regulations and health polices
Participate in the Harvard Flagship course
Participate in the country exchange visit to the Philippines
Conduct a training on advocacy and communications in improving access to essential medicines
21/04/23 13
Medicines Transparency Alliance
Success
The MeTA Council has identified Building capacity in pharmaceutical policies for CSOs as one of its three main areas in the country workplan
The CSO committee has drafted a CSO workplan according to the three major priorities in the overall national MeTA workplan in Jordan, “Build capacity of (CSOs) to monitor and increase accountability of all stakeholders concerning the prices, availability, selection and quality of medicines in the public and private sectors
The specific CSO workplan was approved and a MOU has been signed
CSOs are engaged in the MeTA initiatives
A nucleus of CSO coalition started to form
21/04/23 MeTA 14
Medicines Transparency Alliance
Success Cont.
The CSO level of engagement with the MeTA process is moving forward gradually
At the start of the process there was limited activities and meetings but since November 09 they became more engaged
The CSO representative and patient groups actively participated in all MeTA Jordan activities ( MeTA launch, MeTA forum, many workshops)
The voice of patient is becoming heard from policy makers in the public sector/ example MS patient society
Patient group representatives has 2 seats in the MeTA council
A workshop on advocacy and communication was organized for CSOs with emphasis on team building activity, communication skills, persuasion & negotiation skills, advocacy, how to form a Coalition and engagement with the Media
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Medicines Transparency Alliance
Challenges
Poor role of the CSOs in the decision making process
Few of the patient groups societies budget is partially supported by pharmaceutical companies
CSOs are still not represented in medicines related committees such as : the pricing committee, higher drug committee / JFDA
Limited CSOs role in improving patient counseling
Encouraging new patient groups societies to join the coalition is a challenge
Shortages of medicines availability in public health and high prices of medicine in the private sector
21/04/23 MeTA 16
Medicines Transparency Alliance
Challenges Cont.
Limited participation of CSO representatives in Data disclosure survey tool
MOU has taken some time to be approved and signed, accordingly funds were not available for CSO until a later stage
CSOs need a coordinator to follow up on the activities listed in their work plan
Reach a common understanding on the role of the patients focusing on the regulations ,distribution of medicines and rational drug use
21/04/23 17
Medicines Transparency Alliance
Lessons Learned
A budget for a CSO coordinator should have been listed in the CSO workplan
CSO engagement with the MeTA process complements the overall picture and highlights patients’ need
Capacity for CSOs to engage more effectively needs to be built
To engage parliament in the MeTA council process
There should be an organized structure for the CSO coalition and the CSO already started working towards forming an organized way on, also formed a three committees on their meeting on the 22 June 2010
21/04/23 18
Medicines Transparency Alliance
Lessons Learned Cont.
More participation of CSO representatives in Data disclosure survey tool should have been considered
To involve media more
The stakeholders started to understand each others perspectives CSOs realized that this should have been happened earlier
The CSO engagement with the process complement the overall picture and uncovers the patients’ needs
21/04/23 19
Patient Groups NGOs MediaDiabetes Association
Jordan cancer society
Jordan ass. For hemophilia & Thalasemia
Environmental Protection Society
Jordan Association for Consumer Protection
AL GHAD newspaper- Jordan
cerebral palsy foundation
Kidney patients friends society
Jordan ass. For diabetic and cancer pt.
Jordanian society for tonsumer protection
Jordan medical association
IBN-CINA FOR CELEBRAL palsy
Jordan Rose of Hope Society for arthritis pt.
Jordanian psychiatric rehabilitation society
Jordan pharmacist association
Garden and Home Association
liver patients friends society
Jordanian friends of behcet's disease pt. society
Jordan society for phenyl-keton urea
Jordan cultural ass. For development of law and legal capacities
multiple sclerosis society
The Jordanian friends of cystic fibrosis association
Examples of Interested Civil Society Organizations
Medicines Transparency Alliance21/04/23 21
Thank you
Dr Abdel Fattah Al Kilani
Consumer Protection Organization Representative Email jor_vet_asso@yahoo.com
Mobile number +962 799958059
Website www.meta.jo
Medicines Transparency Alliance21/04/23 22
MeTA Kyrgyzstan
Burul MakenbaevaCSO Coordinator, Kyrgyzstan
Medicines Transparency Alliance21/04/23 23
Summary Analysis at start of MeTA
What were the needs and issues in your specific sector at the start of MeTA?Mission of Mental Health and Society is the return of people with mental disorders into the community of closed psychiatric institutions. Access to medicines in the community is a main matter. Since 2006 Drug Package of SGP for patients with mental disorders has been implemented at the primary health care level but patients were not informedAnd a high level of mistrust between the sectors, the myths and stereotypes from all partiesThe lack of communication between NGOs and the public sector: only letters - ineffective communicationEverything was a thick and gray clouds!
Medicines Transparency Alliance
Major milestones
What milestones have been achieved during the MeTA pilot phase?Establishment of CSO Coalition, trainings and small grants surveys
Studies have begun sowing clouds, the picture became more clear, what works and how, and why if not working
The regular communication is created
Building trust and respect
21/04/23 24
Medicines Transparency Alliance
Successes
What were the successes for your sector during the MeTA pilot phase?NGOs participate in public procurement process at the national level
The initiative of NGO inclusion comes from government
All Coalition members have full access to information
Building trust with the public media, local authorities, local community
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Medicines Transparency Alliance
Challenges
What challenges has your sector endured during the MeTA pilot phase?
Lack of capacity and knowledge on drug circulation and lack of legal capacity
The diversity of interests and different ideas of how to act in coalition
Discussion took a long time and it was a risk to lose interest
Change Leadership
21/04/23 26
Medicines Transparency Alliance
Lessons Learned
What are the lessons that your sector has learned from MeTA?
Identification of interests and motivations
Maintaining a balance of interests to develop a unified strategy
Solidarity and broad cooperation including the International MeTA
The necessity to react quickly to unforeseen difficulties
Flexibility
Full involvement of stakeholders from the beginning
21/04/23 27
Medicines Transparency Alliance
Lessons Learned
Topics:
Availability of psychotropic medicine under the State Guarantee Program in Bishkek and Osh Cities. (PF Public Health in partnership with PF New View on Mental Health).
Availability of medicine under the State Guarantee Program in rural areas based on the example of Kochkor District, Naryn Province (PF Harmony Plus in partnership with Village Health Committee (Kochkor District, Naryn Province), PF Etiyat (Issyk-Kul Province) and NGO Door Eli (Bishkek).
Availability of vitally important medicines in children’s residential institutions (League of Child Rights Defenders)
Study of State Procurement Practice at the National Cancer Center (PF People Living with Chronic Myeloleukemia)
Rationality of medicine use at Bishkek hospitals based on the example of Hospitals #1 and #6 (NGO For Safe and Rational Use of Medicine)
Availability of diabetes medicine in Chui Province.
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Medicines Transparency Alliance21/04/23 29
Medicines Transparency Alliance21/04/23 30
Medicines Transparency Alliance21/04/23 31
MeTA Peru
Marco Alegre Romero – Coordination CSOs
Medicines Transparency Alliance21/04/23 32
Analytical Summary at the beginning of MeTA
What were the needs and problems in this specific sector at the beginning of MeTA?
43% of the country's population lacks access to essential medicines.
CSOs had not fluent access to essential critical information by the state and the private sector in relation to access to medicines.
There was limited space for Civil Society participation to generate public policy on essential medicines.
Absence of a National Policy for Generic Medicines.
Weakness in the mechanisms of transparency and accountability of public administration in the early stages of the medicines supply chain.
Medicines Transparency Alliance
Main mailstones
What milestones have been reached during the MeTA pilot phase?
Being able to start working together to address access to generic medicines, between the State, Civil Society and Private.
Forming a Coalition of Civil Society Organizations
To be able to formulate a national project by the CSOs Coalition and users, to train leaders in monitoring access to medicines.
21/04/23 33
Medicines Transparency Alliance
Successes
Which were the successes of the sector during the MeTA pilot phase?
Raise the issue about lack of access to medicines at national and regional levels.
Reach an agreement with the University for the development of post-graduate courses to train leaders in monitoring access to medicines.
Manage to jointly formulate a project that contribute to access of medicines among the national and regional CSOs
The engagement of 18 out of 25 regions of the country in the implementation of the project
21/04/23 34
Medicines Transparency Alliance
Challenges
What challenges has this sector confronted during the MeTA Pilot Phase?
To provide a better positioning of the CSOs on the National Council and the Executive Board of META Peru.
To achieve a cohesion between CSOs – Users, and technical people.
To engage active leaders in monitoring access to medicines at the national level articulated in the network.
21/04/23 35
Medicines Transparency Alliance
Lessons Learned
What lessons has this sector learned from MeTA? You can better address the problem of access to essential medicines when working in collaboration with the state, civil society and the private sector.
The Civil Society can improve the quality of dialogue and negotiation with the public and private sector when it has continuous access to information.
The Civil society is divided according to the interests of each of its members.
The regions of Peru would like to address the problems ofaccess to essential medicines but do not have strategies and information to give an appropriate response.
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Medicines Transparency Alliance21/04/23 37
Thank you
Marco Alegre Romero
C-electrónico: malegre84@yahoo.com
Número Celular: (51) 1997273931
Skype:
Página Web: www.forosalud.org.pe
Medicines Transparency Alliance21/04/23 38
MeTA Philippines
Cecilia C. SisonCoordinator, Coalition for Health Advocacy and TransparencySecretary, MeTA Council - Philippines
Medicines Transparency Alliance21/04/23 39
Summary Analysis at start of MeTA
What were the needs and issues in your specific sector at the start of MeTA?
Loose network of CSOs with an overriding agenda, despite differences in programs, priorities & mode of engagement
Common advocacy to improve access to low-priced medicines and better health services for the poor
Range of specific concerns: patients’ rights, high medicine prices, parallel importation, restrictions in current IPR Code
Generally, adversarial stance towards MNCsDisappointment over inefficiencies and inconsistent efforts of
government to champion patients’ rightsEfforts focused on ensuring passage of the Cheaper Medicines
Law, after it was bypassed in previous Congress
Medicines Transparency Alliance
Major milestones
What milestones have been achieved during the MeTA pilot phase?
Organization of the Coalition for Health Advocacy and Transparency (CHAT); membership expansion
Representation of the CSO sector in the MeTA Council Participation in government-initiated advisory and oversight
committees for Cheaper Medicines Act CHAT Discussion Series, CHAT Official Statements,
individual CSO research & advocacy projects, skills training Engagement in multi-stakeholder programs, discussion
groups and advocacy activities
21/04/23 40
Medicines Transparency Alliance
Successes
What were the successes for your sector during the MeTA pilot phase?
Engagement as a co-equal stakeholder Recognition as the health coalition in the CSO community,
and the voice of patients and consumers Deeper appreciation of a range of concerns: quality, health
financing, marketing and promotion, regulation, price control Broader appreciation of the perspectives of other
stakeholders Access to resources / funding to implement programs
21/04/23 41
Medicines Transparency Alliance
Challenges
What challenges has your sector endured during the MeTA pilot phase?
Sustaining interest of members to participate in activities Low budget utilization and delayed implementation of
projects in current Work Plan Need to increase public awareness of CHAT advocacies
and programs Expansion of membership base to the regions Implementation of individual CSO projects Need for direct and quick access to funds for projects and
operations
21/04/23 42
Medicines Transparency Alliance
Lessons Learned
What are the lessons that your sector has learned from MeTA?
Maximizing varied roles of civil society : watchdog, disseminate information by maximizing reach, feedback from the grassroots, support govt & industry initiatives
Importance of trust, transparency and openness when interacting with other stakeholders and groups
Synergy can result when groups of varying perspectives work together on a common advocacy
Continuous dialogue helps stakeholders better appreciate positions and motivations of other groups
Exchange of information with similarly situated groups must be encouraged
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Medicines Transparency Alliance21/04/23 44
Thank you
Cecilia C. Sison
CSO Coordinator Email: ceciliacsison@yahoo.com
Mobile number: +639175295718
Website: www.metaphilippines.org.ph
Medicines Transparency Alliance21/04/23 45
MeTA Uganda
Rosette MutambiCSO Coordinator
Medicines Transparency Alliance21/04/23 46
Summary Analysis at start of MeTA
What were the needs and issues in your specific sector at the start of MeTA?
Access to medicines:- Availability of medicines; Medicine prices; Monitoring and accountability; Rational use
Create public awareness; increase transparency in medicine supply chain (policy and practice), roles of key medicine sector institutions (NDA,NMS etc)
CSO coordination and communication
Capacity building of CSOs for effective participation in medicine sector
Representation of CSOs on the different decision making structures
Medicines Transparency Alliance
Major milestones
What milestones have been achieved during the MeTA pilot phase?
Two CSOs HEPS and Uganda National Health Consumers Organization (UNHCO) were selected to sit on MeTA Council
Rosette Mutambi (Executive Director HEPS) was chosen as first rotating Co-Chair of MeTA Uganda Council.
At inception of MeTA in early 2008, HEPS was chosen to present CSOs on Ministry of Health Technical Working Group on Medicines Procurement and Management
CSOs empowered to meaningfully participate in the planned multi-stakeholder activities in Uganda and feel more comfortable to engage with national policy processes
MeTA has provided CSOs with access to government bodies
Work plan on track
21/04/23 47
Medicines Transparency Alliance
Successes
What were the successes for your sector during the MeTA pilot phase?
For the first time ever, the Ministry of Health invited CSOs to the National Pharmaceutical Sector Strategizing Workshop in July/ August 2009
Increased public debate and reporting on medicine issues for example stock outs
Increased collaboration between government bodies, private sector to improve access to medicine
MeTA council provided useful input into materials used for the Stop Stock outs campaign
Shared responsibility among CSOs in implementing work plan
21/04/23 48
Medicines Transparency Alliance
Challenges
What challenges has your sector endured during the MeTA pilot phase?
Constant communication which is required to maintain interest and to keep members updated on MeTA issues is a challenge
High member expectations of funding
District CBOs not yet aware of MeTA
Increased pressure from public to CSOs to demand/cause change
21/04/23 49
Medicines Transparency Alliance
Lessons Learned
What are the lessons that your sector has learned from MeTA?
There is shared responsibility by all stakeholders to increase access to medicines and all sectors have a contribution
MSP helps sectors to understand role of others and their key competencies in improving access to medicines
MSP important in increasing transparency and accountability
An enlightened Civil Society is crucial to advocacy
21/04/23 50
Medicines Transparency Alliance21/04/23 51
Capacity Building Workshop
CSO participants of Capacity Building Workshop
Medicines Transparency Alliance21/04/23 52
Thank you
Rostte Mutambi
Executive Director HEPS Uganda/ Co-chair MeTA Uganda Email: heps@utlonline.co.ug; rosemutambi@gmail.com
Mobile number: +256 782 371401
Skype:
Website: www.heps.or.ug
Medicines Transparency Alliance21/04/23 53
MeTA Zambia
Dimuna Phiri
Paralegal Officer- Zambia AIDSLaw Research and Advocacy Network
Medicines Transparency Alliance21/04/23 54
Summary Analysis at start of MeTA
What were the needs and issues in your specific sector at the start of MeTA?
*To build capacity amongst CSO’s so as to enable them to engage and deliberate in the multi stakeholder process*
To acquire advocacy skills
To understand policy formulation and analysis as well as government structures and functions
To understand the drug supply chain in Zambia
To acquire research and budget tracking skills
To understand the Multi Stakeholder Process
Medicines Transparency Alliance
Major milestones
Advocacy training was conducted
Drug supply chain training was conducted
A training on policy formulation and analysis as well as the functions of government and it’s structures was conducted.
15 Civil society organization are fully committed in the coalition
MeTA CSO’s took part in the radio programs and television documentary.
21/04/23 55
Medicines Transparency Alliance
Successes
MeTA CSO secretariat is in operation
The Work-plan was successfully developed and approved
An advocacy strategy has been developed
Increased knowledge amongst CSO’s on medicine issues to participate in various opportunities and forums.
Developed networks with the private government and similar campaigns such as the Stop Stock Out Campaign.
MeTA CSO has legitimacy because it has representation from the community.
Multi-dimension civil society participation.(e.g. governance, faith based, media and human rights organisations.)
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Medicines Transparency Alliance
Challenges
The implementation period of the work-plan was too constraining.
Dividing time between respective organisational duties and MeTA activities was a challenge
Delay in the disbursement of funds
Health issues are complex and time is needed to build adequate capacity to understand them.
Co-opting organisations in the MeTA CSO process was a challenge on inception
21/04/23 57
Medicines Transparency Alliance
Lessons Learned
The work plan was over ambitious (time-frame)
Some trainings were too technical.
Fluctuation in exchange rates affected the budget
Harmonizing MeTA Zambia and MeTA CSO work-plan was a challenge
There was under budgeting during the budget planning process
There is so much that MeTA CSO’s can do as regards to issues on health in Zambia.(evidenced from the trainings)
There is a need to share and link with other similar campaigns.
CSO’s became aware that they had a role to play in the pharmaceutical sector
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Medicines Transparency Alliance21/04/23 59
Thank you
Name of presenter : Dimuna Phiri
Job Title: Paralegal Officer- Zambia AIDSLaw Research and Advocacy Network
Email: dimunaphiri@gmail.com
Mobile number:+260979092885
Website: www.metazambia.org
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