1. Wilbert Bannenberg Technical Director, Intl MeTA Secretariat 28 April 2010, IPC meeting, Copenhagen Medicines Transparency Alliance: improving people’s access to essential medicines 1

2. What is the Medicines Transparency Alliance? The Medicines Transparency Alliance is a unique collaboration between governments, business and civil society in seven countries, working to deliver safe, affordable medicines more efficiently. 2

3. Medicines Transparency Alliance? A global alliance between: – DFID, World Bank, WHO, private sector, civil society, professional organisations. A country-led effort in 7 pilot countries to improve access to medicines. – Government, CSOs and Private Sector An International Secretariat to support country work, and, upon request, technical assistance – 4 staff, 20 local & international consultants MeTA28/4/20103

4. What does MeTA want to achieve? MeTA goal: to increase access to essential medicines, especially for the poor in developing countries Concept of essential medicines is valid for all countries… But, after 30 years, 2 billion people are still not having access… MeTA28/4/20104

5. How does MeTA try to do this? Multi-stakeholder collaboration Country led, bottom-up Improved transparency and disclosure of all players should lead to better information & greater accountability in the supply chain MeTA28/4/20105

6. What should this lead to? All stakeholders better informed More trust, collaboration and win-win activities between stakeholders Analyzing the problems together Seeking improved, joint solutions Better policies Improved access to medicines... MeTA28/4/20106

7. Supply chain – Transparent? Source: SSDS Inc for the World Bank 4/12/20097MeTA

8. 4/12/2009MeTA8 Transparent prices & availability, but quality? Source: TI Global corruption report 2006

9. Supply chains are prone to corruption 28/4/2010 Source: TI Global corruption report 2006

10. Page 10 The Pilot New validated data on pharmaceutical sector Disclosure of data and scrutiny by multi- stakeholder group Development of policy options Policy change and implementation Changes in drug prices, availability, quality and/or promotion Improved information for management Improved processes. New validated data on pharmaceutical sector New validated data on pharmaceutical sector Disclosure of data and scrutiny by multi- stakeholder group Development of policy options Policy change and implementation Changes in drug prices, availability, quality and/or promotion Changes in drug prices, availability, quality and/or promotion Improved information for management Improved processes. Pilot ££, toolkit & technical support Policy research, shared learning Sector plans, domestic and CPs

11. Where is MeTA being piloted? 13/03/2016MeTA11

12. Pilot Countries Status Stakeholders engaged – Civil Society Coalition (8-20 CSOs) – National secretariat (1-5 staff) – MeTA Council (15-25 members, all 3 sectors) Workplan developed, being implemented Baseline, disclosure survey, pharma sector scan Documenting MeTA Too early for signs of policy reform MeTA28/4/201012

13. Who should disclose what? Government: VAT, taxes, budget, selection, quantification, Procurement agency: purchase & selling prices DRA: quality and registration data, inspection, QC lab results Private sector: prices, margins, availability, promotion codes of conduct Civil society / academics: Availability (equity), Affordability, Rational use MeTA28/4/201013

14. MeTA Toolbox Baseline surveys – Disclosure survey, Pharma Sector Scan (Harvard) – Level II household, facility surveys (WHO/Harvard) – Multi-stakeholder collaboration (IDS - new) Political analysis mapping (Michael Reich) Supply chain mapping (MIT Zaragoza) Pricing, affordability, components (HAI/WHO) Quality (Minilab surveys, DRA & transparency) Promotion (HAI-new) Rational use (INRUD) MeTA13/03/201614

15. Where are we in the MeTA pilot timeline? 2007 – preparing for MeTA May 2008 – Global launch of MeTA Until March 2009 – setting up country pilots Since 2009 – implementing MeTA Q1 2010 – External evaluation ← ← Fora: Ug 25 May, Zm 27 May, Pe 3 June, KG ? 28 June – 2 July 2010 – Global Forum (London) 30 Sept 2010 – end phase 1; start MeTA-2 MeTA28/4/201015

16. Preliminary outcome of evaluation Multi-stakeholder process is making progress in the 7 MeTA pilot countries Some level of engagement by all three sectors (albeit at different levels in the countries) Process of gathering information around the supply chain and barriers is well underway. Too early to tell whether the availability of robust information will lead to more informed policy development There signs that the MeTA process is leading to increased focus on, and broader discussion of medicines policies MeTA28/4/201016

17. Collaboration in countries? MeTA Council includes partners WHO (NPO’s) World Bank Bilateral donors (DFID, NL, others) National health review/reform process Potential for collaboration with other partners having transparency problems in supply chain MeTA28/4/201017

18. Comparing MeTA and GGM Pilot 2008-2010 7 countries Measures price, quality, access etc Existing methodologies 1-phase Pilot 2 year 10 yr Commitment DFID MeTA concepts GGM started 2004 26 countries Prevents vulnerability for corruption New GGM tools 3-phase process Open ended WHO guidelines & framework 13/03/2016MeTA18

19. MeTA and GGM (2) Multi-stakeholder, country-led approach Intl Advisory Group National Forum, Council National Secretariat DFID (pilot funding) Value- and discipline- based approach Global Advisory Group GGM Steering Committee GGM Task force Germany, DFID, others 13/03/2016MeTA19

20. Transversal topics: Procurement & transparency (World Bank interest in Southern/Eastern Africa) Drug regulation & transparency (aiming for guidelines; a transparency track at ICDRA Dec 2010?) Comparing pricing studies: so what? MeTA28/4/201020

21. MeTA Global Forum, London, 29 June-1 July 2010 Objectives – To share lessons learned on access to medicines, transparency, sharing of data, information and accountability, and – To inform stakeholders on the implications of improving governance in the medicines supply chain Run-up: WHA, Global Health Council Want to attend? admin@metasecretariat.orgadmin@metasecretariat.org MeTA28/4/201021

22. MeTA-2 DFID still defining the future of MeTA UK General Elections 6 May 2010 DFID next steps on MeTA in mid May May take some time for new government to consider DFID’s proposals & announce plans – Expand – Consolidation – Slim down – Stop MeTA28/4/201022

23. Thank you! Wilbert Bannenberg, wilbert@metasecretariat.org Mobile: +31-6-20873123 www.MedicinesTransparency.org MeTA28/4/201023

24. Contextual information collected [From surveys rather than from disclosures] Supply chain operations – Supply chain mapping data Affordability – Generic utilization data, cost of treatment (related to salary) Equitable access – Data on health and medicines expenditure by income group, and experiences of treating key illnesses by income group. Rational use – Household survey data, prescribing data in health facilities MeTA 28/4/201 024