Concept and structure of MeTA

Wilbert Bannenberg Technical Director Concept and Structure of MeTA 21/7/2009

What is MeTA? A global alliance between: DFID, World Bank, WHO, private sector, civil society, professional organisations. Multi-stakeholder collaboration Government, CSOs and Private Sector Working in 7 pilot countries to improve access to medicines. An International Secretariat to support country work, and, upon request, technical assistance. 4/12/2009 MeTA

MeTA hypothesis? Cooperation and commitment by the 3 main stakeholder groups to disclose and jointly analyse data around the medicines supply chain will lead to better access to essential medicines 4/12/2009 MeTA

Transparency? Improving information access, scrutiny and use, in order to support the development of viable, efficient medicines markets and supply systems that benefit all developing country consumers Transparency = not only disclosure of the price, quality, use, availability of medicines; but also: how to use the information to identify barriers, and to agree on solutions 23/06/2009 MeTA

Key data collected in MeTA [Mainly through disclosures by stakeholders] Price data of medicines Procurement prices (~ MSH Intl price indicator) Retail prices private, public sector (~WHO/HAI methodology) Components (tax, VAT, margins, profit etc) Quality and registration status Medicines, GMP plants, GDP wholesalers, Licensed outlets Availability (basket) Promotion (being developed) 23/06/2009 MeTA … for each area: Policy Practices Outcomes?

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 23/06/2009 MeTA

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 23/06/2009 MeTA

What should this lead to? Better information to the sector & general public More engagement in MeTA Councils All stakeholders better informed More trust and collaboration between stakeholders Seeking improved, joint solutions Better access to medicines Key hypothesis to be proven! 23/06/2009 MeTA

1. Responsibility for access Governments are responsible for providing access to health care, including access to essential medicines 05/09/2009 3 MeTA FIP

2. Role of transparency Stronger and more transparent systems and improved supply chain management will increase access 05/09/2009 3 MeTA FIP

3. Equity Increasing equitable access to medicines improves health and enables other human development objectives to be achieved 05/09/2009 4 MeTA FIP

4. Evidence-based policy Improved information about medicines can inform public debate, and provide a basis for better policy 05/09/2009 6 MeTA FIP 2. Affordable prices ACCESS 1. Rational selection 4. Reliable health and supply systems 3. Sustainable financing

5. Mutual accountability through mutli-stakeholder action A multi-stakeholder approach that involves all sectors – private, public and civil society - will lead to greater accountability 05/09/2009 7 MeTA FIP

MeTA Structure Pilot Country National Stakeholder Forums, each with a Secretariat, The International Secretariat A Management Board (consisting of UK's DFID , which chairs the Board, the World Health Organization and the World Bank ) An International Advisory Group DFID, WHO, WB, Private Sector, Academia, Pilot Country reps .

MeTA Core Principles Governments are responsible for providing access to health care, including access to essential medicines Stronger and more transparent systems and improved supply chain management will increase access increasing equitable access to medicines improves health and enables other human development objectives to be achieved Improved information about medicines can inform public debate, and provide a basis for better policy A multi-stakeholder approach that involves all sectors – private, public and civil society - will lead to greater accountability

MeTA’s goal MeTA’s overall goal is to increase access to essential medicines for the poorest of the poor in developing countries

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

Concept and structure of MeTA

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