[p2p-research] Fwd: The Drum Beat 486 - Medicines Transparency: Access, Quality, and Accountability

Sat Mar 28 08:45:21 CET 2009

---------- Forwarded message ----------
From: The Drum Beat <drumbeat at comminit.com>
Date: Sat, Mar 28, 2009 at 10:29 AM
Subject: The Drum Beat 486 - Medicines Transparency: Access, Quality, and
Accountability
To: michelsub2004 at gmail.com

The Drum Beat - Issue 486 - Medicines Transparency: Access, Quality, and
Accountability
March 30 2009

>From The Communication Initiative Network - where communication and media
are central to social and economic development.

Subscribe to The Drum Beat: http://www.comminit.com/en/user/register
Access this issue online at http://www.comminit.com/en/drum_beat_486.html

Drum Beat Subscribers: 43,868
CI Portal User Sessions, past 12 months: 2,651,548

===

This issue of the Drum Beat looks at the issues surrounding access to
medicines, including increasing transparency and accountability, and
magnifying the voices of patients and consumers in the healthcare
marketplace. Beginning with information about a new alliance of partners
working in this field within 7 pilot countries, this issue highlights
projects, strategic thinking, and resources of relevance.

Please send any additional information on communication-related work around
medicines transparency to us at drumbeat at comminit.com Many thanks!

===

The Drum Beat 486 contains:
* A focus on the MEDICINES TRANSPARENCY ALLIANCE.
* A space for all knowledge on MEDICINES TRANSPARENCY ON THE CI.
* Examples of ACTION to address access, quality, and accountability.
* Access to OTHER CI E-NEWSLETTERS on medicines transparency: The Soul Beat
and Son de Tambora.
* Examples of STRATEGIC THINKING on addressing access, quality, and
accountability.
* Become a member of the CI ASSOCIATES PROCESS.
* Examples of RESOURCES to support work on access, quality, and
accountability.
* Vote in a POLL on journalists, transparency, and media freedom.

===

MEDICINES TRANSPARENCY ALLIANCE (MeTA)

1.      What Is the Medicines Transparency Alliance (MeTA) and How Will It
Work?
MeTA is an alliance of governments, pharmaceutical companies, civil society,
and other stakeholders which aims to increase access to essential medicines
for people in developing countries. This will be done by working to increase
transparency and accountability in medicines procurement and supply chains
to tackle inefficiency, corruption, and fraud in 7 pilot countries: Ghana,
Jordan, Kyrgyzstan, Peru, the Philippines, Uganda, and Zambia.
For more information about MeTA please see:
* Medicines Transparency Alliance (MeTA)
http://www.comminit.com/redirect.cgi?cimo=1&r=http://www.medicinestransparency.org/
* Q&A for the Medicines Transparency Alliance launch May 2008 [PDF]:
http://www.comminit.com/redirect.cgi?cimo=1&r=http://www.medicinestransparency.org/fileadmin/uploads/Documents/MeTAQandA.pdf
* The MeTA Model [PDF]
http://www.comminit.com/redirect.cgi?cimo=1&r=http://www.medicinestransparency.org/fileadmin/uploads/Documents/The-MeTA-Model.pdf
* Medicines Transparency Alliance (MeTA) - 7 pilot countries
launched officially in May 2008
http://www.comminit.com/en/node/282263/2850
* Medicines Transparency Alliance (MeTA) in Ghana
launched in November 2008
http://www.comminit.com/en/node/287789/2850
* Medicines Transparency Alliance (MeTA) in Jordan
set to launch later in 2009
http://www.comminit.com/en/node/288733/2850
* Medicines Transparency Alliance (MeTA) in Kyrgyzstan
set to launch in April 2009
http://www.comminit.com/en/node/288740/2850
* Medicines Transparency Alliance (MeTA) in Peru
launched in November 2008
http://www.comminit.com/en/node/288568/2850
* Medicines Transparency Alliance (MeTA) in the Philippines
began activities in December 2007
http://www.comminit.com/en/node/288742/2850
* Medicines Transparency Alliance (MeTA) in Uganda
launched in March 2009
http://www.comminit.com/en/node/288729/2850
* Medicines Transparency Alliance (MeTA) in Zambia
launched in March 2009
http://www.comminit.com/en/node/288730/2850

2.      What is Transparency?
According to MeTA, "transparency" is: the property of being able to see
through something. In financial and political terms it has come to mean the
full, clear and timely disclosure of relevant information, which in turn
makes for easier understanding and encourages public scrutiny of processes
and practices. For more information on transparency from MeTA's perspective,
please see [PDF]:
http://www.comminit.com/redirect.cgi?cimo=1&r=http://www.medicinestransparency.org/fileadmin/uploads/Documents/What-is-Transparency.pdf

3.      MeTA's Pilot Phase
In this first pilot phase, MeTA aims to focus on strengthening the capacity
of 7 pilot countries to collect, analyse, disseminate, and use data on the
quality, availability, pricing, and use of medicines. This work intends to
help improve transparency and accountability with regard to the selection,
regulation, procurement, distribution, and supply of medicines - including
the ways in which they are prescribed to and used by patients. At the end of
the 24-month-long pilot phase, MeTA plans to use an agreed-upon set of
indicators to evaluate the campaigns. These indicators, which are currently
being developed, will focus on the process of facilitating greater
transparency and accountability. However, MeTA plans to also use these
evaluation efforts to begin mapping the contribution that greater
transparency and accountability can make: (1) to improving the efficiency of
markets and health systems, and (2) to the ultimate goal of increasing
access to medicines in developing cou!
 ntries, particularly for economically poor and disadvantaged people. MeTA
plans to fully and directly involve the pilot countries in all monitoring
and evaluation activities.
For more information on implementing the pilot phase of MeTA, please see
[PDF]:
http://www.comminit.com/redirect.cgi?cimo=1&r=http://www.medicinestransparency.org/fileadmin/uploads/Documents/MeTA_Implementing-pilot-phase.pdf

4.      MeTA Dialogue
The MeTA Dialogue is an open online forum where you can have your say about
transparency and accountability issues around medicines and see what other
people are saying. See:
http://www.comminit.com/redirect.cgi?cimo=1&r=http://www.medicinestransparency.org/resources/meta-dialogue/

===

MEDICINES TRANSPARENCY ON THE CI

The CI has collected and organised summaries of action, strategic thinking,
and resources related to Medicines Transparency!
See http://www.comminit.com/en/meta.html

If you have information on communication initiatives or resources related to
access, quality, transparency, and accountability in the healthcare
marketplace in your country, please let us know - drumbeat at comminit.com

===

ADDRESSING ACCESS, QUALITY, AND ACCOUNTABILITY ACROSS THE WORLD

ACTION
http://www.comminit.com/metaaction.html

5.      Good Governance for Medicines - Global
Launched in 2004, this World Health Organization (WHO) programme works to
ensure that essential medicines reach people - not the black market - by
raising awareness of abuse in the public pharmaceutical sector and promoting
good governance. Good Governance for Medicines (GGM) is an effort to curb
corruption in pharmaceutical sector systems through the application of
transparent and accountable administrative procedures and the promotion of
ethical practices among health professionals. GGM uses a bottom-up approach
in implementation of project and policy development.
Contact: Dr. Guitelle Baghdadi-Sabeti ggminfo at who.int
http://www.comminit.com/en/node/289055/2850

6.      Stop Stock-outs - Kenya, Madagascar, Malawi, Uganda, Zambia
Launched in February/March 2009, this campaign is a call to action for
African governments to meet their obligations to provide essential medicines
by increasing the national budgetary allocation for the purchase of these
medicines and by ensuring efficiency and transparency in the procurement,
supply, and distribution of medicines. This advocacy campaign uses in-person
events and information and communication technology (ICT) to demand action
to eliminate "stock-outs", the term used when a pharmacy (in a medical store
or health facility) temporarily has no medicine on the shelf.
Contact: info at stopstockouts.org
http://www.comminit.com/en/node/288347/2850

7.      National Awards for Good Governance in Medicines - Philippines
In 2008, the WHO and the Department of Health (DoH), in collaboration with
META Philippines, undertook an initiative to highlight the importance of
good governance and transparency in improving access to essential medicines
for all Filipinos. The primary goal of the National Awards was to
institutionalise the concept of good governance and transparency in the
registration, selection, procurement, use, and management of medicines and
overall management of medicines in the public and private sector. By
recognising innovative and exemplary programmes from both the public and
private sector, organisers hoped to provide incentives for good practices,
build models and duplicate them, and create public awareness of good
governance for medicines.
Contact: Crispinita Valdez ggmawards at yahoo.com
http://www.comminit.com/en/node/288324/2850

8.      Foro de la Sociedad Civil en Salud (ForoSalud) - Peru
Established in 2002, ForoSalud works to influence the development and
implementation of more responsive health policies in Peru. ForoSalud
promotes research and participatory dialogue and debate on health issues
within the country. It encourages civic engagement and review of the health
sector and the government's policies related to the health sector. Through a
long-term series of capacity-building workshops ForoSalud has worked to
build awareness and action on issues such as human rights, the right to
health, the rights contained in Peruvian law, and how people have a right to
participate in decisions that affect them. This capacity-building process
involved training ForoSalud on participatory methodologies to ensure that
local health issues would be identified by the local people. Successive
workshops focused on the importance of participation in realising people's
right to health and on building capacity to participate in spaces such as
Regional Health Councils. Particip!
 ants were trained on topics such as how policies are constructed, the
identification of different groups involved in policy development and
implementation, and the power relations that shape the process.
Contact: Ariel Frisancho Arroyo afrisancho at care.org.pe
http://www.comminit.com/en/node/288530/2850

9.      ZdravPlus Quality Public Health and Primary Health Care in Central
Asia Project - Kazakhstan, Kyrgyzstan, Tajikistan, Turkmenistan, Uzbekistan
The primary emphasis of the ZdravPlus Project is on drafting, revising,
implementing, and evaluating pharmaceutical policies to support the health
reforms in 5 countries in the Central Asian region. The emphasis in
Kyrgyzstan and Kazakhstan is on the establishment, maintenance, and
expansion of health insurance systems for medicines. Other regional and
country-level work has addressed medicine quality, decentralisation of
medicine procurement, medicine prices, human resource shortages, and
evidence-based medicine, including selection and standard treatment
guidelines and rational use of medicines. On a community level, ZdravPlus
seeks to inform people not only about how to keep themselves and their
families healthy, but also on their rights and responsibilities within the
reformed and restructured primary health care system.
Contact: office at zplus.kz
http://www.comminit.com/en/node/288538/2850

More ACTION related to increasing transparency, access, and accountability
for medicines is available through The CI's Medicines Transparency site -
http://www.comminit.com/metaaction.html

===

The Soul Beat 126 focused on issues in Africa surrounding access to
medicines, including increasing transparency, accountability, and magnifying
the voices of patients and consumers in the healthcare marketplace. See
http://www.comminit.com/africa/soul-beat-126.html for The Soul Beat 126.

Son de Tambora 232 (in Spanish) focused on issues in Latin America
surrounding access to medicines, including increasing transparency,
accountability, and magnifying the voices of patients and consumers in the
healthcare marketplace. See
http://www.comminit.com/es/la/drum_beat_232.htmlfor Son de Tambora
232.

===

STRATEGIC THINKING
http://www.comminit.com/en/metastrategic.html

10.     Accountability and the Right to the Highest Attainable Standard of
Health
by Helen Potts
This January 2008 study analyses the concept of accountability as a feature
of human rights in the context of the right to the highest attainable
standard of health. According to the author, accountability is the process
that provides individuals and communities with the opportunity to understand
how governments and others have discharged their right to health
obligations, including the right to redress where mistakes are made. This
monograph is intended as a starting point for health policymakers seeking to
develop greater understanding of the area of accountability.
http://www.comminit.com/en/node/288460/2850

11.     Human Rights Guidelines for Pharmaceutical Companies in Relation to
Access to Medicines: The Sexual and Reproductive Health Context
by Rajat Khosla and Paul Hunt
Published in August 2008, this briefing considers the responsibilities of
pharmaceutical companies for enhancing access to medicines in the context of
sexual and reproductive health. It draws upon and amplifies the work of one
of the authors, Paul Hunt, who acted as United Nations (UN) Special
Rapporteur from 2002-2008. For the most part, he - and colleagues in the
Right to Health Unit - looked at the duties of States in relation to access
to medicines. However, States reported that when endeavouring to enhance
access to medicines, the policies and practices of some pharmaceutical
companies were a serious obstacle.  The Guidelines are grouped by themes
such as transparency, management, monitoring and accountability, pricing,
and ethical marketing. Each theme is followed by a brief commentary.
http://www.comminit.com/en/node/287828/2850

12.     Making Health Markets Work for Poor People
by Hilary Standing and Gerry Bloom
This editorial from the March 2009 id21 insights web magazine describes the
weaknesses in regulation of the variety of market-based providers of
health-related goods and services. Providers range from highly organised and
regulated hospitals and specialist doctors to informal health workers and
drug sellers operating outside the legal framework. The issue of id21 within
which this article was published discusses the unregulated markets
associated with porous public and private boundaries in the field of health
and resulting problems with safety, efficacy, and cost in medical diagnosis
and pharmaceuticals. Aspects of market characteristics, privatised pharmacy
influence on prices, a model of wide provision of eyeglasses as social
entrepreneurship, technology as a change agent for provider-patient
relationships, and health insurance as a catalyst for provider behaviour are
the range of topics that are covered in this id21 publication.
http://www.comminit.com/en/node/287978/2850

13.     Improving Access to Essential Medicines: How Health Concerns can be
Prioritised in the Global Governance System
by Devi Sridhar
This July 2008 paper discusses the politics of access to essential medicines
and identifies "space" in the current system where health concerns can be
strengthened relative to trade. This issue is addressed from a global
governance perspective focusing on the main actors who can have the greatest
impact, including developing country coalitions and citizens in developed
countries through participation in civil society organisations (CSOs). These
actors have combined forces to tackle this issue successfully, resulting in
the 2001 Doha Declaration on Public Health. The collaboration has been
powerful due to the assistance of the media as well as the decision to work
to compromise with pharmaceutical companies and their host countries.
According to this paper, to improve access to essential medicines, six C's
are needed: coalitions, civil society, citizenship, compromise,
communication, and collaboration.
http://www.comminit.com/en/node/288617/2850

14.     Health Systems and the Right to Health: An Assessment of 194
Countries
by Gunilla Backman, Paul Hunt, Rajat Khosla, Camila Jaramillo-Strouss,
Belachew Mekuria Fikre, Caroline Rumble, David Pevalin, David Acurio Páez,
Mónica Armijos Pineda, Ariel Frisancho Arroyo, Duniska Tarco, Mitra Motlagh,
Dana Farcasanu, and Cristian Vladescu
This December 2008 Lancet: Right to Health article reports on a survey of
health and human rights in 194 countries over 18 months. It is based on
General Comment 14, an understanding of the right to health care established
in 2000 through the work of the United Nations (UN) Committee on Economic,
Social, and Cultural Rights. This describes the right to the highest
attainable standard of health as encompassing medical care, access to safe
drinking water, adequate sanitation, education, health-related information,
and other underlying determinants of health. 72 indicators were used for the
survey assessment. The article contains several tables that present data in
relation to how specific countries met the indicators. The final section of
the article contains recommendations for various national and international
actors within international efforts to apply, protect, and sustain the right
to health.
http://www.comminit.com/en/node/288375/2850

15.     Towards Equitable and Affordable Medicine Prices Policies in Jordan:
Interpretation of Jordanian Patent Law and JUSFTA to Improve Access to
Medicines
by Hiba A. Zarour
In this presentation from a December 2007 event organised by the Jordan Food
and Drug Administration and Health Action International (HAI), an
intellectual property attorney explores legal approaches to increasing
access to essential medicines in Jordan. Zarour begins by advising the
government to engage in a process of listening to and learning from other
governments, as well as NGOs, regarding access issues. He advises advocacy
where appropriate, encouraging openness to interpreting or even challenging
intellectual property (IP) laws. He advises legislating wisely, balancing
rights with exceptions and insisting on flexibility. In the area of
pharmaceuticals, he urges that a balanced legal system is essential. While
rules are important to ensure IP protection of new medicines, limitations on
these rules are equally important so that the medicines are made readily
available and affordable.
http://www.comminit.com/en/node/288312/2850

16.     Snakebites, Patents and Medicine Prices
by Bienvenido Oplas, Jr.
This report provides an overview of a symposium held in September 2008 to
explore strategies for improving access to health in the Philippines.
Presentations and discussions focused on: improving access to medicines; the
role of free trade and property rights in improving access to medicines and
health care; barriers to access to health care, such as poor or non-existent
infrastructure; and approaches to help bring down medicine prices.
http://www.comminit.com/en/node/288060/2850

17.     Eastern and Southern Africa CSOs Discuss Their Role in Advocating
for Access to Medicines
In October 2008, CSOs from 10 countries in Eastern and Southern Africa met
to discuss issues related to access to essential medicines in their
respective countries and to map out a strategy on how they could go about
advocating and promoting access. Country presentations from Kenya, Malawi,
Uganda, Zambia, and Zimbabwe revealed some crosscutting issues, such as
stock-outs of essential medicines, a lack of government of accountability,
the need for community mobilisation to advocate for better public access and
availability of medicines, inadequate funding for medicines sector, lack of
trained human resources, and rivalry between government agencies involved in
procurement.
http://www.comminit.com/en/node/288446/2850

18.     The Impact of Information and Accountability on Hospital Procurement
Corruption in Argentina and Bolivia
by William D. Savedoff
According to this May 2008 U4 Brief on corruption in the health industry,
hospitals spend a great deal of money on supplies and have been the object
of a wide range of scams, including kickbacks and delivery of expired and
substandard products, all of which can make the difference between an
equipped facility and one that cannot offer life-saving treatments.
Argentina and Bolivia have both attempted to curb corruption in procurement
of hospital supplies. With varying degrees of success, their experiences
tell a lesson: unless there are consequences attached to identified
mal-practice, monitoring and publicising information will not guarantee
sustained gains. The brief concludes that: corruption was common wherever
impunity was the rule; shining light in dark corners can modify behaviors
initially, but unless publicizing information has some consequences -
whether through convictions, loss of employment, disciplinary actions or
moral disapprobation - the gains from publicizin!
 g corruption may be short-lived; active local oversight can modify
behaviors; and collecting data and comparing facilities can provide hard
facts that not only assist in detecting corruption but also in understanding
how it responds to different strategies.
http://www.comminit.com/en/node/289143/2850

19.     Public Reporting and Transparency
by John M. Colmers, M.P.H.
Prepared for The Commonwealth Fund/Alliance for Health Reform 2007
Bipartisan Congressional Health Policy Conference, this issue brief provides
a short history of efforts to report information on health system
performance in the United States (US) and identifies policy issues to
consider when advancing such efforts. According to Colmers, publicising
information on health system performance can make the health care system
more accountable. Policymakers and health care purchasers advocate for
public reporting with 3 goals in mind, in addition to promoting competition.
They are: (1) to help providers improve by benchmarking their performance
against other providers; (2) to encourage private insurers and public
programmes to reward quality and efficiency; and (3) to help patients make
informed choices about their care. While health care providers and payers
face demands to conduct their business more transparently, questions remain
about the accuracy of the reported price, proce!
 ss, and outcome information; the comparability of the results across
different populations; and whether and how patients and others use the
information in making decisions. To address these and other questions,
health services research has been undertaken; specific lessons learned and
proposed legislation are noted in this brief.
http://www.comminit.com/en/node/289063/2850

More STRATEGIC THINKING articles related to increasing transparency, access,
and accountability for medicines are available through The CI's Medicines
Transparency site - http://www.comminit.com/en/metastrategic.html

===

BECOME A CI ASSOCIATE

This is just a gentle reminder to please raise within your organisation the
possibility of supporting The CI's work through the CI Associates process -
details and sign up at http://www.comminit.com/en/ci_associates/ Also see
Warren Feek's note in The Drum Beat 485 at
http://www.comminit.com/en/drum_beat_485.html Thank you.

===

RESOURCES
http://www.comminit.com/en/metaresources.html

20.     Corruption in the Health Sector
by Carin Nordberg and Taryn Vian
This November 2008 issue of the web journal U4 presents some resources for
anti-corruption work in the health sector and information on the challenges
of corruption in the health sector. The overview includes the causes and
consequences of corruption, financial resources management, management of
medical supplies, and health worker/patient interaction. The issue focuses
on good practise examples, budget transparency, and the topic of salaries.
It includes a literature review and links to relevant websites on health
sector corruption.
http://www.comminit.com/en/node/287494/2850

21.     Global Corruption Report 2006
Published by Transparency International, this report focuses on the
relationship between corruption and health. This document states that
corruption in the health sector deprives those most in need of essential
medical care and helps spawn drug-resistant strains of deadly diseases. The
book includes reports on: the risks of corruption in different health care
systems; the scale of the problem: from high-level corruption in Costa Rica
to counterfeit medicines in Nigeria; health care fraud in the US; the costs
of corruption in hospital administration and the problem of informal
payments for health care; the impact of corruption at various points of the
pharmaceutical chain; and anti-corruption challenges posed by the fight
against HIV/AIDS.
http://www.comminit.com/en/node/289068/2850

22.     Measuring Medicine Prices, Availability, Affordability and Price
Components: 2nd Edition
Published by the WHO and HAI in May 2008, this manual offers a standardised
methodology for measuring medicine prices, availability, affordability, and
price, thereby facilitating national and international comparisons. It is a
refinement of the first edition, published in 2003, in that it now
integrates the experience gained through the more than 50 surveys that have
since been conducted worldwide. The results have exposed many problems of
poor access to medicines; for example: people having to work 15 days or more
to afford one month's treatment for a chronic disease; important medicines
not being available locally to patients; governments not passing on low
procurement prices to their citizens; excessive mark-ups in the private
sector; and taxes and duties being applied to essential medicines.
http://www.comminit.com/en/node/289067/2850

23.     Medicine Pricing Matters
Published quarterly, this e-bulletin provides information on the medicines
prices survey work of HAI and the WHO, including ongoing survey results,
workshops, advocacy campaigns, policy changes, monitoring work, project
activities, and publications.
http://www.comminit.com/en/node/289076/2850

More RESOURCES related to increasing transparency, access, and
accountability for medicines are available through The CI's Medicines
Transparency site - http://www.comminit.com/en/metaresources.html

===

Please VOTE in our current POLL on journalists, transparency, and media
freedom:

What are the best possibilities for journalist-readership connections?
(you may choose more than one; please add clarifying comments)

Connection:
* Readers should hold journalists to a high standard of transparency.
* Journalists should ascertain topical concerns of readers.
* Journalists should build support for public risk-taking in the name of
media freedom.
* Readers should hold editors, managers, and media owners accountable for
journalistic freedom.

VOTE and COMMENT: http://www.comminit.com/en/node/288047/2754

===

The Drum Beat is the email and web network of The Communication Initiative
Partnership - ANDI, BBC World Service Trust, Bernard van Leer Foundation,
Calandria, CFSC Consortium, CIDA, DFID, FAO, Fundación Nuevo Periodismo
Iberoamericano, Ford Foundation, Healthlink Worldwide, Inter-American
Development Bank, International Institute for Communication and Development,
Johns Hopkins Bloomberg School of Public Health Center for Communication
Programs, MISA, PAHO, The Panos Institute, The Rockefeller Foundation,
SAfAIDS, Sesame Workshop, Soul City, Swiss Agency for Development and
Cooperation, UNAIDS, UNDP, UNICEF, USAID, WHO, W.K. Kellogg Foundation.

Chair of the Partners Group: Garth Japhet, Founder, Soul City
garth at heartlines.org.za
Executive Director: Warren Feek wfeek at comminit.com

===

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