challenges of multi-stakeholder processes: the experience of the medicines transparency alliance
DESCRIPTION
Outlines the main benefits and reasons for using a multistakeholder process, describes the Medicines Transparency Alliance (MeTA) and highlights key lessons and main challenges from the programme to improve access to medicines by increasing transparency and accountability in medicine supply.TRANSCRIPT
Andrew Chetley
Communication and Capacity Strengthening Director
International MeTA Secretariat
18 June 2009, Tracing Pharmaceuticals in South Asia: Dissemination Workshop, Edinburgh
Medicines Transparency Alliance (MeTA): The challenges of multi-stakeholder working
MeTA 16/09/2008 1
MeTA
Outline
What’s an MSP? What’s a MeTA? Why is MeTA an MSP? What’s new in all of this? What has MeTA learned? What are the big challenges? Will this help poor people access medicines?
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What’s an MSP?
Multi-stakeholder process/initiative/approach Brings all those with an interest in or who will be
affected by an issue into a new form of communication, decision finding (and maybe decision making)
3 or more stakeholder groups Transparency, accountability, participation,
equity, dialogue
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Why an MSP?
To deal with complex issues Useful where there are “governance gaps” Where “steer and negotiate” is needed Where movement has been bogged down To facilitate negotiation, broaden participation, share
knowledge Correct market failures Identify global public needs
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What’s a MeTA? International alliance: DFID, WHO, World Bank (plus 7 pilot countries: Peru, Ghana, Uganda, Zambia, Jordan,
Kyrgyzstan, the Philippines)
Test the hypothesis that multi-stakeholder dialogue will develop creative solutions to problems of access to medicines
Country-led, focus on disclosure of information in 4 broad areas: Price, Quality, Availability, Promotion.
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Why? Complexity of medicines supply…
Contra-ceptives and
RHequipment
STIDrugs
EssentialDrugs
Vaccinesand
Vitamin ATB/Leprosy
BloodSafety
Reagents(inc. HIV
tests)
DFID
KfW
UNICEF
JICA
GOK, WB/IDA
Source offunds for
commodities
CommodityType
(colour coded) MOHEquip-ment
Point of firstwarehousing KEMSA Central Warehouse
KEMSARegionalDepots
Organizationresponsible
for delivery todistrict levels
KEMSA and KEMSA Regional Depots (essential drugs, malaria drugs,
consumable supplies)
ProcurementAgent/Body
CrownAgents
Governmentof Kenya
GOK
GTZ(procurement
implementationunit)
JSI/DELIVER/KEMSA LogisticsManagement Unit (contraceptives,
condoms, STI kits, HIV test kits, TBdrugs, RH equipment etc)
EU
KfW
UNICEF
KEPI ColdStore
KEPI(vaccines
andvitamin A)
Malaria
USAID
USAID
UNFPA
EUROPA
Condomsfor STI/
HIV/AIDSprevention
CIDA
UNFPA
USGov
CDC
NPHLS store
MEDS(to Missionfacilities)
PrivateDrug
Source
GDF
Government
NGO/Private
Bilateral Donor
Multilateral Donor
World Bank Loan
Organization Key
JapanesePrivate
Company
WHO
GAVI
SIDA
NLTP(TB/
Leprosydrugs
Commodity Logistics System in Kenya (as of July 2006) Constructed and produced by Steve Kinzett, JSI/Kenya - please communicateany inaccuracies to [email protected] or telephone 2727210
Anti-RetroVirals
(ARVs)
Labor-atorysupp-lies
GlobalFund forAIDS, TB
and Malaria
PSCMC(CrownAgents,GTZ, JSI
and KEMSA)
BTC
MEDS
DANIDA
Mainly District level staff: DPHO, DPHN, DTLP, DASCO, DPHO, etc or staff from the Health Centres,Dispensaries come up and collect from the District level
MEDS
Provincial andDistrictHospital
LaboratoryStaff
Organizationresponsible fordelivery to sub-district levels
KNCV
MSF
MSF
JSI/DELIVER
KEMSA
JSI
WHO
Source: SSDS Inc for the World Bank
innovation new and different voices
equity
dynamic dialogues
transformation
different perspectives
problem solving
mutual accountability
changing business practice
social justice
new partnerships
transparency
… and more complexity
What’s new about MeTA?
“Learning to engage in dialogue means to move from hearing to listening.”
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Lessons from MeTA
Right mix Enough time Clear aim and approach Sufficient resources Facilitation Learning and flexibility
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Challenges
Will mutual accountability flow? Will civil society have a strong voice? Will the private sector engage? Will governments let go of some control? Is there a clear outcome, or only gradual change over
time that might have happened anyway? (What can we measure?)
Can everyone win?
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Will poor people in these countries have greater access to medicines?
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[email protected] www.MedicinesTransparency.org