Medicines Transparency
Alliance (MeTA): The
challenges of multi-
stakeholder working
Andrew Chetley
Communication and Capacity Strengthening Director
International MeTA Secretariat
18 June 2009, Tracing Pharmaceuticals in South Asia:
Dissemination Workshop, Edinburgh
MeTA 16/09/2008 1

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?
2
MeTA 16/09/2008

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
3
MeTA 16/09/2008

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
4
MeTA 16/09/2008

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.
5
MeTA 16/09/2008

Source: SSDS Inc for the World Bank
Why? Complexity of
medicines supply…
Constructed and produced by Steve Kinzett, JSI/Kenya - please communicate
Commodity Logistics System in Kenya (as of July 2006) any inaccuracies to skinzett@cb.jsikenya.com or telephone 2727210
Commodity
Type Blood Anti- Labor-
Contra- Condoms MOH
(colour coded)
STI Vaccines Safety
ceptives and for STI/ Essential Retro atory
and TB/Leprosy Reagents Malaria Equip-
RH HIV/AIDS Drugs Drugs
Vitamin A (inc. HIV
Virals
ment
supp-
equipment prevention (ARVs) lies
tests)
Organization Key
Government
World Bank Loan
Bilateral Donor
Multilateral Donor
NGO/Private
JSI/DELIVER
U U D
Source of D J C G K S A Global
S K N W B G
funds for E F I I A N I N GOK, WB/ US Fund for
A f F H GOK T UNICEF D MSF
commodities I W
U
P
I
O C
C D V
F
C D I IDA Gov AIDS, TB
I D
D A A V A and Malaria
D A A
U U K GTZ C J PSCMC
Procurement E
S K U N Crown W E Government Japanese (Crown
Agent/Body R Private UNICEF MEDS (procurement D S
A f O F Agents H M of Kenya Company implementation Agents, MSF
I W P P O unit) C I GTZ, JSI
A S
D A and KEMSA)
A
KEMSA
Point of first Regional KEPI Cold
KEMSA Central Warehouse MEDS NPHLS store
warehousing Depots Store
Organization Provincial and
NLTP KEMSA and KEMSA Regional Depots JSI/DELIVER/KEMSA Logistics KEPI
responsible MEDS District Private
for delivery to (TB/
(essential drugs, malaria drugs,
Management Unit (contraceptives, (vaccines Hospital Drug
(to Mission
Leprosy condoms, STI kits, HIV test kits, TB and Laboratory Source
district levels consumable supplies) facilities)
drugs drugs, RH equipment etc) vitamin A) Staff
Organization
responsible for Mainly District level staff: DPHO, DPHN, DTLP, DASCO, DPHO, etc or staff from the Health Centres,
delivery to sub- Dispensaries come up and collect from the District level
6
district levels

… and more complexity
innovation new and
different
voices
transformatio dynamic
n dialogues
changing
business
problem practice
solving equity
social mutual
justice accountability
transparency new
partnerships different
perspectives

What’s new about MeTA?
 “Learning to engage in dialogue means to
move from hearing to listening.”
MeTA 16/09/2008 8

Lessons
from MeTA
 Right mix
 Enough time
 Clear aim and approach
 Sufficient resources
 Facilitation
 Learning and flexibility
MeTA 16/09/2008 9

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?
MeTA 16/09/2008 10

Will poor people in these countries
have greater access to medicines?
MeTA 16/09/2008 11

 info@metasecretariat.org
MeTA 16/09/2008  www.MedicinesTransparency.org 12