MeTA Philippines: Sharing Responsibility, Achieving as One MeTA 06/04/09

06/04/09 MeTA Introduction Philippines challenges and progress in access to medicines and improving governance and transparency Early experience with using MeTA to bring stakeholders together to increase momentum towards these goals What would other countries like to know about Philippines’ experience with setting up MeTA Council and national multistakeholder forum? What would other countries like to know about pre-existing measures to increase transparency and governance in relation to medicines procurement and prices

Philippines challenges and progress in access to medicines and improving governance and transparency

Early experience with using MeTA to bring stakeholders together to increase momentum towards these goals

What would other countries like to know about Philippines’ experience with setting up MeTA Council and national multistakeholder forum?

What would other countries like to know about pre-existing measures to increase transparency and governance in relation to medicines procurement and prices

Challenges in the Philippines High cost of medicines Non transparent mechanisms of medicines pricing High out-of-pocket payments – burdening the poor and the disadvantaged Preference for branded medicines Low availability in many local government health centers 06/04/09 MeTA

High cost of medicines

Non transparent mechanisms of medicines pricing

High out-of-pocket payments – burdening the poor and the disadvantaged

Preference for branded medicines

Low availability in many local government health centers

Government Goals: Improve access to essential medicines by: Cutting the price of essential medicines to 50 % from base prices in 2004 Reducing out-of-pocket payments Improving generic competition and assuring quality Instituting mechanisms for transparency and good governance Engaging local governments in these goals 06/04/09 MeTA

Improve access to essential medicines by:

Cutting the price of essential medicines to 50 % from base prices in 2004

Reducing out-of-pocket payments

Improving generic competition and assuring quality

Instituting mechanisms for transparency and good governance

Engaging local governments in these goals

Achievements and Strengths Strong civil society tradition Health Reforms geared towards improved access (Affordable and Quality medicines) Reforms towards transparency, and good governnance (Fourmula I) DOH works with CSOs in monitoring procurement and distribution of medicines and advocating for legislation on access to medicines Philippines national social health insurance fund

Strong civil society tradition

Health Reforms geared towards improved access

(Affordable and Quality medicines)

Reforms towards transparency, and good governnance

(Fourmula I)

DOH works with CSOs in monitoring procurement and distribution of medicines and advocating for legislation on access to medicines

Philippines national social health insurance fund

Basic Strategy 06/04/09 MeTA Multi-stakeholder Collaboration Sharing Responsibility, Achieving as One through

Building MeTA in the Philippines December 2007 Induction of Officers, & First National Multi-Stakeholder Forum (Launch) November, 2007 Election of Officers July to September, 2007 Invitation and enlisting of prospective members May to July, 2007 Technical Working Group Meetings to form MeTA Structure April 2007 Scoping Visit

Induction

The MeTA Stakeholders

Who are involved? The MeTA Council 24-member Council Chaired by a former Health Secretary Phil Health Insurance Corporation, Phil International Trading Corporation, Local Government Service Providers Department of Health, Senate, House of Representatives Policy Makers Bureau of Food and Drugs, Commission on Audit, Dept of Budget Management Regulators, Oversight Agencies Professional Groups, Academe, NGO’s, CSO Watch Groups Civil Society Some MNCs, Philippines Chamber of Pharmaceuticals, Inc. Industry WHO, World Bank, EU, GTZ International Development Partners

The MeTA Council

24-member Council

Chaired by a former Health Secretary

How do we work? MeTA Council Administrative Committee Technical Committee Research and Assessments Secretariat and In- Country Coordinator (WHO Country Office ) MeTA Forum

How the Council Works Structure/Operations Collegial body, each with one vote Guided by an Internal Rules Meets regularly every three months, with some “ disciplinary” measures for non-active members Function of Council Propose policies for government and other sectors to act upon Decides/votes on matters of membership, programmes, activities, etc

Structure/Operations

Collegial body, each with one vote

Guided by an Internal Rules

Meets regularly every three months, with some

“ disciplinary” measures for non-active members

Function of Council

Propose policies for government and other sectors to act upon

Decides/votes on matters of membership, programmes, activities, etc

Little Big Wins Forging a strong multi stakeholder collaboration Pooling resources and technical expertise to support government reforms Policy inputs to major issues (Affordable and Quality Medicines Act of 2008, Pric Monitoring, Generics, TRIPs) First to launch MeTA and National Forum on Medicines Transparency Set up MeTA Council Office

Forging a strong multi stakeholder collaboration

Pooling resources and technical expertise to support government reforms

Policy inputs to major issues (Affordable and Quality Medicines Act of 2008, Pric Monitoring, Generics, TRIPs)

First to launch MeTA and National Forum on Medicines Transparency

Set up MeTA Council Office

Current Activities MeTA Assessment Package Facility and Household Survey (initial funding from WHO) Assessment of LGU Procurements (tech support from EU) Development of the MeTA-Phil Website Academic and technical discussions on issues surrounding the Cheaper Medicines Bill National Awards for Good Governance in Medicines WHO-led The Philippines Pharmaceutical Benchbook WHO-led

MeTA Assessment Package

Facility and Household Survey (initial funding from WHO)

Assessment of LGU Procurements (tech support from EU)

Development of the MeTA-Phil Website

Academic and technical discussions on issues surrounding the Cheaper Medicines Bill

National Awards for Good Governance in Medicines

WHO-led

The Philippines Pharmaceutical Benchbook

WHO-led

Integrating MeTA Support into Local reforms Health Reforms: FOURmula I for Health (F1) Service delivery Financing Regulations Good Governance MeTA Transparency and Good Governance Assessment and Technical Support Systems for proper resource management and building sustainable financing models Improved access and support to decentralized systems

Summary What has been learned: A multi-stakeholder collaboration can work Need for facilitating organization to coordinate and organize at country level Willingness to share resources to jump start activities. In-country initiative and ownership is important 06/04/09 MeTA

What has been learned:

A multi-stakeholder collaboration can work

Need for facilitating organization to coordinate and organize at country level

Willingness to share resources to jump start activities.

In-country initiative and ownership is important

Lessons Learned “ Every collaborator must concede a little…” in order to gain more

“ Every collaborator must concede a little…”

in order to gain more

Useful Information Available on Request MeTA Council documents Internal rules of the MeTA Council Member Declaration of Interest Proceedings of MeTA National Stakeholder Forum Proceedings of Regular Meetings Government documents Philippines National Drug Policy Philippines National Drug Formulary DOH Administrative Order governing health reform (“FOURmula One”) Cheaper Medicines Bill 2008 06/04/09 MeTA

MeTA Council documents

Internal rules of the MeTA Council

Member Declaration of Interest

Proceedings of MeTA National Stakeholder Forum

Proceedings of Regular Meetings

Government documents

Philippines National Drug Policy

Philippines National Drug Formulary

DOH Administrative Order governing health reform (“FOURmula One”)

Cheaper Medicines Bill 2008

Thank You 06/04/09 MeTA