Dennis Ross-Degnan MeTA Tool Box 04/06/09

MeTA Goal and Strategy Goal: Equitable access to affordable essential medicines in order to improve health outcomes Primary Objective 1: Increased transparency Disclosure and use of key pharmaceutical sector information Quality, availability, affordability, access, and use Primary Objective 2: Multi-stakeholder alliance Support multi-stakeholder process Strengthen governance and stakeholder accountability

Goal: Equitable access to affordable essential medicines in order to improve health outcomes

Primary Objective 1: Increased transparency

Disclosure and use of key pharmaceutical sector information

Quality, availability, affordability, access, and use

Primary Objective 2: Multi-stakeholder alliance

Support multi-stakeholder process

Strengthen governance and stakeholder accountability

MeTA Country Activities During Pilot Develop and sustain national multi-stakeholder alliance and activities Disclosure and use of key pharmaceutical data Public and private sector Medicine availability, affordability, quality, access, and use Applied research to address key questions Use of data for policy-making and advocacy Share experiences

Develop and sustain national multi-stakeholder alliance and activities

Disclosure and use of key pharmaceutical data

Public and private sector

Medicine availability, affordability, quality, access, and use

Applied research to address key questions

Use of data for policy-making and advocacy

Share experiences

MeTA Toolbox Protocols and methods to assess and explore key aspects of pharmaceutical system Build on existing tools where they exist Develop new tools to address key gaps Core tools to gain basic understanding of pharmaceutical sector in pilot countries in relation to MeTA objectives Additional tools to guide priority processes identified by stakeholder groups Tools to be available on MeTA website Technical support in implementation

Protocols and methods to assess and explore key aspects of pharmaceutical system

Build on existing tools where they exist

Develop new tools to address key gaps

Core tools to gain basic understanding of pharmaceutical sector in pilot countries in relation to MeTA objectives

Additional tools to guide priority processes identified by stakeholder groups

Tools to be available on MeTA website

Technical support in implementation

Role of Early Data Gathering Encourage use of core tools in pilot countries Compile and synthesize existing information Roster and summary of publicly available data Community access to medicines Foundation of country information portal Data for priority setting Review by MeTA Stakeholder Group Systematic consideration of sector-wide issues Identify priority activities and future research Early data against which to measure progress

Encourage use of core tools in pilot countries

Compile and synthesize existing information

Roster and summary of publicly available data

Community access to medicines

Foundation of country information portal

Data for priority setting

Review by MeTA Stakeholder Group

Systematic consideration of sector-wide issues

Identify priority activities and future research

Early data against which to measure progress

Core Tool: Pharmaceutical Sector Scan Objective: To summarize key pharmaceutical sector data for review by stakeholder group in order to identify priorities Many existing tools and databases Existing pharmaceutical sector data Structures and processes Legislation and regulation Financing and expenditure Market statistics Therapeutic frameworks (e.g., essential medicines lists) Tools and templates to assemble data for review by MeTA stakeholder group 04/06/09 MeTA

Objective: To summarize key pharmaceutical sector data for review by stakeholder group in order to identify priorities

Many existing tools and databases

Existing pharmaceutical sector data

Structures and processes

Legislation and regulation

Financing and expenditure

Market statistics

Therapeutic frameworks (e.g., essential medicines lists)

Tools and templates to assemble data for review by MeTA stakeholder group

Core Tool: Review of Data Availability Objective: To summarize the public availability and use of key types of pharmaceutical data Key for understanding progress in transparency agenda during MeTA pilot phase Focus areas for disclosure Registration status and quality Availability and price Policies on promotion Tool to be developed in collaboration with MeTA pilot countries

Objective: To summarize the public availability and use of key types of pharmaceutical data

Key for understanding progress in transparency agenda during MeTA pilot phase

Focus areas for disclosure

Registration status and quality

Availability and price

Policies on promotion

Tool to be developed in collaboration with MeTA pilot countries

Core Tool: Stakeholder Process Objective: To describe nature and processes of stakeholder engagement Key for understanding progress in accountability agenda during MeTA pilot phase Focus areas Stakeholder mapping Review of stakeholder process and activities Tool to be developed in collaboration with MeTA pilot countries

Objective: To describe nature and processes of stakeholder engagement

Key for understanding progress in accountability agenda during MeTA pilot phase

Focus areas

Stakeholder mapping

Review of stakeholder process and activities

Tool to be developed in collaboration with MeTA pilot countries

Core Tools: Community Access to Medicines WHO/HAI Pricing Survey To gather price data where unavailable Launched WHA 2003 Measures Availability Price & affordability Price components 50+ surveys to date Methods refined in 2007 WHO Monitoring Survey Facility survey Price, availability, affordability Treatment appropriateness 35+ surveys to date Revised in 2007 Household survey Expenditures, access Availability, affordability Attitudes Field-tested in 3 countries Integrated MeTA survey being tested in Philippines, Ghana, Uganda

WHO/HAI Pricing Survey

To gather price data where unavailable

Launched WHA 2003

Measures

Availability

Price & affordability

Price components

50+ surveys to date

Methods refined in 2007

WHO Monitoring Survey

Facility survey

Price, availability, affordability

Treatment appropriateness

35+ surveys to date

Revised in 2007

Household survey

Expenditures, access

Availability, affordability

Attitudes

Field-tested in 3 countries

Status of Community Data Collection Planned June 2008 April 2004, monitoring 2007 June 2002, February 2005 May 2002, Sept 2005 February 2005 May 2004 May 2002, October 2004, monitoring 2007 WHO-HAI pricing survey World Bank (TBD) MeTA in process WHO 2006 Zambia WHO-MeTA May 2008 pre-2004, WHO-MeTA May 2008 Uganda WHO-MeTA May 2008 pre-2004, WHO-MeTA May 2008 Philippines World Bank planned Peru USAID July 2007 MeTA in process WHO pre-2004 Kyrgyzstan World Bank planned Jordan WHO-MeTA May 2008 WHO in process WHO-MeTA May 2008 Ghana Household survey Price components WHO health facility survey

Additional MeTA Tools: Existing, Planned, or Possible Price components analysis (WHO-HAI) Price monitoring (HAI, others using routine data) Supply chain mapping (WHO, MIT-Zaragosa) Good Governance for Medicines review (WHO) Political mapping policy review (Harvard) Public procurement performance analysis Communication and media mapping and review Assessment of quality of promotional materials & practices Others?

Price components analysis (WHO-HAI)

Price monitoring (HAI, others using routine data)

Supply chain mapping (WHO, MIT-Zaragosa)

Good Governance for Medicines review (WHO)

Political mapping policy review (Harvard)

Public procurement performance analysis

Communication and media mapping and review

Assessment of quality of promotional materials & practices

Others?

Technical Assistance Available to pilot countries through several channels MeTA Secretariat WHO World Bank International and national consultants Country to country collaborations

Available to pilot countries through several channels

MeTA Secretariat

WHO

World Bank

International and national consultants

Country to country collaborations