1. Medicines.
Health Systems.
Universal Health Coverage.
Smart Governance.
Remarks from James A. Rice, Ph.D.
Project Director,
USAID Project for Leadership, Management, Governance

2. UHC
Coverage
Design
Provider
Contracting
Pharma
Quality
Pharma
Supply
Chain
Pharma
Retail
Access
Governing the Many Facets of Pharma in UHC
What are the key issues/challenges?
How to mitigate and manage these challenges?
Many Instruments in “Governance”
1. Regulations
2. Law Suits
3. Market Forces
4. Contract Obligations
5. Oversight by Governing Bodies
6. Ethics of Players

3. Our Panel:
Catalysts and Guides for
Smart Conversation on Issues and Initiatives
Moderator: Jim Rice, MSH
 Gilles Forte (WHO)
 Julio Siede (PAHO)
 John Simon (PharmAccess and Total Impact Advisors)

4. 4
The Focus of Smart Governance in UHC Pharma

5. Smart Governance.
Governance at All Levels:
 Macro: Cross National. Patents, Policies, Intellectual
Property and Trade Regulations (WTO & WHO)
 Meso: Within a National State (Ministry of Health, FDA
equivalent, Ministry of Finance & Economics)
 Micro: Within Public and Private Health Insurance
Organizations, Service Delivery
Systems, Manufacturers, Distribution Companies, Retail
Units/Enterprises
But what is to be governed, and what is
Smart Governance?

6. UHC
Coverage
Design
Provider
Contracting
Pharma
Quality
Pharma
Supply
Chain
Pharma
Retail
Access
Governing the Many Facets of Pharma in UHC
What are the key issues/challenges?
How to mitigate and manage these challenges?

7. The Governance in UHC
Challenge is Complicated:
1. Who is covered
2. What is covered
3. How much is covered
4. What is available &
how to access what is
covered
5. Cost/price of what is
covered
6. Quality of what is
delivered
7. How much out-of-
pocket

8. Smart Governance at All Levels

9. Smart Governance at All Levels
Many Resources

11. Smart Governance at All Levels
Four
Essential
Governance
Practices

13. Need Clarity on All Dimensions
 Medicines.
 Health Systems.
 Universal Health Coverage.
 Smart Governance.
WHO Provides Common Concepts.

16. Smart Decision Making
Principles, Practices and Infrastructure.

18. Smart Governance.
Governance at All Levels:
 Macro: Cross National. Patents, Policies, Intellectual
Property and Trade Regulations (WTO & WHO)
 Meso: Within a National State (Ministry of Health, FDA
equivalent, Ministry of Finance & Economics)
 Micro: Within Public and Private Health Insurance
Organizations, Service Delivery
Systems, Manufacturers, Distribution Companies, Retail
Units/Enterprises
But what is Smart Governance?

19. Smart Governance at All Levels

22. Governing the
Supply Chain

24. Smart Governance at All Levels

25. Smart Governance at All Levels

26. One Example to Illustrate Governing Framework: Australia

28. Smart Governance at All Levels

29. Smart Governance at All Levels

30. Smart Governance at All Levels

31. Smart Governance at All Levels

32. Smart Governance at All Levels

33. Transparency and
Information
Coherent Decision
Making Structures
Consistency and
Stability
Stakeholder
Participation
Supervision and
Regulation
Assessing
Nation’s
Governance

35. Many Players Expected in The Governance Landscape

39. Govern UHC Design
Top 1-3 Factors Frustrating
Smart Governance
Top 1-3 Factors Facilitating
Smart Governance

40. Govern Financing of UHC
Top 1-3 Factors Frustrating
Smart Governance
Top 1-3 Factors Facilitating
Smart Governance

41. Govern Pharma Supply Chain
Top 1-3 Factors Frustrating
Smart Governance
Top 1-3 Factors Facilitating
Smart Governance

42. The Leadership, Management & Governance
(LMG) Project
Thank you!
Questions/Comments