ENRICHING THE POLICY-MAKING PROCESS THROUGH MULTISTAKEHOLDER DIALOGUE WHO BI-REGIONAL CONSULTATION ON GOOD GOVERNANCE FOR IMPROVED ACCESS TO MEDICINES 9 Nov 2015 Manila Philippines 1
INTRODUCTION MeTA: Unique global initiative that seeks to contribute to good governance, transparency and accountability across the medicines supply chain Hypothesis: Making information transparent and bringing stakeholders together to discuss it will improve access to quality medicines for those who need them Transparency + Multistakeholder Dialogue Good Governance Access to Medicines 2
THE META APPROACH Bring academics, civil society & patients around the same table as health professionals, private industry & government to engage in meaningful dialogue Collect information & evidence to guide policy recommendations & action Empower stakeholders to bring scrutiny to decision-making, & hold government accountable for resources & programs 3
THE META PHASES Pilot Phase (2008-2010) 2010) Focused on establishing multistakeholder platforms & collecting baseline data using existing tools Phase II (2012-2015) 2015) Focused on making information transparent & using evidence to make policy recommendations 4
META IN THE PHILIPPINES Alliance of over 80 member-organizations & individuals committed to MeTA principles Has evolved into a credible platform that engages all stakeholders Coalition for Health Advocacy and Transparency (CHAT), Mar 2009 first alliance of healthfocused CSOs & POs in the Philippines The ETHIKOS Movement, Mar 2014 advocacy for ethical behavior & a stronger regulatory framework for pharmaceutical promotion 5
META IN THE PHILIPPINES First Philippine Patients Conference (One Voice), April 2015 initiative to engage patients & patient organizations Advisory Council for the Implementation of RA 9502 (Cheaper Medicines Law) Coalition for Safe Medicines Vice Chair, Research and Policy Development Alternative Budget Initiative (ABI) Health Cluster civil society engagement in the health budget process & monitoring 6
THE META PROCESS Collection & analysis of robust evidence Dissemination of information & multistakeholder dialogue Policy or process recommendations Action or reform Advocacy & awareness raising 7
META PLATFORMS FOR MULTISTAKEHOLDER DIALOGUE MeTA Philippines Council Annual MeTA Philippines Forum Medicines transparency (Dec 2007) Transparency & access to medicines (Jan 2009) Transparency as a human rights issue (Jan 2010) Transparency & governance in UHC (Sept 2010) UHC policy options for the Philippines (Oct 2010) Multistakeholder collaboration to promote transparency & ethics (Feb 2014) Engaging the Filipino patient (Feb 2015) 8
META PLATFORMS FOR MULTISTAKEHOLDER DIALOGUE MeTA Discussion Series Outpatient benefits through social health insurance (April 2013) Improving pharmacy standards (June 2013) Medicine access programs (Nov 2013) Multistakeholder collaboration for safe & quality medicines (Nov 2014) CHAT Workshop Series Trade agreements, intellectual property rights, access to medicines & public health (Sept 2014) Theory of Change (March 2014) Community monitoring (April 2015) 9
META PLATFORMS FOR MULTISTAKEHOLDER DIALOGUE MeTA Policy Dialogue Series FDA fee restructuring scheme (July 2013) Civil society participation in regulation of pharmaceutical promotion (Sept 2015) Patient engagement and consultation mechanisms within the DOH (Oct 2015) Multistakeholder collaboration in addressing barriers to reporting, monitoring & containment of SSFFC medical products (Dec 2015) 10
THE MeTA MULTISTAKEHOLDER APPROACH Pharmaceutical Promotion Patient Engagement SSFFC Reporting Good Pharmacy Practices Supply Chain Management 11
REGULATING MEDICINES PROMOTION CONTEXT Guidelines exist, but must be clearer Voluntary selfregulation thru codes Non-member firms unregulated Low public awareness No civil society participation Weak enforcement of codes Unclear reporting & feedback mechanisms RECOMMENDATIONS Strong policy framework/ issuance FDA capacity building Engage a civil society coalition Awareness & IEC activities Engage academe in integrating courses in curriculum Effective mechanisms to encourage reporting NEXT STEPS Issuance of AO / guidelines TWG to assess proposed models Organize civil society core group Code of ethics for patient organizations Improved feedback mechanisms Training workshops for students Resource mobilization plan
PATIENT ENGAGEMENT & EMPOWERMENT CONTEXT No formal mechanism within DOH to consult & engage patients Alliance exists, but many others are unaffiliated & unaware Low awareness of patients rights & how to avail of programs Gaps: information, resources, patient services, linkages RECOMMENDATIONS Support a coalition of patient groups Capacity-building & training Public information campaign on patients rights, programs, services Institutionalize patient engagement in the DOH structure Patient desks to navigate responses to concerns & needs Document best practices RESPONSES First Philippine Patients Conference Study to propose mechanisms to formalize patient engagement in the DOH planning & policy process Participation in the DOH hospital scorecard project Patients desks in government agencies
MAINSTREAMING GOOD PHARMACY PRACTICES CONTEXT Joint WHO/FIP GPP Guidelines Philippine Practice Standards for Pharmacists (PhilPSP) Need to mainstream & upgrade standards in 5 areas of practice Goal of empowering pharmacists to take more active roles in a patient-centered health system ACTIONS Rollout of the PhilPSP through regional training workshops in collaboration with PPhA Information campaign targeting other stakeholders NEXT STEPS Advocacy for legislation Mandatory training on PhilPSP Integration of PhilPSP in regular curriculum Public information campaign Updating of the training modules
SSFFC REPORTING CONTEXT Relatively weak regulatory & monitoring framework & capacity Barriers to reporting exist & concrete action is needed Potentials for effective consumer & community interventions MeTA RESPONSE RTD on advocacy for quality medicines & SSFFC initiatives Training workshops using PPhA modules Coalition for Safe Medicines Study on addressing barriers to SSFFC reporting & containment RECOMMENDATIONS Creation of an SSFFC unit within FDA Formalize & define coordination linkages among enforcement agencies Effective, transparent & user-friendly reporting mechanism Engage local governments Multistakeholder collaboration model to sustain reporting & containment
SUPPLY CHAIN MANAGEMENT CONTEXT Relatively low LGU capacities in effective medicines supply chain management Lack of alignment between national & LGU supply chain systems Constraints posed by public procurement regulations Procurement inefficiencies affecting supply & prices Information gaps RESPONSES Pilot course on the medicines supply chain Pilot workshop on pharmaceutical supply chain management for local health facilities using the DOH training modules Monitoring of action plans NEXT STEPS Rollout of training workshops using the DOH modules Operations Manual for LGUs Guidelines on medicine donations Guidelines on disposal of medicines Advocacy for reforms in government procurement laws Information sharing IEC targeting LGUs
BREAKTHROUGHS Raised stakeholder awareness on priority issues thru the MeTA Policy Dialogue Series Built consensus on the need for ethical medicines promotion & guidelines Drew attention to the need to empower patient organizations, prompting DOH to commit to engage them 17
BREAKTHROUGHS Committed to address barriers to SSFFC reporting, monitoring & containment Trained educators, professionals & students on good pharmacy practice standards Built capacity in pharmaceutical supply chain management among local governments 18
EVOLVING A NEW PARADIGM Civil society, patients & the elderly were used to campaigning from the sidelines. MeTA changed that & provided them a seat at the dialogue table. MeTA elevated civil society & patients concerns in the policy making process, making the process more efficient & robust. MeTA is recognized as an important enabler of stakeholders. As it seeks accountability, so does it support stakeholder efforts to 19 meet commitments.
THANK YOU! 20