Can a multistakeholder initiative improve transparency and accountability in the pharmaceutical sector? Evidence from the Medicines Transparency Alliance

Background: Access to affordable quality essential medicines is crucial if universal health coverage and the Sustainable Development Goals are to be achieved. Multistakeholder initiatives might help to overcome barriers to access such as weak pharmaceutical sector governance and lack of transparency...

Full description

Bibliographic Details
Main Authors: Taryn Vian, PhD, Jillian Clare Kohler, PhD, Deirdre Dimancesco, MBA, Gilles Forte, PhD
Format: Article
Language:English
Published: Elsevier 2017-04-01
Series:The Lancet Global Health
Online Access:http://www.sciencedirect.com/science/article/pii/S2214109X17301134
_version_ 1818297218239561728
author Taryn Vian, PhD
Jillian Clare Kohler, PhD
Deirdre Dimancesco, MBA
Gilles Forte, PhD
author_facet Taryn Vian, PhD
Jillian Clare Kohler, PhD
Deirdre Dimancesco, MBA
Gilles Forte, PhD
author_sort Taryn Vian, PhD
collection DOAJ
description Background: Access to affordable quality essential medicines is crucial if universal health coverage and the Sustainable Development Goals are to be achieved. Multistakeholder initiatives might help to overcome barriers to access such as weak pharmaceutical sector governance and lack of transparency and public accountability. The Medicines Transparency Alliance (MeTA) is a multistakeholder initiative implemented in the pharmaceutical sectors of seven countries (Ghana, Jordan, Kyrgyzstan, Peru, the Philippines, Uganda, and Zambia) between 2008 and 2015. In this study, we aimed to assess whether MeTA has had an effect on transparency (defined here as the degree to which access to information is available and citizens are informed about how and why government decisions are made) and accountability in the pharmaceutical sector in the seven pilot countries. Methods: We applied case study methods to examine MeTA's efforts to increase transparency and accountability in the seven pilot countries. We reviewed archival data that focused on MeTA Phase II (August, 2011, to December, 2015), although we also noted key events and data from Phase I. We included: country-level semi-annual progress reports, work plans, Department for International Development (DFID) annual review reports, MeTA global meeting notes and presentations, country-level technical study reports, stakeholder forum reports, country policies, and content from web sites and social media. We compared information between countries to identify commonalities and differences in strategies and tactics used to promote MeTA's goals and, where possible, identify how these strategies might link to project results, particularly with regard to improving access to medicines. Findings: We found that the pilot countries used special studies and analyses, open meetings, and proactive information dissemination strategies to expand transparency. Additionally, MeTA fostered multistakeholder policy dialogue to bring together different actors to discuss evidence on access to medicines barriers and progress. We found strong evidence that transparency was improved, for example, through the promotion of proactive dissemination strategies by the government, as well as open public meetings to discuss medicines access issues. Furthermore, MeTA's efforts contributed to new policies, such as revised national medicines policies (for example, in Ghana, Kyrgyzstan, and Uganda) and the elimination of taxes on imported raw material for medicines, as happened in Ghana. Interpretation: Our study provides evidence that transparency can be improved in the pharmaceutical sector through multistakeholder initiatives, and that increased availability of information, coupled with communications between the various stakeholders, could facilitate progress towards access-to-medicines goals and result in greater government accountability. Longer-term outcomes will depend on the sustainability of initiatives, which is furthered predominantly through country ownership of such programmes, and specific actions to promote transparency in the pharmaceutical sector as good practice and clarify how information is used to hold institutions and leaders accountable for performance. Funding: World Health Organization through a grant from the UK Department for International Development.
first_indexed 2024-12-13T04:15:56Z
format Article
id doaj.art-c45fc8e8109544e991f53102ddf2114d
institution Directory Open Access Journal
issn 2214-109X
language English
last_indexed 2024-12-13T04:15:56Z
publishDate 2017-04-01
publisher Elsevier
record_format Article
series The Lancet Global Health
spelling doaj.art-c45fc8e8109544e991f53102ddf2114d2022-12-21T23:59:53ZengElsevierThe Lancet Global Health2214-109X2017-04-015S1S610.1016/S2214-109X(17)30113-4Can a multistakeholder initiative improve transparency and accountability in the pharmaceutical sector? Evidence from the Medicines Transparency AllianceTaryn Vian, PhD0Jillian Clare Kohler, PhD1Deirdre Dimancesco, MBA2Gilles Forte, PhD3Boston University, Boston, MA, USAUniversity of Toronto, Toronto, ON, CanadaWorld Health Organization, Geneva, SwitzerlandWorld Health Organization, Geneva, SwitzerlandBackground: Access to affordable quality essential medicines is crucial if universal health coverage and the Sustainable Development Goals are to be achieved. Multistakeholder initiatives might help to overcome barriers to access such as weak pharmaceutical sector governance and lack of transparency and public accountability. The Medicines Transparency Alliance (MeTA) is a multistakeholder initiative implemented in the pharmaceutical sectors of seven countries (Ghana, Jordan, Kyrgyzstan, Peru, the Philippines, Uganda, and Zambia) between 2008 and 2015. In this study, we aimed to assess whether MeTA has had an effect on transparency (defined here as the degree to which access to information is available and citizens are informed about how and why government decisions are made) and accountability in the pharmaceutical sector in the seven pilot countries. Methods: We applied case study methods to examine MeTA's efforts to increase transparency and accountability in the seven pilot countries. We reviewed archival data that focused on MeTA Phase II (August, 2011, to December, 2015), although we also noted key events and data from Phase I. We included: country-level semi-annual progress reports, work plans, Department for International Development (DFID) annual review reports, MeTA global meeting notes and presentations, country-level technical study reports, stakeholder forum reports, country policies, and content from web sites and social media. We compared information between countries to identify commonalities and differences in strategies and tactics used to promote MeTA's goals and, where possible, identify how these strategies might link to project results, particularly with regard to improving access to medicines. Findings: We found that the pilot countries used special studies and analyses, open meetings, and proactive information dissemination strategies to expand transparency. Additionally, MeTA fostered multistakeholder policy dialogue to bring together different actors to discuss evidence on access to medicines barriers and progress. We found strong evidence that transparency was improved, for example, through the promotion of proactive dissemination strategies by the government, as well as open public meetings to discuss medicines access issues. Furthermore, MeTA's efforts contributed to new policies, such as revised national medicines policies (for example, in Ghana, Kyrgyzstan, and Uganda) and the elimination of taxes on imported raw material for medicines, as happened in Ghana. Interpretation: Our study provides evidence that transparency can be improved in the pharmaceutical sector through multistakeholder initiatives, and that increased availability of information, coupled with communications between the various stakeholders, could facilitate progress towards access-to-medicines goals and result in greater government accountability. Longer-term outcomes will depend on the sustainability of initiatives, which is furthered predominantly through country ownership of such programmes, and specific actions to promote transparency in the pharmaceutical sector as good practice and clarify how information is used to hold institutions and leaders accountable for performance. Funding: World Health Organization through a grant from the UK Department for International Development.http://www.sciencedirect.com/science/article/pii/S2214109X17301134
spellingShingle Taryn Vian, PhD
Jillian Clare Kohler, PhD
Deirdre Dimancesco, MBA
Gilles Forte, PhD
Can a multistakeholder initiative improve transparency and accountability in the pharmaceutical sector? Evidence from the Medicines Transparency Alliance
The Lancet Global Health
title Can a multistakeholder initiative improve transparency and accountability in the pharmaceutical sector? Evidence from the Medicines Transparency Alliance
title_full Can a multistakeholder initiative improve transparency and accountability in the pharmaceutical sector? Evidence from the Medicines Transparency Alliance
title_fullStr Can a multistakeholder initiative improve transparency and accountability in the pharmaceutical sector? Evidence from the Medicines Transparency Alliance
title_full_unstemmed Can a multistakeholder initiative improve transparency and accountability in the pharmaceutical sector? Evidence from the Medicines Transparency Alliance
title_short Can a multistakeholder initiative improve transparency and accountability in the pharmaceutical sector? Evidence from the Medicines Transparency Alliance
title_sort can a multistakeholder initiative improve transparency and accountability in the pharmaceutical sector evidence from the medicines transparency alliance
url http://www.sciencedirect.com/science/article/pii/S2214109X17301134
work_keys_str_mv AT tarynvianphd canamultistakeholderinitiativeimprovetransparencyandaccountabilityinthepharmaceuticalsectorevidencefromthemedicinestransparencyalliance
AT jillianclarekohlerphd canamultistakeholderinitiativeimprovetransparencyandaccountabilityinthepharmaceuticalsectorevidencefromthemedicinestransparencyalliance
AT deirdredimancescomba canamultistakeholderinitiativeimprovetransparencyandaccountabilityinthepharmaceuticalsectorevidencefromthemedicinestransparencyalliance
AT gillesfortephd canamultistakeholderinitiativeimprovetransparencyandaccountabilityinthepharmaceuticalsectorevidencefromthemedicinestransparencyalliance