Medicines Transparency Alliance07/09/2015 1 MeTA Zambia Country Overview Public Sector Private Sector Civil Society.

Medicines Transparency Alliance19/04/23 1

MeTA Zambia

Country OverviewPublic SectorPrivate SectorCivil Society


Country Overview

Violet Kabwe MeTA Zambia Consultant


Multi-stakeholder process

What were the major milestones in the multi-stakeholder process? Establishment of the MeTA Management Structure: Council, Forum and Sub –

Committees

Establishment of National Secretariat

Developed Zambia MeTA website

Communication strategies implemented at both policy and community levels: motion in parliament, TV and radio live phone in progs, community sensitization road shows, development of fact sheets etc

Orientation workshops for MeTA Council members held in supply chain systems and regulatory issues/mandate

Have developed synergies with GGM

Conducted data disclosure tool

Drafted advocacy position papers on ‘ADDO’ system in Zambia and counterfeit and sub-standard drugs

Commissioned studies impinging on availability, affordability, and access to medicines

Provided technical support to CSO Coalition capacity building on supply chain systems

Medicines Transparency Alliance

Major achievements and successes

What where the main achievements and successes of MeTA in your country?Successful, well-attended MeTA launch, opened by Minister of Health.

Effective capacity building of Council members in supply chain management and functions of PRA.

Successful mobilization of cross-party parliamentarians; moved motion in parliament which introduced MeTA concept to august house.

Good buy-in from Cabinet Office –agreement to distribute MeTA materials.

Establishment of national MeTA Secretariat

Effective community mobilization efforts in rural pilot districts of North-Western Province –included 2 successful radio shows.

Live radio/TV programmes have become popular and made MeTA ‘visible’

Community radio station managers mobilized through sensitization workshop.

Mainstreaming of MeTA in community programs have gained popularity

MeTA included in national health reform processes

Reports commissioned for challenges of manufacturing sector, pricing structures in public/private sector, private sector mapping survey and data disclosure survey.

MeTA Zambia website commissioned –impressive design.

MeTA Forum meeting held

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Overall challenges (1)

What have been the main challenges during the MeTA pilot phase?Creating trust and Commitment among stakeholders by striving to share joint MeTA learning among all stakeholders common MeTA benefits strategy or/and understanding that cuts across all sectors

Commitment by all stakeholders was a challenge

MeTA Council/CSO Coalition synergies were not apparent

Felt need to set up sub – committees as implementation bodies of MeTA Council

Expected support from government and CPs did not fully materialize

Used two pronged approach, targeting both policy and community levels as entry points for dialogue/sensitization concerning MeTA core principles

Capacity building of MeTA Council members in pharmaceutical sector and health care delivery systems.

Making private sector representatives, line ministry officers and members of parliament to become aware and gain knowledge on MeTA issues

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Overall challenges (2)

Delayed funding due to local bureaucracy meant late start to implementation of national work plan

Delayed/disrupted recruitment and housing of Secretariat

Support of other MeTA CPs to Initiative was not forthcoming

Need to maintain continuous buy-in of all sectors and stakeholders time-consuming.

Operations of Council and Sub-Committees depend on voluntarism, and high levels of commitment and time.

Most members in full-time work so regular participation challenging, very apparent in the Research & Survey sub - committee.

Large Council makes convening meetings logistically challenging and expensive. –Large numbers with varied skills mix means decision-making is slow.

Initially, a calendar of Council and Sub-Committee meetings was not published in advance, made planning and scheduling challenging.

Lack of clarity on the log frame, delayed work plan approval, and disrupted timely funding/ implementation.

Adhoc requests from MeTA International for sudden activities a big challenge; especially with a tight work plan to implement

Non – disclosure of pricing structures by most pharma industry

Disclosure tool only made available in Sept 2009 –would have been useful as baseline data and for work plan development.

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Lessons Learned

What are the main lessons from MeTA in your country? MeTA process is technical and complex, hence requires capacity for all

members to move at the same pace.

There are diverse interests among MeTA members who continuously strive to have common understanding and expected outcomes from the MeTA Process

Establishing consensus requires constant lobbying for exchange of views

Commitment of people important otherwise multi-stakeholder processes will not work

MeTA members need medicines and management expertise

MeTA can not operate in a political vacuum

MeTA CSO needs to include members that are able to engage in dialogue at high profile level

Two pronged approach in MeTA process (sensitization/lobbying at grassroots and policy levels respectively), improved MeTA ‘visibility”

Non completion of desk review of data affected other dependent activities

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Community Awareness

Community awareness activities – MeTA roadshow in Mkushi

Opportunity to create public awareness about MeTA

Positive response to MeTA issues in rural communities


Thank you

Violet Kabwe Email: [email protected]

Mobile number: +260976939364

Website: www.metazambia.org


Public Sector

Mrs Bernice Mwale Director – Product Registration Pharmaceutical Regulatory Authority


Summary Analysis at start of MeTA

What were the needs and issues in your specific sector at the start of MeTAMeTA was initially to be housed within MOH, later agreed that Transparency International (Z) be host

MeTA very much linked to public sector; MOH key to success of MeTA, even though not driving MeTA

MeTA provides big opportunity to have all different stakeholders on one roundtable to discuss issues that could influence policies/practices

Understanding core principles of MeTA by members very key

Expected support from CPs

MeTA members are volunteers, their time is at a premium

The size of MeTA Council directly relates to MeTA effectiveness

Targeting issues that directly impacts general public is measure of MeTA success


Major milestones

Government has shown support towards MeTA as shown by the Minister of Health launching of MeTA in Zambia and other activities

Government has participated in the MeTA live radio programs after some initial hitches

Orientation workshop for MeTA Council members in PRA mandate/functions

Orientation of MeTA Council members in the national supply chain systems (public and private)

Collaborative meeting held between PRA and its stake holders

Active participation of MOH and its institutions in Forum meeting

Co-chairing of MeTA Council meetings

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Successes

MeTA provided another forum for dissemination of information to wider circle of stake holders

Participation in live MeTA radio programs

MOH representative is Vice Chairperson of MeToA Council

Successful orientation of MeTA Council members in the functions/mandate of PRA

Successful collaboration by PRA with key stakeholders on various issues affecting them

Successful orientation of MeTA Council members by MOH/its institutions on the national supply chain system

Active participation of MOH, PRA and MSL IN THE MeTA Forum meeting

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Challenges (1)

Big challenge for government employees to talk about transparency and accountability issues

Finding time to attend to MeTA activities given busy schedules

Weakness in the tools that were used to carry-out some surveys; should have been field tested first

The surveys were supposed to gather more evidence for advocacy and influencing change

Ensuring quality verses spending more money in a short time (to beat financial deadline).

It was a challenge for some government officials in the MeTA sub-committees to follow tendering procedures rather than those followed in government (Comprehensive Tendering Procedures)

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Challenges (2)

Balancing MeTA activities and government duties was a challenge, especially that MeTA programs do not give sufficient notice

The role of MOH in MeTA is key, however, need to recognise that MOH is not the driver for MeTA

MeTA may be expected to address all kinds of issues, even if these are influencing access to affordable essential medicines

Most CPs needed to be reminded about MeTA.

MeTA can be seen as a tool with which to ‘punish’ or ‘expose’ the weaknesses in the public health sector

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Challenges (3)

The challenge MeTA presents is that all stakeholders and concerned citizens want to be counted within MeTA. This is clearly a difficult situation for MeTA Council and admin team

MeTA is still in the formative stage and it may feel inadequate to tackle certain issues that impact on access to essential medicines

Initial focus was on private sector from the regulatory point of view

Misrepresentation of facts by consultant involved in desk review, delayed other MeTA follow on activities

Some of the tools used for data collection appeared to be deficient in certain critical information.

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Lessons Learned (1)

MeTA should have an independent stand alone registered secretariat

It was an opportunity for government to share information with the general public to discuss health issues, the forum can be used to share information dialogues with other stakeholders to introduce/withdraw new policies, schemes,fees and report illegal practices

It was learnt that it is important to identify issues surrounding a survey before it is carried out.

Difficult to fit in MeTA activities

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Lesson Learned (2)

There was need to have clear cut issues identified if a change was to be achieved

it was a big opportunity for government to have all different stakeholders on one table hence a chance to raise awareness to other sectors. Awareness was also raised through the MeTA radio programs

MeTA is very much linked to the public health sector. The MOH, even though not driving MeTA, is key to the success of MeTA

There is a need to advocate for more infrastructure and health personnel to improve quality and accessibility of good quality medicines

Focus on one or two issues was very necessary if tangible results were to be achieved

The public health sector need not be seen as the only target for MeTA

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Lessons Learned (3)

Knowledge of the purpose and intentions of MeTA by stakeholders. There is a need for all members and stakeholder to keep in mind the background that resulted in MeTA

The support from Cooperating Partners has been below expectation

MeTA members are volunteers and their time is at a premium

The size of MeTA Council directly relates to the effectiveness of MeTA

Targeting issues that directly impact the general public is a measure of MeTA’s success

Clearly the time- frame for MeTA put pressure on members and the MeTA administrative team. All parties want to succeed.

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Thank you

Name of presenter : Mrs Bernice Mwale

Job Title: Director – Product Registration (PRA) Email: [email protected]

Mobile number:+260977804353



Private Sector

Presenter Name : Ruth MudondoJob Title: Director – Unicare Pharmaceuticals. Chair person – Zambia Pharmaceutical Business Forum.



What were the needs and issues in your specific sector at the start of MeTA?

Issues

Private sector was battling with the challenges & problems– alone. Though Zambia Pharmaceutical business Forum (ZPBF) was in place.

Lack of transparency at MOH – One of the major concerns of the Private sector

Lack of flow of information and very little consultation between Pharmaceutical regulatory authority – Private sector – PRA

Private sector was not able to access some of the information at PRA.

Lack of unity among the business community - drive to fight for the common cause.....

Needs

Wanted someone to represent the private sector in the MeTA process


Major milestones

What milestones have been achieved during the MeTA pilot phase?

Establishment of Multi stake holders forum – Fantastic

PRA (Pharmaceutical Regulatory Authority) heard the challenges of the Private sector from a neutral body like MeTA

MOH was more willing to respond to the queries raised by the Private sector.

CSO and Media got to know the role of private sector in Health care.

Private sector found it easy to express their challenges in the MeTA meetings and most of the time private sector got the positive support from MeTA.

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Successes

What were the successes for your sector during the MeTA pilot phase?

Zambia Pharmaceutical Business Forum – Recognition

Issues pertaining to Local Pharmaceutical Manufacturers were taken up on FAST TRACK and are being addressed by relevant authorities.

Media Campaigns: Ordinary citizens got to know more about distribution of medicines and the challenges that are faced by the Public & Private sector in delivering quality medicines.

Radio program: Flow of information – Interactions – Public Participation

Documentary: Public awareness about the role of Private industry in National Health care – Increased

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Challenges

What challenges has your sector endured during the MeTA pilot phase?

Certain segment of Private sector is yet to appreciate MeTA activities.

Certain segment of private sector – Sceptical about MeTA.

Balancing the MeTA activities with the routine business activities is a challenge.

Getting co operation – conducting survey – is a real tough job

Understanding the concept of disclosure – Cant visualize the benefits – hence it is difficult to get the support of private sector.

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Lessons Learned

What are the lessons that your sector has learned from MeTA?

Importance of MULTISTAKE HOLDERS approach – well understood

Strength and weaknesses of other government institutions, learnt others limitations and started appreciating their efforts to be more transparent and accountable.

Importance of Disclosure tools – Give and take policy.

Importance of lobbying

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PHARMACEUTICAL PRIVATE SECTOR IN ZAMBIA

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Manufacturers Wholesalers Retailers


Challenges of Pharmaceutical manufacturing in Zambia

Challenges of Pharmaceutical manufacturing in Zambia – Lack of modern equipment – Limited research and development

expertise


Thank you

Ruth Mudondo

Director - Unicare Pharmaceuticals


Civil Society

Dimuna Phiri

Paralegal Officer- Zambia AIDSLaw Research and Advocacy Network



What were the needs and issues in your specific sector at the start of MeTA?

*To build capacity amongst CSO’s so as to enable them to engage and deliberate in the multi stakeholder process*

To acquire advocacy skills

To understand policy formulation and analysis as well as government structures and functions

To understand the drug supply chain in Zambia

To acquire research and budget tracking skills

To understand the Multi Stakeholder Process


Major milestones

Advocacy training was conducted

Drug supply chain training was conducted

A training on policy formulation and analysis as well as the functions of government and it’s structures was conducted.

15 Civil society organization are fully committed in the coalition

MeTA CSO’s took part in the radio programs and television documentary.

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Successes

MeTA CSO secretariat is in operation

The Work-plan was successfully developed and approved

An advocacy strategy has been developed

Increased knowledge amongst CSO’s on medicine issues to participate in various opportunities and forums.

Developed networks with the private government and similar campaigns such as the Stop Stock Out Campaign.

MeTA CSO has legitimacy because it has representation from the community.

Multi-dimension civil society participation.(e.g. governance, faith based, media and human rights organisations.)

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Challenges

The implementation period of the work-plan was too constraining.

Dividing time between respective organisational duties and MeTA activities was a challenge

Delay in the disbursement of funds

Health issues are complex and time is needed to build adequate capacity to understand them.

Co-opting organisations in the MeTA CSO process was a challenge on inception

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Lessons Learned

The work plan was over ambitious (time-frame)

Some trainings were too technical.

Fluctuation in exchange rates affected the budget

Harmonizing MeTA Zambia and MeTA CSO work-plan was a challenge

There was under budgeting during the budget planning process

There is so much that MeTA CSO’s can do as regards to issues on health in Zambia.(evidenced from the trainings)

There is a need to share and link with other similar campaigns.

CSO’s became aware that they had a role to play in the pharmaceutical sector

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Thank you

Name of presenter : Dimuna Phiri

Job Title: Paralegal Officer- Zambia AIDSLaw Research and Advocacy Network

Email: [email protected]

Mobile number:+260979092885


Medicines Transparency Alliance07/09/2015 1 MeTA Zambia Country Overview Public Sector Private Sector Civil Society.

Documents

successes of meta

popularity meta

meta materials

meta concept

meta zambia website

meta management structure

meta forum meeting

meta pilot phase