Medicines Transparency Alliance (MeTA) in Ghana

Following 2 scoping missions by the United Kingdom (UK) Department for International Development (DFID), the MeTA core team worked to secure high-level country political commitment and to fine-tune strategies for sharing learning across countries. Key Principles for 2007-2011 include several communication-centred themes, such as an emphasis on partnership, participation, and equity, as well as plans to proactively engage civil society in consensus-building and in providing more information to consumers.

MeTA Ghana is establishing mechanisms to strengthen the collection, analysis, and dissemination of data on medicines along the supply chain. Sustaining regular, open stakeholder dialogue is a core component of this process. Also, participants are facilitating peer oversight systems within and across health professions. This open, collaborative approach is designed to build accountability to address inefficiencies and reduce excessive pricing, and to support principles of equity and social justice by increasing transparency.

To understand exactly how best to proceed, MeTA Ghana is planning to draw on research as a core way to uncover and spread information - for example, by undertaking studies to assess the level of transparency and accountability in medicines regulation, procurement, distribution, and use. Periodic annual studies will assist in understanding and/or explaining provider and consumer behaviour. In addition, members of the core team will be promoting regular monitoring of medicine prices and availability as well as their rational use using World Health Organization (WHO) standard indicators. Sentinel testing with German Pharma Health Fund (GPHF) "minilabs" will facilitate regular monitoring of medicine quality.

Echoing MeTA Ghana's collaborative approach, a core focus will be on fostering agreement by pharmaceutical companies to data publicise their supply prices to match tender data. The group will work to bring chemical sellers fully on board in ensuring medicines availability, affordability, and rational use through regulation, training, and efficient monitoring. As indicated above, MeTA Ghana will make it a priority to enhance the capacity of CSOs and the media so that they can play more active role in medicine advocacy (e.g., by supporting disclosure and accountability). CSOs have released a statement [PDF] indicating their desire to participate fully.

Health, Transparency.

According to organisers, economically poor people frequently lack access to essential medicines because prices are too high (private sector), products are not available (public sector), there are concerns about quality of products (public and private), and there is inadequate focus on distribution from "port to patient". Available evidence shows: variable efficiency of public procurement, price mark-ups along supply chains, low local manufacture, and counterfeits.

Although there are measures put in place to make concrete Government and Presidential commitment to good governance (e.g., the Public Procurement Act 2003, Ministry of Health (MOH) Guidelines for health sector procurement, and a forthcoming Right to Information Bill), MeTA Ghana contends that the benefits of improved procurement are not translating into affordability and availability for patients. One culprit is low consumer awareness due to very little information in the public domain on quality, availability, and prices of medicines. Other issues include: inconsistency across the public, private, and mission sectors in terms of how standards (i.e. quality, availability, and pricing) are developed and applied; non-adherence to treatment guidelines by prescribers and irrational use of medicines by providers; and mutual suspicions between stakeholder groups.