Medicines Transparency Alliance (MeTA) in Zambia

MeTA is based on the premise that bringing together various stakeholders - the private sector, civil society, the government, and other interest groups - in both face-to-face and virtual gathering spaces can spark action for supporting the development of viable, efficient medicines markets and supply systems.

Civil society organisations (CSOs) have been active in building the MeTA strategy in Zambia. Four Zambian CSO representatives took part in a skills-building seminar in Uganda in February 2008 designed to improve the capacity of the health sector to ensure that patients take appropriate, affordable, safe medicines when they are needed. A number of skills development sessions provided opportunities for participants to sharpen their abilities in research, communication and advocacy, and influencing and negotiating. They also explored how to monitor prices, improve collaboration and networking, make use of a rights approach to access to medicines, engage with the media, interpret data, develop policy briefs, and understand equity issues. A key feature of all the skills sessions was the emphasis on building on the experience of the participants and sharing that experience. The Zambia group met separately, which led to the resolution to brief the wider CSO community and meet other organisations participating in the MeTA process, to develop a baseline assessment of the situation in their country, and to organise an advocacy strategy.

Health, Rights.

"Bribery in the health system results in higher drug prices", Goodwell Lungu of Transparency International Zambia said as MeTA Zambia was being formed. And, Lungu elaborated, lack of information for patients about services and medicines - about where and when they are provided, about who provides them, and the procedures to be followed - creates an environment in which corruption can flourish.

Recent health reforms in Zambia aim to "provide equity of access to cost-effective, quality health care as close to the family as possible." But, according to MeTA Zambia, there are 3 main challenges around access to health: proximity to services, costs, and human resources. In urban areas, 99% of households are within 5 kilometres of a health facility as compared to 50% in rural areas. Household expenditures on health also vary according to location; economically poorer rural households spend a higher proportion on health when costs in kind are included. Human resources are also strained due to medical staff leaving the country or moving from the public sector to the private sector, as well as the impact of HIV and AIDS.

MeTA Zambia explains that, in recent years, failures in the procurement and supply of medicines have been acknowledged, with essential drugs often out of stock. The connection between the different units and health care facilities and the related information system (health care facilities sending up usage data to forecast, placing orders before drugs get out of stock, etc.) did not work routinely, forcing emergency procurements when/if funds were available. This led to high prices being paid, further deteriorating the situation.