MeTA Jordan

Medicines Transparency Alliance20/04/23 1

MeTA Jordan

Dr Taher Abu ElSamenMeTA Council ChairHHC Secretary General


Multi-stakeholder process

The Multi-stakeholder process in Jordan started by:

Establishing the MeTA Council based on a multi-stakeholder membership , the MeTA Council is represented (fully/ cant considered fully as the private sector is poorly represented) by multi-stakeholder, public and private sectors and the CSO

The Stakeholders jointly agreed on a national country workplan for 21 months

Medicines Transparency Alliance

Multi-stakeholder in MeTA Council

WHO DFID WB04/20/23

MeTA Int. Partners


Multi-stakeholder process cont.

The national forum Nov. 2009 created an opportunity to re-motivate and engage stakeholders especially the private sector and the CSOs, the diversity of the represented attendees gave a unique flavor for the forum especially during the discussion session

The one day multi-stakeholder collaboration for MeTA pilot countries workshop carried out by Wageningen University in January 2010 was a success, 70 attendees from all MeTA Countries attended, the multi-stakeholder training on January aimed to improve dialogue and collaboration

Conducting the data disclosure survey was an opportunity not only to collect data but also to work together as a multi-stakeholder, share information and exchange ideas which created more interest and commitment for future activities

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MeTA Jordan will carry out the stakeholder mapping and communication audits in July to help map out the local communication partners and individual consultants

Having MeTA in Jordan was an opportunity to get key people working in the pharmaceutical sector engaged together in a multi-stakeholder membership and including patients along the way

MeTA Jordan stakeholders has reached a stage of realizing that they need skills to help them communicate with representatives of institutional partners who may come from very different positions has

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MeTA Jordan stakeholders are thinking strategically to develop a clear brand identity for MeTA and to recommend development of communication tools and messages to support the multi-stakeholder process

The International MeTA Secretariat offered countries to identify and communicate the barriers and ensure that the appropriate guidance and support is mobilised within MeTA to address them

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Multi-stakeholder Milestones

Establishing a multi-stakeholder MeTA Council

MeTA Jordan national forum invited multi-stakeholder Nov. 2009

One day multi-stakeholder collaboration for MeTA pilot countries workshop in January 2010

Conducting the disclosure survey with stakeholders working together

The planned stakeholder mapping and communication audits to take place in July 2010 through the IDS

MeTA Jordan stakeholders have identifies the skills neded to help them communicate with representatives of institutional partners who may come from very different positions, planned between July and Sep. 2010

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Overall challenges in multi-stakeholder process

A new concept and idea, it needs more time for people to accept and understand

Lack of experience of multi-stakeholder process and the need for different communication skills for members

Inter-personal /inter-institutional communication skills for MeTA Council Members was a challenge, (active listening etc training is needed)

There are currently issues related to Council members listening to each other and putting their point across in a non- confrontational way

People are not all used to operating in a forum where people represent organizations with such different positions and they need support on consensus building

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Major achievements and successes for MeTA in Jordan

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The Government is highly supportive of the MeTA process it supported and hosted MeTA at the HHC, a governmental institution, this gave the whole process an official identity and led to have the diverse public sector more engaged

MeTA was launched in Jordan as a high profile national event in May 09

The highly committed MeTA Council Members started realizing the concept of transparency, they agreed on a national workplan based on the NDP, they agreed to publish all outcomes on Jordan MeTA web site, participated in the data disclosure survey and issued the first MeTA newsletter on April 2010

Jordan had hosted a session at the WHA on transparency and good governance May 09

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The MeTA process has opened channels of communication between different stakeholders and between different countries. Common understanding of each of the other stakeholder perspectives was identified, the fact that there are common priorities and one objective between stakeholders became more clear

MeTA council private sector representative attended the private sector meeting in London June 09

Pharmaceutical Baseline Assessment Survey-Level II and a WHO/HAI surveys took place

Supply Chain Mapping assessment took place in March 09

A Successful National Forum Nov 09

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In terms of CSO building capacity area:

The CSO committee has drafted a CSO workplan where it is derived form the three major priorities in the overall national MeTA workplan in Jordan, “Build capacity of (CSOs) to monitor and increase accountability of all stakeholders with respect to the prices, availability, selection and quality of medicines in the public and private sectors

A nucleus of a CSO coalition has started to form and a MoU was signed with the Int. MeTA Secretariat in November 2009 and a specific CSO workplan was approved accordingly the voice of patient is now becoming heard by the Government policy makers

The very first activity was conducted to map and identify CSOs to assess their ability and willingness to work together and to engage them with the MeTA council, this activity has set the baseline work for the CSOs in Jordan

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In terms of CSO building capacity area:

Workshop on building capacity of CSOs in order to strengthen their ability to monitor and increase accountability of all stakeholders regarding medicines prices, availability, selection and quality of medicines

CSOs have Participated in the Harvard Flagship course and have participated in the country exchange visit to the Philippines

Conduct a training on advocacy and communications in improving access to essential medicinesThe CSO level of engagement with the MeTA process is moving forward gradually

At the start of the process there was limited activities and meeting but since November they become more engaged

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In terms of evidence based medicine:

Reviewed TORs and SOPs of various (therapeutic area-related) committees involved in selection of drugs to be included in Rational Drug List (RDL), reviewed criteria for adding and deleting drugs to and from the RDL, and finally reviewed classification of drugs (Restricted, Un-Restricted, Authorized and Un- Authorized) in RDL

Introduce the pharmaco- economics concept and its importance for RDL addition and deletion to the local industry and generic importers

A series of training sessions on pharmaco-economics to PTC

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In terms of RDU:

NICE has Pilot the development of an evidence-based care pathway, first step was (STG Gap Analysis in the public sector and second step was developing essential Hypertension STG) for all public primary health care facilities

Conducted a Promotional for Rational Drug Use workshop

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Overall Challenges

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Overall Challenges

At Pharmaceutical level:

Poor forecasting and estimation of medicines needs which led to low availability of medicines in public sector

High Health expenditure 9.05% of GDP where 34% out of it is spent on medicines with 2/3 expenditure is out of pocket and all this is seen as our fault and Irrational Use of Medicines

Willingness of the private sector to share information, such as information related to prices, promotional activities and quality

High pharmaceutical promotion / hard to control even some patient group's budgets are partially supported by pharmaceutical companies

No base line data to measure outcomes

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Overall challenges

At the MeTA Level:

Short period, the two year MeTA pilot is not enough to present and measure the impact on the availability and RDU,, as much as we worked and contributed as a sector the outcome will be noticed through years to come

We started the MeTA process with no base line data to rely on, the base line data to be collected started after the MeTA process commenced

Changes in MeTA Council representatives positions/agendas can hinder their participation in medicines policy changes and creates a gap between Council members

Private sector is poorly represented in the MeTA Council

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Overall Challenges

At the MeTA Level:

CSOs are still not represented in drug related committees like the Pricing Committee or Higher Drug Committee

Difficulty in attracting new CSO groups to join the MeTA CSO coalition and there is an absence of coordination or sharing of expertise and experiences among the various CSOs

Limited participation of CSO representatives in MeTA Baseline Data Disclosure Survey and no coordination for the CSOs work

Poor role of the CSOs in the decision making process with limited role in patient counseling

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Lessons Learned

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Lessons Learned

To continue exploring national opportunities for pursuing MeTA post-pilot in Jordan

Looking for sustainability when MeTA ends in the country, we need to keep searching for other fund and contact other international partners like EU

Opening channels with media to engage external stakeholders with the MeTA process and raise public awareness

To recommend activities and present a prioritised workplan to the International MeTA Secretariat for discussion as soon

To engage parliament in the MeTA process

The stakeholders started to understand each others perspectives

CSO engagement with the MeTA process complements the overall picture and highlights patients’ need. Capacity for CSOs to engage more effectively needs to be built

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Lessons Learned

A budget for a CSO coordinator should have been listed in the CSO workplan and there should be an organized structure for the CSO coalition

The MeTA process has opened channels of communication between different stakeholders and between different countries

MeTA has acted as a coordinating body for the pharmaceutical sector players and stakeholders and for people working in the pharmaceutical sector

We have learned the Importance of Data Disclosure, many outputs we were keen to participate in towards disclosure it was a useful exercise that improved communication, sharing and disclosing of information, a core MeTA principle we agreed to publish all outcomes on Jordan MeTA Web site and learned that we should involve the media more

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Lessons Learned

MeTA has acted as a coordinating body for the pharmaceutical sector, also the MeTA process has opened channels of communication between different stakeholders and between different countries

The Consultants Technical Advisory role is of a high value for the MeTA process and in improving quality of implementation of the national workplan

The multi-stakeholders ( public, private and CSOs) process in very hard, it takes time to have the stakeholders understand each other's perspectives and identify that there were in fact common priorities and one objective to work on together

The international and the national MeTA Secretariat coordination role is integral for the MeTA process to move forward

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Thank you for Listening

Dr Taher Abu El Samen Email: [email protected]

Mobile number: +962 79 726 7444

Website: www.meta.jo

Documents

MeTA Jordan