First Evaluation of Good Governance for Medicines Programme Brief Summary of Findings

Purpose of the Evaluation To analyse experiences and lessons learnt after 8 years of implementation

Principal Findings (1) In Phase II and III countries: Improved medicines procurement Revised pharmaceutical laws and regulations Increased transparency in registration and licensing Improved management of conflict of interest More public information on medicines policy and governance

Principal Findings (2) Increased awareness about impact of weak governance, including unethical behaviour, on country capacity to achieve universal access Increased commitment to create and sustain transparency in key stages of the medicines chain Increased international awareness Acknowledged value of 3 phase methodology Value for money

Observation In some countries GGM process is strongly country owned and driven. Others remain dependent on WHO support. This has implications for WHO skills, capacities and resources.

Lessons learnt (1) Increased vulnerability due to: Inability to control medicines promotion Weak policy base and lack of operational procedures on medicines registration Lack of formal criteria to guide selection of members of key committees e.g. medicines selection Lack of public access to information about medicines legislation, regulations and written procedures

Lessons learnt (2) Factors that promote good implementation: High national priority to tackling corruption including tangible support at highest political levels Intersectoral mechanisms for improving good governance, including ministry of finance Dedicated GGM management group comprising senior stakeholder representatives WHO support specific to country context, benchmarking progress and sharing lessons

Lessons learnt (3) GGM is about strenghthening systems and reducing vulnerability through increased transparency and promoting ethical conduct. The GGM methodology: Engages stakeholders Increases awareness Stimulates dialogue Identifies problems

Towards next phase of GGM (1) GGM experience should inform future WHO work on strengthening transparency and institutional integrity It should become an integral component of WHO action to promote universal coverage

(2) Implications WHO must: Complete unfinished work, especially to develop impact indicators for monitoring and evaluation Establish strong and consistent staff and budgetary support across 3 levels of the organization

(3) Dialogue with partners Evaluation showed partner interest in GGM but wanted to know more e.g. through regular updates Widen remit to include private sector Opportunities to use GGM tools more widely e.g. in the wider health sector, for risk assessment More work needed to measure effectiveness