1. Presented to CSO workshops in Kabwe on 18 July 2014, Livingstone on 28 July 2014 and Lusaka on 27 August 2014

2. MeTA CORE PRINCIPLES Introduction  Medicines Transparency Alliance (MeTA) is a network of individuals and organizations in seven countries.  Network includes health workers, administrators, Civil servants, politicians, pharmaceutical company employees, civil society and international organizations and the media.

3. MeTA CORE PRINCIPLES AIM – Improving the lives of millions of people by helping them get access to the medicines they need. METHOD – The use of the tools of Transparency and Accountability They are also committed to the core principles that underpin MeTA’s approach. Signing up to these principles is an important first step for all stakeholders wanting to engage in the MeTA process.

4. MeTA CORE PRINCIPLES The Core principles are  Governments are responsible for providing access to health care, including access to essential medicines  Stronger and more transparency systems and improved supply chain management will increase access

5. MeTA CORE PRINCIPLES  Increasing equitable access to medicines improves health and enables other human development objectives to be achieved  Improved information about medicines can inform public debate, and provide a basis for better policy

6. MeTA CORE PRINCIPLES  A multi-stakeholder approach that involves all sectors – private, public and civil society – will lead to greater accountability Why Transparency and Accountability? Why ACCESS? Why Multi-stakeholder Alliance?

7. Transparency & Accountability  In many developing countries like ZAMBIA there is little publicly available information on the price, quality, availability and promotion of medicines.  The three information blockages are: Information doesn’t exist It exists but not in a publicly accessible form or It is publicly available but no-one knows so no-one uses it

8. Transparency & Accountability Lack of openness and accountability contribute to  Excessive price mark-ups  Corruption  Poor forecasting of essential medicines leading to shortages

9. Transparency & Accountability  Large but infrequent orders that put a burden on local infrastructure leading to the trashing of products that are beyond their sell-by date  Increased risk of theft or spoilage through inefficient storage and supply and  Poor quality counterfeit drugs

10. Transparency & Accountability For MeTA information improves decision making and therefore efficiency in the medicines supply chain. Openness – disclosure of information – is at the heart of MeTA’s work. Efficiency can mean lower prices and greater consistency in the quality of medicines: especially, medicines that are more cost-effective and clinically effective. In Zambia theft was cut by providing information on the delivery of medicines in rural health centres to local health committees made up of members of the local community.

11. ACCESS  Access to health care is a fundamental human right recognized by governments around the world.  Fulfillment of that right must include access to good, quality, affordable medicines.

12. ACCESS  Availability can be restricted by a variety of factors, ranging from cost of medicines to transport problems and from fraud and inefficiency in the supply chain to doctors’ lack of knowledge about specific drugs.  Weak health systems, a common deficiency in developing countries, can mean that staff to prescribe, dispense and deliver medicines are not available

13. MULTI-STAKEHOLDER ALLIANCE  MeTA is not a funding mechanism but a programme that strongly advocates creating conditions for multi- stakeholder processes,  MeTA coordinates action and synthesizes knowledge that enables social learning to resolve collectively issues on medicines.

14. MULTI-STAKEHOLDER ALLIANCE One of MeTA’s key elements is to use a multi- stakeholder approach. This important principle recognizes that complex issues such as the supply of effective, affordable medicines involve many different interest groups and individuals who see the problems and solutions only from their own perspective. The resulting clash of interest often leads to the emergence of a dominant group which imposes its favoured policy.

15. MULTI-STAKEHOLDER ALLIANCE  But there is another way, the various stakeholders can agree to work together on an equitable basis recognizing the validity of others’ interests, sharing information and views.  A ‘neutral’ space in which to work is created, a shared understanding of the problems, common ways of working and an agreed agenda among everyone taking part.

16. MULTI-STAKEHOLDER ALLIANCE  In MeTA’s case, this means establishing a forum for representatives of everyone involved in the medicines supply chain viz  Manufacturers, governments, international organizations, traders, medical workers, academics, the media and patients.