Medicines Transparency Alliance (MeTA) in the Philippines

Having pinpointed lack of transparency in pricing, promotion, and procurement of medicines as critical factors, stakeholders in the 24-member MeTA Council Philippines are overseeing the development and implementation of the country work plan, reporting progress to the MeTA International Secretariat. The first year saw the establishment of a collaboration process and a common understanding that improving access to medicines would require each stakeholder to share information and exercise transparency and accountability in order that sound policies and reforms could be worked out. MeTA's discussions were described as "a robust interaction" between government agencies, companies, academics, and the international development partners.

The MeTA Council started work on disclosure of information, such as baseline data on the registration, prices, availability, and procurement of medicines. It has served as a venue for discussions on issues around the Cheaper Medicines Act and other reforms.

In 2008, MeTA collaborated with the World Health Organization (WHO) and the Department of Health to offer the Good Governance for Medicines (GGM) National Awards, which was an effort to institutionalise the concept of good governance and transparency in the registration, selection, procurement, use, and management of medicines and overall management of medicines in the public and private sector. By recognising innovative and exemplary programmes from both the public and private sector, organisers hoped to provide incentives for good practices, build models and duplicate them, and create public awareness of GGM.

As of 2009, MeTA Philippines is working to overcome barriers to transparency and accountability, including a lack of established tools for disclosure of information, legal and structural barriers, and business systems and corporate strategies that do not allow voluntary disclosure of information. Transparency on medicines pricing and promotion, for example, remain shrouded behind the veil of trade practices. To address this problem, the MeTA National Stakeholder Forum convened a National MeTA Forum, Breaking Barriers for Transparency. The January 2009 event drew about 140 participants from government, industry, private sector, and academia.

The Council is also finalising a country work plan. Initial activities will focus on baseline assessments and the setting up of systems and structures for transparency and progressive disclosure of information. It is also looking into starting regional MeTA hubs. Civil society participation is recognised as pivotal to MeTA's success, and a mechanism for civil society organisation (CSO) representation and collaboration is being worked out.

Health, Rights.

Access to medicines is a public health concern in the Philippines. A survey by the World Health Organization (WHO) and Health Action International (HAI) in 2006 showed that medicine prices were between 3.4 and 184 times higher than the international reference index, and that the availability of essential medicines was only 11% in the public sector. A lack of transparency and accountability in the pricing, selection, promotion, procurement and use of medicines was pinpointed as a critical factor in this unsatisfactory situation.

According to GGM Awards personnel, the Local Government Code has devolved health services to Local Government Units (LGUs), with each level procuring medicines on their own. Transparency and accountability become an issue, as illustrated by this case example: Commissioned by WHO in 2006, a study of 10 LGUs across income levels revealed that, of the total health budget, the allocation for medicines was only .08% in a 6th class municipality and 10% in one of the biggest cities. The procurement cycle was found to be between 2 and 18 months, making essential medicines unavailable most of the time. Further, availability of core essential medicines is only around 10-12%. On the other hand, the WHO/HAI survey in 2006 showed that the price of medicines in the Philippines is 3.4 to 184 times higher than the international reference prices and that the availability of core essential medicines is only 11.5% and 15% in the public and private sector, respectively.

MeTA Philippines explains that access to health care for rural dwellers and the economically poor continues to be a serious challenge, as does the severe brain drain of nurses and doctors to the West due to greater earning potential, which contributes to the vulnerability of the rural population. The high cost of drugs and medicines also remains a major challenge, as prices range from 2 times to as much as 30 times higher than in Canada or in neighbouring Asian countries. The private sector distributes about 88% of medicines in the market through drugstores and 8.4% through private hospitals.