MeTA is, first and foremost, a collaboration: Stakeholders from public, private, and non-profit sectors working together to effect significant positive change. It is hoped that, by joining these personnel in face-to-face and virtual meeting spaces, brainstorming will be sparked about how to improve information access, scrutiny, and use, to the end of supporting the development of viable, efficient medicines markets and supply systems of essential health commodities such as contraceptives, diagnostics, drugs, laboratory supplies, and vaccines.

Specifically, MeTA's financial and technical support encourages a focus on making information about medicines publicly available. To that end, it will implement actions designed to strengthen national capacity – including the capacity of stakeholder groups to engage in a process to collect, analyse, disclose, and use data on the quality and registration status of medicines, their availability, price, and promotion policies and practices. Each country has its own context and ways of providing medicines. Analysis and public disclosure of how the medicine supply chain works, and issues affecting the affordability of medicines, equitable access, and the rational use of medicines will help to see how to improve policy, practice, and health outcomes for people. In general, however, when a country implements MeTA, it makes a commitment to progressively disclose a standard set of core data covering the quality, availability, price, and promotion of medicines. Stakeholders sign on to a core code of principles, and also commit to fully involve civil society, business, and other stakeholders in the effort to help address problems in the pharmaceutical market. This multi-stakeholder approach aims to shift some decision-making power to consumers and put greater competitive pressure on suppliers, as well as to promote better governance and more appropriate resource allocation by public purchasers.

In MeTA countries, the average person – in time – should be able to access a wide range of information on the price, availability, quality, and promotion of medicines via the internet, local newspapers, television, and radio, and through community meetings. Details about specific in-country events, activities, and strategies for information dissemination may be located on the interactive MeTA website.

To explore one strategy in detail, an important component of MeTA is dedicated civil society support managed by the MeTA International Secretariat since March 2008. Two consultants with experience in the medicines field and in working with civil society, governments, and industry around access to medicines, transparency, and accountability issues were hired to develop skills building workshops, the first of which was held in Uganda in February 2008, with the second in the Philippines in June 2008. These will be followed by: country-based activities by civil society organisations (CSOs) in the MeTA pilot countries, and a global feedback meeting during early 2010, where the lessons learned can be discussed, conclusions drawn, and recommendations made for future work.

A brief summary of the Uganda meeting illustrates MeTA capacity building strategies. Part of the first day was spent in a series of introduction exercises to encourage people to get to know each other. As this was meant to be a highly participatory workshop, particular attention was placed on identifying the skills and experience of the participants, through developing short descriptions of each participant to be part of the "gallery of experts" that was placed on a wall in the workshop room throughout the week. This helped to affirm the more than 280 years of experience in the medicines and transparency fields that participants brought into the room. Two sessions helped explain the overall MeTA process. The workshop followed a similar pattern throughout most of the week, with initial knowledge sharing sessions first thing in the morning, followed by a skills development session. In the afternoon, an open space period enabled participants to share experience and for the coverage of issues that emerged during other sessions. This was followed by a final session each day for participants to work in country groups to analyse the country situation and identify possible actions upon their return home. A series of field visits halfway through the week provided an opportunity for participants to test some skills and to explore issues of transparency and accountability with key institutions working in the pharmaceutical supply chain in Uganda.

Health, Rights.

According to the World Health Organization (WHO), 40 million people are living with HIV and AIDS in developing countries, but antiretroviral medicines (ARVs) are available to only 300,000 of the 5-6 million people currently in need of them. By 2015, WHO figures indicate, an estimated 10.5 million lives could be saved every year by expanding access to existing interventions for infectious diseases, maternal and child health, and non-communicable diseases. WHO cites the following central barriers preventing people from accessing essential medicine:

• Medicines are unaffordable to many people; ARVs and artemisinin-based anti-malaria medicines are particularly expensive.
• It is estimated that half of all medicines are inappropriately prescribed, dispensed, or sold, and that half of all patients fail to take their medicine properly.
• Health financing mechanisms leave households responsible for the cost of medicines, and the economically poorest and sickest are the least able to pay.
• Failures at any point of a country's supply system can lead to shortages of medicines; inefficient procurement systems have been found to pay up to twice the global market price for essential medicines.
• The quality of medicines varies greatly. One-third of WHO member states either have no regulatory authority or only limited capacity to regulate the market.
• Over 90% of medical research and development (R&D) focuses on the medical conditions of the richest 20% of the global population.