MeTA centres around stakeholders from public, private, and non-profit sectors gathering in face-to-face and virtual meeting spaces to brainstorm about ways to improve information access, scrutiny, and use of essential health commodities such as contraceptives, diagnostics, drugs, laboratory supplies, and vaccines. 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.

 

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. The workshop, which was hosted by the non-governmental organisation (NGO) Coalition for Health Promotion and Social Development (HEPS), brought together 22 participants from 20 organisations. A number of skills development sessions provided opportunities for participants to sharpen their abilities in research, communication and advocacy, and influencing and negotiating. They also explored how to monitor prices, improve collaboration and networking, make use of a rights approach to access to medicines, engage with the media, interpret data, develop policy briefs, and understand equity issues. A key feature of all the skills sessions was the emphasis on building on the experience of the participants and sharing that experience. A series of field visits halfway through the week provided an opportunity for participants to test some of the skills they had learned and to explore issues of transparency and accountability with key institutions working in the pharmaceutical supply chain in Uganda.

 

The core work in Uganda will involve mobilising and building the capacity of civil society organisations (CSOs) to advocate for increased access to essential medicines. Research will facilitate the production and dissemination of information (guidelines, laws, etc.) on policies and practices on access to essential medicines. Another focus will be on undertaking advocacy to influence policy formulation and implementation, and monitoring and evaluation to increase CSO representation on decision-making structures at all levels. Planned MeTA activities in Uganda include:

• Continued monitoring of prices and availability of medicines
• Monitoring of quality (reassurance for the public on generics)
• Improving the availability of drugs in health facilities
• More rational use of medicines (by both prescribers and consumers).

 

The idea is that, "[o]nce citizens, government regulators, healthcare workers and companies have access to information, they can challenge corrupt practice, challenge excessive pricing, and identify the problems of inefficiency and waste." MeTA CSO participants will collaborate with pharmaceutical sector to improve information flows, and to increase transparency and accountability about the selection, regulation, procurement, sale, distribution, and use of medicines in developing countries. By doing so, MeTA will work to improve how decisions are made about medicines, improve the way they are purchased and supplied, encourage innovative and responsible business practices, and increase the voice of patients and consumers. Here is an example of the type of action that may be undertaken, as described by a MeTA International officer detailing a replicable effort: "In Uganda a health consumers group found that orders were failing to meet demand at one rural health centre. So they encouraged the district health officer to involve community members in the planning process to create a better understanding of what medicines were actually needed. As the supply of the right medicines increased, so too did confidence in the healthcare system with attendance of patients doubling at that self-same health centre."

Health, Rights.

An international MeTA document cites a survey which found that among 28 medicines included on Uganda's essential medicines list, only just over half could be found in health facilities where treatment was offered for free. The Ugandan Minister of Health announced in 2008 that as many as half of all medicines bought for use in the public health system were being siphoned off by health workers and resold to private clinics or pharmacies. In short, MeTA Uganda will focus on addressing documented problems related to inadequate availability of essential medicines, high prices in retail outlets and from dispensing doctors, public mistrust of the quality of generics, and a low level of consumer empowerment.

Partly because of its experience and initiatives in dealing with HIV and AIDS, Uganda reportedly has a diverse range of NGOs, and they are expected to make a strong contribution to MeTA Uganda.