Professional Documents
Culture Documents
SARPAM CS MEETING REPORT | Civil Society Partnership for Action on Access to Medicines & Diagnostics in Southern Africa
Record of the consultation
9. Conclusions 6
ANNEXES
A. Overview of Sarpam 7
C. Participants List 10
I. Workshop Evaluation 38
SARPAM CS MEETING REPORT | Civil Society Partnership for Action on Access to Medicines & Diagnostics in Southern Africa
1. Establishing a common agenda to improve access TO MEDICINES in Southern Africa
The Southern African Regional Programme on The meeting started with an open agenda for
Access to Medicines & Diagnostics (SARPAM) is participants to define their own priorities to address
being designed through a process of consultation the challenge: “How can we work in partnership to
and information-gathering during an inception improve access to medicines and diagnostics in the
phase that started in January 2010. During the Southern Africa region?”.
period, Partnerships for Action (PACTs) are
being explored to improve the availability, Over 2 days, participants started the process of
affordability and quality of essential medicines engaging with each other as African Civil Society
and diagnostics across the SADC region. These to initiate a regionally focused Civil Society Action
PACTs should support implementation of the SADC Network that will focus on what Civil Society in the
SADC region can do to support implementation of
Pharmaceutical Business Plan to the end of 2013.
the SADC Pharmaceutical Business Plan.
SARPAM offers the potential to strengthen the
Strong commitments to action were made by those
capacity of regional institutions and civil society
present to lead a Partnership for Action (PACT)
to implement joint plans that will achieve agreed
that will promote greater transparency in the
results through multi-stakeholder action across
regional pharmaceutical marketplace and more
countries in the region.
effective sharing and use of pharmaceutical market
information.
The Responsible Action Consortium managing
SARPAM (on behalf of the U.K. Department A Reference Group of Civil Society focal persons
for International Development) facilitated this was constituted to take this process further with the
consultation for Civil Society in March 2010. SARPAM programme management team.
Through initial email-based discussions, regional • Learn about SARPAM and the possible
and national CS representatives shared ideas on contributions it could make to the Access
how they could potentially contribute towards agenda;
improving access to medicines through more • Interact with other CSOs working directly or
intensive focus on the southern Africa region. indirectly on pharmaceutical and treatment
access issues within the SADC region;
The subsequent consultation was called at short • Define a Civil-Society led Partnership for Action
notice to take advantage of the fact that a number (PACT) in which each organization’s potential
of key Civil Society representatives would be contributions are mapped out;
in Nairobi for other meetings. This offered an • Engage with a process for assessing the support
opportunity for these individuals to engage in an that each organization needs to make their
intensive process to: contributions as partners in the PACT;
• Map out the agenda for Civil Society to improve • Learn a methodology for developing further
access to medicines and diagnostics in southern Partnerships for Action.
Africa;
The 25 participants (Annex C) represented a good cross-section of regional Civil Society Organizations (CSO)
and Faith Based Organizations (FBO) working on different Access issues, including: advocacy and campaigns;
legal and trade; research; service delivery; professional standards and research.
Record of the consultation (continued) 4
SARPAM CS MEETING REPORT | Civil Society Partnership for Action on Access to Medicines & Diagnostics in Southern Africa
4. The meeting proceedings
The meeting was implemented through an broad areas. These were further discussed as the
innovative facilitation approach1 that provided an meeting schedule for in-depth discussion was
open space for participants to set and prioritise developed.
their own agenda for addressing the question of • All key issues were incorporated into a full
how to work in partnership to improve access to schedule of small meetings held in parallel.
medicines & diagnostics in southern Africa. This Eleven group meetings were carried out over
(un)conferencing approach effectively allowed the two days that created rich interactive
many issues and priorities to be identified and put discussions and debates.
onto the agenda for civil society action on access • Participants were encouraged to freely
to medicines. A more detailed description of this move between groups to cross-pollinate the
discussions and to ensure that they were making
process appears at the end of this report (Annex H).
maximum contributions and to get the most out
of these discussions.
Through this process:
• Each discussion was recorded on a template and
• Each participant raised two to three issues,
these notes are available in Annex D, exactly as
which were all shared in the group.
reported by participants.
• Next, the participants grouped the issues into
Following the rich agenda that was set by participants, • Regularly produce evidence based decision
individuals self-selected into small group discussions papers that can be used for action
over a number of parallel sessions. People were 4. Partnerships (between SARPAM stakeholders)
all highly engaged in these short discussions • Partnerships should be formalized by either
that yielded an impressive array of insights and having MoU2 or Compacts to which members
suggestions on each topic. Each group captured make firm commitments
key points on a template and these can be found in • Agreed principles of engagement (defined in a
Annex D. Manifesto to which CSOs and FBOs sign up to)
• SARPAM should help to provide platform
for building partnerships, one of which is to
1. Supply Chain Management
ensure CS are involved in all PACTs.
• Emphasized the necessity to monitor and
5. TRIPs and Trade
evaluate the procurement and supply chain
• CS should advocate for maximizing TRIPs
and to prepare, evaluate and share reports and
flexibilities and for increased availability of
lessons.
patent-free essential medicines
• Use of strengths within the CSO/FBO
• Information is needed on situation of TRIPs in
community for information and technical
the 15 countries; implication for post 2016; use
support
of TRIPs flexibilities by the industry (private
2. CSO/FBO Networking
sector) and on patent pool impact. This should
• Map and develop a comprehensive strategy to
be made available and discussed at relevant
network CSO/FBO networks involved in ATM
forums.
• Have common campaign issues that tap into
strengths of each CSO/FBO 6. Capacity Building (CB)
3. Research and Sharing of Research Findings • A complete understanding of the SARPAM
• Establish the SARPAM InfoHub as a platform programme and the SADC Pharmaceutical
that strongly links the Civil Society Action Business Plan is necessary to identify CS’s areas
Network with the Access to Medicines of action and capacity building needs
Research network • CS can be both recipients and implementers of
CB activities.
1. The PACT Methodology and case study of the workshop process is being developed as part of a toolkit on how to establish Partnerships for Action
(to be published by SARPAM in October 2010.
2. MoU/Compacts: An MoU is typically a bilateral agreement where the parties can seek external arbitration if either party defaults on the agreement,
whereas a Compact is a multi-party agreement that needs to be enforced through mutual accountability.
Record of the consultation (continued) 5
SARPAM CS MEETING REPORT | Civil Society Partnership for Action on Access to Medicines & Diagnostics in Southern Africa
7. Quality of Medicines • Advocate for sustainable financing of
• Support for regional standards and accredited programmes that support communities e.g.
quality control facilities. the WHO community care giver plan
• Involvement of CS in pharmacovigilance and 10. Good Governance
raising profile of quality issues. • Promote drug supply systems that are robust
and transparent and have measurable
8. Private Sector Engagement
indicators.
• CS platform can open debates on positive
• CSOs can act as critical watchdogs and
engagement of the private sector including
lobbyists.
participation in PACTs and other stakeholder
11. Human Rights and Access to Medicines
opportunities e.g. MeTA
• CSOs can carry out evidence-based advocacy
• CS advocate for increased Corporate Social
• CS be strategic in aligning their competencies
Responsibility (CSR) at country levels
for maximum impact, including building
9. Community Involvement
capacity for operational research.
• Study and identify best ways to work with and
support true community representation in the
different countries
• Link with and build capacity of Community
Based Organizations (CBOs).
On the second day, participants discussed possible by 2011; and the re-establishment of the SADC
intervention areas in which CSOs/FBOs could take Pharmaceutical Task Force (in which CSO are
more effective joint action with an intensified focus members).
on southern Africa. They made the case for a range • Establish a system for CS to continuously evaluate
of proposals for joint action through the PACT Pharmaceutical Supply Management. Actions areas
mechanism, including to: could include: monitoring the supply chain as
• Establish a mechanism that will support pooled well as the prices and availability of medicines at
and bulk procurement initiatives for essential facility level.
medicines. This would require: engagement of the • Advocate for development, harmonization and
SADC Secretariat to recognize the role of FBOs implementation of treatment and diagnostic
e.g. in service delivery; analysis of the reasons for guidelines in Southern Africa.
failures of cross border bulk/pooled procurement
This process produced consensus that the most
attempts; and inclusion of FBOs in discussions on
useful immediate PACT that Civil Society should
a SADC pooled procurement market survey. lead is to promote greater transparency in the
• Strengthen the capacity of CSO/FBOs working regional pharmaceutical marketplace and more
on access in the region to effectively support effective sharing and use of market information.
implementation of SARPAM. Action areas
proposed could include: increasing capacity Initial mapping of the PACT Framework for this
of CSO/FBOs to handle medicines and access identified the highest priority results that could be
issues; providing oversight through professional jointly pursued, the range of partners that could work
pharmacy networks/associations; harmonizing together and some initial ideas of what each partner
the CS actions; targeting the maximization of the organization might be able to specifically contribute
towards achieving these results. This draft framework
utilization of the current TRIPS flexibility (to 2016)
follows in Annex E.
as provided for in WTO agreement.
• Establish a collaboration platform between SADC The group agreed that this framework for the PACT
and regional CSO/FBOs. Action areas proposed would need to be worked up further and the SARPAM
could include: promotion of transparency and programme management team was charged to
accountability by applying the MeTA principles; complete this task in collaboration with a Civil Society
supporting at least 3 SADC countries to join MeTA Reference Group (see section 6 below).
Record of the consultation (continued) 6
SARPAM CS MEETING REPORT | Civil Society Partnership for Action on Access to Medicines & Diagnostics in Southern Africa
Having the means to gather and disseminate online collaboration site in the SARPAM InfoHub.
information, hold discussions and share documents Use of short message service (SMS) was discussed as
was considered a key requirement for successfully a possible way of keeping everyone in the network
implementing this PACT. Participants agreed to use updated.
of the Civil Society Action Network newsgroup and
1. Complete the drafting of a manifesto 5. The SADC Pharmaceutical Business Plan and
(responsibility of the SARPAM secretariat CS SARPAM’s one page summary to be sent to
Technical Lead and CS Coordinator) that, all meeting participants by email (SARPAM
following consultation with the Reference Group, Secretariat).
should be sent to all meeting participants to
6. The PACT methodology to be written up and sent
present this to their organizations for signature.
to all participants for use in their own meetings.
2. Preliminary report of the consultation to be sent 7. SARPAM Secretariat, in collaboration with the
to participants within a week of the meeting. Reference Group, to complete the development
of the agreed PACT.
3. CS Technical Lead to communicate with the
participants and other CS who could not attend 8. Assessments of what each Civil Society
the meeting on the next steps to take forward the organization’s capacity needs are to effectively
PACT. contribute to the PACT will be carried out by the
SARPAM Secretariat. This will result in Enabling
4. CS Reference Group to consider and recommend
Plans and resource requirements being scoped
how best to gather and disseminate information
out and presented to DFID for Implementation
between the CS, including pilot testing the SMS
Phase funding (to be incorporated into the
methodology.
SARPAM Inception Report).
9. Conclusion
The objectives of the consultation were achieved. However, as not all regional CS representatives were able
to attend, it will be important to share the report and to continue the conversations that were started. The
enthusiasm needs to be kept through regular communication and interactions, led by the SARPAM Civil
Society Lead (Eva Ombaka), supported by a Civil Society Coordinator and in collaboration with the Civil Society
Reference Group.
ANNEX A | OVERVIEW OF SARPAM 7
SARPAM CS MEETING REPORT | Civil Society Partnership for Action on Access to Medicines & Diagnostics in Southern Africa
The Southern Africa Regional Programme on Access to Medicines and Diagnostics (SARPAM) launched in January
2010. SARPAM is founded on the belief that effective collective action and innovation will improve Access to
Medicines across the regional economic community. Working with member state governments, civil society,
regional institutions, international agencies, research networks and the private sector, SARPAM will support the
good work being done through existing partnerships and initiatives, as well as identify new Partnerships for Action
that will achieve ambitious results.
The programme offers new resources in the form of targeted funding, technical assistance, partnership building
and networking opportunities. As the primary sponsor of this new initiative, the UK Government hopes that
SARPAM will develop into a platform for collaboration and partnership that will attract a broad support base over
the next 4-5 years. This will create significant opportunities to substantially improve the marketplace for good
quality essential medicines.
SARPAM offers to support and strengthen the capacity of regional institutions to implement plans that will benefit
from multi-country action. The SADC Pharmaceutical Business Plan endorsed by regional Ministers of Health
in 2007 is the leading example of this. Civil Society Organizations within the region will be supported to lead
Partnerships for Action that have the potential to positively influence the pharmaceutical market, including the
demand for medicines and their rational use.
A regional InfoHub will be established to make transparent pharmaceutical market intelligence and evidence
for policy accessible to all stakeholders in the region. SARPAM will be undertaking an intensive Pharmaceutical
Sector Market Analysis during the first 9 months of 2010 to provide a baseline data set. A regional Evidence for
Action Network will be supported as part of the Global Access to Medicines Research Network to set the agenda
for research and to make research findings available as global public goods.
The Responsible Action Consortium, led by Re-Action! (Southern Africa) has been contracted by DFID to manage
implementation of SARPAM. This includes establishing a network of development professionals to work with the UK
government southern Africa regional team so that priorities on Access to Medicines within SADC can be more effectively
responded to and local capacity can be built.
ANNEX B | SADC PHARMACEUTICAL BUSINESS PLAN 2007 - 2013: SUMMARY4 8
SARPAM CS MEETING REPORT | Civil Society Partnership for Action on Access to Medicines & Diagnostics in Southern Africa
The Southern African Development Community (SADC) was formally launched
on 17th August 2002 under a Treaty, and consists of 14 Member States with an
estimated total population of 200 million people. In its programmes and operations,
SADC is guided by a clear mission statement, which is “To promote sustainable and
equitable economic growth and socio-economic development through efficient
productive systems, deeper co-operation and integration, good governance,
and durable peace and security, so that the region emerges as a competitive and
effective player in international relations and the world economy”.
SADC has identified the need to develop and implement a Pharmaceutical Programme in line with the SADC
Health Protocol and the SADC Health Policy. The purpose of the programme is to enhance the capacities of
Member States to effectively prevent and treat diseases that are of major concern to public health in the Region.
The Programme mainly addresses issues that concern access to quality medicines in all Member States. The SADC
Pharmaceutical Business Plan has been developed within the context of global, continental and regional policy
frameworks, protocols and commitments. Based on a SWOT analysis, the Plan identifies priority areas, objectives
and major activities that will be implemented both at regional and national levels to improve access to quality and
affordable essential medicines including African Traditional Medicines.
The overall goal of the SADC Pharmaceutical Business Plan is to ensure availability of essential medicines including
African Traditional Medicines to reduce disease burden in the region. Its main objective is to improve sustainable
availability and access to affordable, quality, safe, efficacious essential medicines including African Traditional
Medicines. In order to achieve the overall goal and the main objective, the following strategies will be pursued:
In line with the SADC Protocol on Health, the Implementation Plan for the Protocol and the SADC Health Policy
Framework, the SADC Pharmaceutical Business Plan will be coordinated and implemented through the approved
SADC structure. The Business Plan has spelt out clear roles and responsibilities of all stakeholders that will
4. Adapted from SADC PHARMACEUTICAL BUSINESS PLAN, SADC SECRETARIAT, 27 JUNE 2007, p. 3-5.
ANNEX B | SADC PHARMACEUTICAL BUSINESS PLAN 2007 - 2013: SUMMARY 9
SARPAM CS MEETING REPORT | Civil Society Partnership for Action on Access to Medicines & Diagnostics in Southern Africa
be involved in the implementation process. At the political level, the implementation of the Plan will be
monitored through the established institutional framework.
The implementation of the Plan will require substantial resources including human, material and financial from
different sources. The Plan is estimated to cost US$16 million. To ensure ownership and sustainability, Member
States will be required to budget for implementation of some of the interventions that need ongoing financial
support. The SADC Secretariat will make all efforts to mobilize resources from key stakeholders including
International Co-operating Partners.
A monitoring and evaluation framework has been included in order to review activities during implementation
process. The Secretariat will facilitate capacity building on monitoring and evaluation. Appropriate technical
and financial reports will be produced during and after implementation of program specific activities outlined
in the Pharmaceutical Business Plan.
ANNEX C | PARTICIPANTS LIST 10
SARPAM CS MEETING REPORT | Civil Society Partnership for Action on Access to Medicines & Diagnostics in Southern Africa
Name & SURNAME Organization Email Address
1 Aarti Patel SARPAM aarti@sarpam.net
2 Albert Petersen EPN albpetersen@googlemail.com
3 Cesar Mufanequico PATAM matram@tvcabo.co.mz
4 Christa Cepuch HAI christa@haiafrica.org
5 Cryson Miyoba CHAZ cryson.miyoba@chaz.org.zm
6 Desegan Padayachee Re-Action! desegan@re-action.co.za
7 Donna Kusemererwa EPN dkusemererwa@epnetwork.org
8 Eva Ombaka SARPAM e.ombaka@gmail.com
9 Franco Wandabwa ANECCA fwandabwa@rcqhc.org
10 Ginchinga Ndirangu HAI AFRICA gichinga@haiafrica.org
11 Joanne Collinge Meropa joannec@meropa.co.za
12 Joseph Mhando Tanzania/academia jmhando@yahoo.com
13 Mike Upio CME Nyakunde mikupionzenib@gmail.com
14 Nalishebo Mwape CHAZ nalishebo.mwape@chaz.org.zm
15 Olivier Musongya CBCA oliviermusongya@ymail.com
16 Orgenes Lema MEMS orgenesl@mems.or.tz
17 Phillip Mokoena TAC phillip@mail.tac.org.za
18 Redemptor Atieno HAI redemtor@haiafrica.org
19 Rose Ng’oma CHAM rosek@cham.org.mw
20 Sharon White Re-Action! sharon@re-action.co.za
21 Shaun Conway SARPAM shaun@sarpam.net
22 Tapiwanashe Kujinga PATAM tapiwanashek@gmail.com
23 Tasangana Matika SEATINI wmatika@hotmail.com
24 Titus M Kahiga FIP rep –Kenya tkahiga@gmail.com
25 Wilbert Bannenberg HERA / MeTA / SARPAM wilbert.bannenberg@gmail.com
ANNEX D | RECORD OF OPEN AGENDA DISCUSSIONS 11
SARPAM CS MEETING REPORT | Civil Society Partnership for Action on Access to Medicines & Diagnostics in Southern Africa
Topic
Participants
Recommendations
SARPAM CS MEETING REPORT | Civil Society Partnership for Action on Access to Medicines & Diagnostics in Southern Africa
Topic
Participants
• (DRC) organize through social insurance some money, make contracts with health centres and hospitals
– get treatment for a year
• Two evaluations (June / December) communities are involved
• Community participation is through chiefs. One issue brought to the attention is that medicines were
not free. Issue is with representation through chiefs – is like the government – not true representation
of community (e.g. in DRC the Chief is civil servant). In Zambia, the Chief is part of the community, has
headman who is responsible for smaller communities therefore true representation – chief is community
– therefore is representative of CS
• Use of public forums in different countries e.g. in Kenya local CBO’s used to mobilize communities for
stock-out campaign – managed to get information from the ground.
• CBO’s need assistance for transport and a stipend for lunch
• Traditional healers are also important – with regard to rural settings (SA). Sick people go there first.
• Community caregivers – critical for monitoring stock outs, to identify patients in the home – provide
basic services – these are volunteers
• District / Community Clinic committees – link community to formal health care systems – play a critical
role in some settings – Political forces affect those that are made strong – after capacity building
• Use of caregivers is dependent on the specific priority of countries. Need to be careful e.g. SA created a
monster-recruit caregivers – NGOs provide better package than government (unhelpful competition) –
therefore government and the NGO world need to agree
• FBOs as part of community
• Community caregiver programme is received / recognized differently in different countries – issue is
controversial. Scheme worked well in WHO / UN supported areas – also works well in specific programmes
which are supported by outside agencies.
Recommendations
SARPAM CS MEETING REPORT | Civil Society Partnership for Action on Access to Medicines & Diagnostics in Southern Africa
Topic
Participants
1. Broadly there are a number of CSOs and networks that are working on access to medicine. Mapping
exercise needed
2. Regional networks identified are:
− PATAM
− HAI Africa
− ANECCA
− Enquinet
− EPN
3. There are many others working at country level
4. Need to identify key issues for advocacy
− Stop Stock-outs
− CEPA
− Anti Microbial Resistance (AMR)
Recommendations
SARPAM CS MEETING REPORT | Civil Society Partnership for Action on Access to Medicines & Diagnostics in Southern Africa
Topic
Quality of Medicines
Participants
Recommendations
1. Advocate for recognition, rewards and protection of the regional WHO accredited laboratories
2. Support the concept of regional quality control laboratories, fund and supervise
3. Advocate for regional mini standards
ANNEX D | RECORD OF OPEN AGENDA DISCUSSIONS (continued) 15
SARPAM CS MEETING REPORT | Civil Society Partnership for Action on Access to Medicines & Diagnostics in Southern Africa
Topic
Participants
• What drives evidence is the questions we ask. Could we have a ‘FAQ’ established as a knowledge base?
• What do we mean by research? Compiling information and evidence on AEM, Advocating for sharing
and transparency of information. Existence of correct information. As CS we should contribute to the
existence of accurate information – we can also do research (operational, action-oriented, etc). Use CS to
gather information to triangulate what already exists. (e.g. L2 and L1 WHO surveys)
• We need a database (open access) which grows across the region, also internationally. Get collective
evidence on what is going on.
− What info do we collect and how to get into the database?
− How to create a community of users around it? How to get it out?
• EPN is mapping pharmaceutical personnel in various (SADC) countries. Use this methodology and
compare to public sector in SADC countries?
• DFID is sponsoring the ‘ATM Research Network’. What role can CS have in this formalized network? Could
we inform the agenda? Can we provide the relevant academic research questions? CS may be the subject
of (or may implement) the research. CS can assist each other: networking, training, identifying research
areas, getting funds for research etc.
• Information for advocacy purposes information for policy purposes. Know what to do with the results to
impact ATM.
• Domesticate the research to make it useful for country context
• Role of CS in dissemination of research findings – ‘Evidence briefs’ or ‘one pagers’ or ‘decision briefs’ etc.
Based on research: “here are the findings and here are the recommendations signed by those involved”.
Use as basis for advocacy and decision making.
• Important to have links between academic institute and CS.
• National level partners on SARPAM: communications, links, dedicated time, etc. SARPAM “evidence for
Action’ network exists – ensure it is linked to the SARPAM “CS” network
• Use the international networks and their resources, funding, abilities, time, to analyze data and evidence
AEM – access to essential medicine
L1, L2 – Level 1, Level 2 Surveys (WHO)
FAQ - Frequently Asked Questions
Recommendations
1. Set up the SARPAM observatory to include a clearing house on information on research, data studies,
reports, tools in SADC (with a FAQ capability)
2. Mechanism to establish a CS linking facility to the ‘ATM Research Network’
3. CS develop one-page evidence-based ‘decision papers’ (for action, dissemination, influence policy, etc)
that will become widely recognized as having scientific, political and civic support
4. Ensure the SARPAM ‘Evidence for Action’ network is well linked to the SARPAM ‘CS’ Network
5. Advocate for transparency of information
ANNEX D | RECORD OF OPEN AGENDA DISCUSSIONS (continued) 16
SARPAM CS MEETING REPORT | Civil Society Partnership for Action on Access to Medicines & Diagnostics in Southern Africa
Topic
Good Governance
Participants
• Corruption • Selection
• Transparency and accountability • Procurement Budgets
impacting the
• Regulation • Price
whole supply
• Political environment • Finance Distribution
chain
• Efficiency / effectiveness • Use of Drugs
• Outcomes • Availability
CONCLUSION
• Civil Society needs to engage in good governance and can play an important role as a watchdog and
lobbyist
Strategy
• Insist on robust drug supply systems that are well planned, needs based and evidence based
• Ensure that there are measureable (SMART) and relevant indicators that civil society can monitor
• CSO then should act as a critical watchdog
• Insist on greater transparency, which will lead to more accountability
• The process will reduce vulnerability for corruption, promote more and better regulation, leading to more
efficient systems and better access to better medication
Recommendations
SARPAM CS MEETING REPORT | Civil Society Partnership for Action on Access to Medicines & Diagnostics in Southern Africa
Topic
Participants
Recommendations
1. Evidence based advocacy - need to build capacity in operational research – so that evidence is based
to hold governments accountable
2. Empowering users through capacity building
3. Legal campaigns – mobilize legal instruments
4. Being strategic, aligning and harmonizing all our competencies together and having a common
ground for our work
5. Document the evidence properly so that it can be shared across
6. Comparing the countries
9. Lead CSOs / networks to organize capacity development in order to fulfill SARPAM objectives
10. A comprehensive media strategy will help member CSOs / networks to network within the campaign
11. Setting up an email list, website and development of campaign materials
ANNEX D | RECORD OF OPEN AGENDA DISCUSSIONS (continued) 18
SARPAM CS MEETING REPORT | Civil Society Partnership for Action on Access to Medicines & Diagnostics in Southern Africa
Topic
Participants
Donna, Cryson, Phillip, Tasangana, Shaun, Aarti, Mike, Orgenes, Eva, Tapiwanashe
Recommendations
3. MoU/Compacts: An MoU is typically a bilateral agreement where the parties can seek external arbitration if either party defaults on the agreement,
whereas a Compact is a multi-party agreement that needs to be enforced through mutual accountability.
ANNEX D | RECORD OF OPEN AGENDA DISCUSSIONS (continued) 19
SARPAM CS MEETING REPORT | Civil Society Partnership for Action on Access to Medicines & Diagnostics in Southern Africa
Topic
Supply Chain Management
Participants
Franco, Malishebo, Albert, Joseph, Cesar, Titus, Christa, Wilbert, Redemptor
Recommendations
1. CS coalition (umbrella regional) (establish the SARPAM Coalition)
2. M&E by CS of PSM (e.g. SSO campaign – extend to SADC) “SAAB report”
3. CS “Policy Audit” – annual report card
4. Study the barriers to implementation of the recommendations from the PP studies (and network
among those organizations working on governance: (META, HAI Africa, NEPAD, and AU?)
5. Involve / Engage CS in technical issues (with technical support as necessary ) share lessons from
FBOs e.g. Quantification methods / exercise at national level
ANNEX D | RECORD OF OPEN AGENDA DISCUSSIONS (continued) 20
SARPAM CS MEETING REPORT | Civil Society Partnership for Action on Access to Medicines & Diagnostics in Southern Africa
Topic
TRIPS and Trade
Participants
Franco, Albert, Tasangana, Wilbert
Status of Trips
• Middle income countries have to be compliant by 2000 while low income countries have to be by
2016. African countries are producing or are in the forefront of producing first line. By 2016 LDC’s will
be needed to be aligned with TRIPS. German government supporting countries that want to go for
complete licensing. Complete licensing is always point of patent laws. If old activists get involved it
could be watered down.
• Why countries always sign and complaining Health system / ministry is always weaker compared to
the trade ministry.
• Activists have to be careful when discussing issues of TRIPS. Most countries are TRIPS compliant.
Correct and right information need to be given.
• Need to have a paper (research) for the 14 countries on the correct state in terms of compliance.
In Europe there is a lot of case studies by pharmaceuticals but there is a need for comprehensive
information and facts from Africa.
• Make links with legislators / seminars on TRIPS. Need to have meeting with health and trade committees
at national and regional level. Need for information to be presented in a language for the lay people.
• T. Matika (Seatini/Equinet) will share a document presented to SADC on TRIPS.
Patent Pool
• There was a meeting in Germany and there was an agreement about the fact that information needed
to be clarified about the process. Middle income and low income countries are already pressed to
enter the patent pool. Need more information on issues of patent pool
Trips
• Move and encourage countries like South Africa for the adaptation and implementation of the
competition law. We need to analyze the scenario between now and 2016 to see how TRIPS roll out.
A question which we must also follow is to see what will happen in 2017. Analysis results need to be
produced so it can be presented to CS Organizations.
Recommendations:
1. African civil societies need to take up advocacy and be a watchdog of maximum flexibilities and
minimizing TRIPS + (restrictions).
2. Need for an overview study / research among the 14 countries on the current state of TRIPS and
compliance (quick/rapid assessment).
3. More information needed to be provided on patent pool and how it is going to work and what benefits
it provides to SARPAM before moving forward.
4. Meetings with regional policy bodies and countries on TRIPS where briefs are provided.
5. Briefing to health and trade ministry people on discussion of TRIPS.
6. Patent free essential medicines for SARPAM members should be pushed for by CSOs in the region.
ANNEX D | RECORD OF OPEN AGENDA DISCUSSIONS (continued) 21
SARPAM CS MEETING REPORT | Civil Society Partnership for Action on Access to Medicines & Diagnostics in Southern Africa
Topic
Participants
• Definition of private sector differs in different countries (e.g. Private for profit, Private not for profit).
• Private sector has an important role to play, especially private providers of health service.
• A lot of suspicion of private for profit. Tends to be excluded from public sector initiatives.
• Efficiencies and innovation of private sector. Often more effective governance in private sector.
• Good examples of private sector initiatives e.g. Access to malaria products initiative (AMP), ADDO
(accredited drug outlets- MSH).
• What is the evidence for lack of private sector accountability or delivery?
• Distinguish between prices of medication vs. cost of treatment. Private sector can be more cost
effective.
• Trend is towards National Health Insurance, which requires private sector.
• Private sector has not taken full advantage of TRIPS provisions because of lack of government support
(e.g. For comparison licensing). This impedes access.
• In some countries there is over regulation of the private sector. Control vs. collaboration.
• Need positive engagement (rather than negative engagement).
• Define the problems to be solved/challenged for innovative response.
• Define rules of engagement for ethical practice.
• CS can lobby multinationals to do more and deliver more social benefit.
• Normal tendering process does not allow for blended value offers (including social contribution).
Recommendations
SARPAM CS MEETING REPORT | Civil Society Partnership for Action on Access to Medicines & Diagnostics in Southern Africa
Topic
Draft Manifesto for Civil Society Action on Access to Medicines in Southern Africa
(Developed through a meeting of: Gichinga, Shaun, Eva, Phillip, Titus)
Purpose
A document that defines how we collaborate, as CSOs, in the context of SARPAM. Obligations, responsibilities
(of CSOs and of SARPAM) and commits partner to SARPAM
Principles
Obligations
Responsibilities
• Shared responsibility
• Acceptability against agreed commitments
• Work within national legal frameworks
• Consult members
Eligibility
Recommendations:
Being a member-
Regional
ship organization
SEATINI can carry mobilisation in
Spearhead a with members in Network
out advocacy addressing
regional advocacy a number of SADC stock-outs,
Advocacy PATAM’s 7strengths work through advocacy gaps on
e campaign on access countries EPN can campaign
based on Info lies in advocacy Parliamentary stock-out, drug
ANNEX E | First Draft CS-led Partnership for Action (PACT) Framework
SARPAM CS MEETING REPORT | Civil Society Partnership for Action on Access to Medicines & Diagnostics in Southern Africa
RESULTS SEATINI
ANECA EPN FIP HAI AFRICA META PATAM TAC
(To-Be Achieved) (EQUINET)
1. Audit of existing
technical
personnel
2. Information
sharing through
member Training
Build capacity of organization. 1. Agenda PATAM can
ANECCA members 3. Examination of 2. Methods help with policy
f Training on paediatric level of training 3. Tools development as we
formulations and on access matter. 4. Training have members with
medicines 4. Advocacy on Materials technical capacity
those in training 5. Provide Trainer
on access matter.
5. Examine
relevance of
existing training
to access issues
Stakeholder
h Engagement
i Dissemination
Regional Data-
j bases / InfoHub
ANNEX E | First Draft CS-led Partnership for Action (PACT) Framework
24
SARPAM CS MEETING REPORT | Civil Society Partnership for Action on Access to Medicines & Diagnostics in Southern Africa
ANNEX F | The SARPAM Civil Society Reference Group 25
SARPAM CS MEETING REPORT | Civil Society Partnership for Action on Access to Medicines & Diagnostics in Southern Africa
Terms of reference
Membership
The CS Reference Group comprises 5 members from regional Civil Society and Faith Based Organizations
established at their meeting in Nairobi in March. The members are:
• Tapiwanashe Kujinga
• Donna Kusemererwa
• Tasangana Washington Matika
• Franco Wandabwa
• Gichinga Ndirangu
This Reference Group is not a decision-making body and the members are not considered to be
representing their constituencies, but rather to be providing advice in their individual professional
capacity.
The group acknowledges its diversity in affiliation and activity and membership in the group does not
limit the individual’s freedom in carrying out their work as defined by their organization.
Role
The group’s main role is to provide strategic advice and technical guidance to the SARPAM secretariat,
specifically the CS Technical Lead and the Coordinator, on matters relating to output 3 of the SARPAM
programme. The group will however not be held accountable for programmatic work.
The members will, as appropriate, promote SARPAM within their constituencies and will contribute to
building Civil Society in the region as recognized and reputable groups taking action on improving
access to medicines and diagnostics.
Specific tasks
In the inception period of the SARPAM programme, the group will specifically:
• Advise the SARPAM secretariat on the completion of the write up on the proposed PACT area.
• Review and give advice on the partnership manifesto before its submission to the participants and
civil society organizations.
• Consider and recommend best ways to gather and disseminate information across CS, including
pilot testing the SMS methodology.
• Be a sounding board for the SARPAM Secretariat on activities as defined in output 3 of the SARPAM
log-frame.
Time
No specific time limit was set for the members to serve on the group. It is therefore assumed that they
will serve during the SARPAM inception period and should the programme be approved to continuation,
will continue until another meeting of CS when a new decision can be made.
ANNEX G 26
SARPAM CS MEETING REPORT | Civil Society Partnership for Action on Access to Medicines & Diagnostics in Southern Africa
FOR CIVIL SOCIETY ACTION ON ACCESS TO MEDICINES IN SOUTHERN AFRICA
Preamble
The Southern Africa Regional Programme on Access to Medicines and Diagnostics (SARPAM) provides an
opportunity to make a critical difference to people’s lives within the Southern African Development Community
(SADC) region and to encourage and support change that will address the complex issues relating to access
to medicines and diagnostics. One of the key outputs of the programme is an increased voice and influence of
civil society reflected in policies on access to medicines and diagnostics in Southern Africa.
Experience from the Medicines Transparency Alliance (MeTA) countries has shown that Civil Society (CS) has
a vital role in keeping pharmaceutical companies, health professionals and government civil servants and
organizations transparent, honest and accountable and CS organizations, along with the private sector and
governments as equal partners, are key actors to jointly seek solutions.
We, representing the Civil Society with interest in increasing access to medicines in the Southern Africa
region are signatories to this manifesto as follows:
Purpose:
This document defines how we, the partaking civil society and faith based organizations (CSOs and FBOs)
collaborate, in the context of SARPAM. It specifies the intent, obligations, responsibilities and expectations of
SARPAM and our commitments as partners in SARPAM.
Commitments:
We commit to:
• Participate in partnerships for action (PACT) where our contributions will add value
• Support the purpose and actively participate in pursuit of the objectives of SARPAM and the principles of
the SADC Pharmaceutical Business Plan.
• Share information, expertise and resources, and foster open collaboration and consultation in order to
assist each other towards mutual growth and success.
• Be accountable to our CS partners on issues that we commit to carry out.
• Allowthe partner CS organization(s) with the best experience and most appropriate mandate to lead others
when working jointly on specific issues.
• Mutually respect and recognize roles and contributions of each partner to a common agenda and to share
benefits.
• Participate in the platform, Civil Society Action Network, by contributing ideas, comments, advice and
documents as may be appropriate or requested.
• Invite and support the participation of other regional stakeholders in order to increase capacity to achieve
our objectives
• Sign up and adhere to the commitment to each PACT that our organization(s) participates in.
27
SARPAM CS MEETING REPORT | Civil Society Partnership for Action on Access to Medicines & Diagnostics in Southern Africa
Responsibilities:
We accept shared responsibility, acceptability and accountability against these agreed commitments. We
further accept to work within national legal frameworks and to consult members regularly.
Eligibility:
Expectations
We expect the Responsible Action Consortium managing the Southern Africa Regional Programme to:
• Use MeTA definition of Civil Society in this relationship.
• Facilitate the work of the Reference Group that has been established by the CS.
• Support the CS in implementing the agreed programme of work as may be necessary.
• Facilitate relationship-building between the CS and the SADC secretariat, governments, private sector,
donors and other partners committed to increasing access to medicines in the region.
• Keep an accurate record of signatories to this manifesto and to list them as partners of SARPAM
Signature Signature
Date Date
ANNEX H | Case Study: Partnership in Action 28
SARPAM CS MEETING REPORT | Civil Society Partnership for Action on Access to Medicines & Diagnostics in Southern Africa
Purpose
The purpose of this case study is to illustrate how the PACT approach was applied to achieve the following
purpose:
A key principle of the PACT approach is that the participants take ownership of the PACT content and
conversations. Although there is a framework that the PACT follows, the agenda, the conversations and
agreements are incubated and driven by the participants. The following diagram illustrates the process:
Preparing the
1 Environment
Introducing the
2 approach
Arrival Opening Purpose How?
List open
PACT
4 Conversations
agenda
discussion
topics
Review
5 progress
Reflection Closing
Exercise
Relate to
Re-focus agenda
6 for 2nd session
SARPAM and
SADC PBP
List open
PACT
7 Conversations
agenda
discussion
topics
Final
10 CLOSE Summary Clarify next
steps
Closing
Exercise
reflections by
participants
ANNEX H | Case Study: Partnership in Action (continued) 29
SARPAM CS MEETING REPORT | Civil Society Partnership for Action on Access to Medicines & Diagnostics in Southern Africa
1 Preparing the Environment
The scene
On the periphery, five tables each with seating for 10 people, a refreshment station and a stationery
desk.
On the walls, some posters and a banner bearing the SARPAM logo with the words: “How can
we work in partnership to improve access to medicines in southern Africa?”
When participants arrive, they move in and seat themselves at random in the main seating area.
SARPAM CS MEETING REPORT | Civil Society Partnership for Action on Access to Medicines & Diagnostics in Southern Africa
Ticket to ride . . . openness, choice, new beginnings.
With the mood set, the facilitator outlines the four principles of the workshop:
• Show up and choose to be present.
• Be open to the outcome – not attached to it.
• Pay attention to what has heart and meaning.
• Tell the truth without blame or judgment.
The facilitator requests every participant to identify any issues or opportunities that s/he would like
to discuss during the course of the workshop, to write each item on an individual sheet of A4 paper
and to put his or her name on it.
A rush of ideas
Participants duly take sheets of paper, write down their subjects, and read them out loudly.
• “I’m interested in the supply chain – how do we get drugs out of the storerooms and into
communities.”
• “My interest is sharing advocacy strategies for access to essential medicines.”
• “I propose talking about a coalition to influence policy on the affordability of medicines.”
• “I’m interested in TRIPS and medicines – and the impact of free trade agreements.”
. . . and so on.
SARPAM CS MEETING REPORT | Civil Society Partnership for Action on Access to Medicines & Diagnostics in Southern Africa
Everyone goes to inspect the Community Notice Board,
with a view to merge topics or add new ones where there
are gaps. Participants begin to identify common ground
between their own proposals and those of others. They
move individual sheets of paper so that clusters or lists of
related topics emerge and in this way, meeting themes
are defined.
The Community Notice Board
The agenda is now finalised and trading for time and venue begins. With the group’s permission, the
facilitator helps rationalise the process of allocating time slots and meeting venues.
4 PACT Conversations
Four time slots are carved out for meetings, with between two and four meetings running at the same
time.
For the remainder of the first day and the first hour on Day 2, the meetings on participants’ self-
selected themes continue. Each group is chaired by an individual who proposed one of the original
topics that was “collapsed” into the theme. Main discussion points and recommendations are captured
on a standard reporting form. These forms are posted on the Community Notice Board and, from
time to time, the facilitator reminds participants to consult the board to see what other groups have
debated and concluded.
The groups are very stable and participants intensely involved. The meetings are small enough for
everyone to have a say and hardly anyone makes use of the “Law of the Two Feet”.
SARPAM CS MEETING REPORT | Civil Society Partnership for Action on Access to Medicines & Diagnostics in Southern Africa
5 Review progress
The first day concludes with a game – a modified version of charades – and reflection on the day. Asked
to describe their experiences, participants venture:
A game of charades and reflections to The facilitator reflects on the learning from the
conclude Day 1 day from her lens
The facilitator touches on aspects of a number of discussions and mentions that the meeting on
partnership had come up with the idea of a manifesto that would be the foundation of the civil
society (CS) partnership within SARPAM.
A discussion on how the process should unfold, follows. Participants express a need to focus and move
towards an action plan:
• “I have fears we could be as inactive as the SADC Pharmaceutical Business Plan.”
• “We need a bit more structure, a little better idea of where the destination lies.”
The facilitator confirms that most of Session 2 will be devoted mostly to prioritisation and action
planning.
ANNEX H | Case Study: Partnership in Action (continued) 33
SARPAM CS MEETING REPORT | Civil Society Partnership for Action on Access to Medicines & Diagnostics in Southern Africa
6 Re-focus agenda for 2nd session
The Facilitator opens the next session. She creates a space for participants to reflect on the previous
session and give feedback on their thoughts for the progress of this session.
7 PACT Conversations
Participants gather in three discussion groups to complete the PACT meeting schedule from Session 1.
The participants’ response is positive, captured in the comment: “I want to suggest we look at ourselves
as the drivers of this agenda. We must own the platform.”
Some participants are active in canvassing support for their proposals while others simply paste
them on the notice board and hope the ideas will speak for themselves. After all proposals have been
pasted up the process of discussing their merits begins.
The SARPAM Director chairs this session, where necessary providing information about how the
proposal relates to other actions that SARPAM will undertake in the inception phase.
ANNEX H | Case Study: Partnership in Action (continued) 34
SARPAM CS MEETING REPORT | Civil Society Partnership for Action on Access to Medicines & Diagnostics in Southern Africa
A taste of the proposals
• Develop a framework for collaborative work with SADC (because “it is more productive to be at the
table than to shout from the sidelines”).
• Conduct a human resources mapping exercise, focusing on pharmacists.
• Advocate for the harmonisation of diagnostic processes and treatment guidelines for selected health
conditions.
• Establish a system for civil society data collection and “watch-dogging” of prices, supply chains and
availability of medicines in facilities.
To establish a joint civil society system for gathering information on pricing of selected medicines,
supply chain effectiveness and availability of these medicines at facility level.
The Director indicates that this will strengthen one of the main deliverables of SARPAM during the
inception stage: an analysis of pharmaceutical markets across the SADC region.
Those organizations in the room are then asked to outline more specifically what they might
be able to contribute in terms of the various categories of activity. These details are written on Post-it
notes in the organization’s colour and posted into the relevant cell on the matrix.
ANNEX H | Case Study: Partnership in Action (continued) 35
SARPAM CS MEETING REPORT | Civil Society Partnership for Action on Access to Medicines & Diagnostics in Southern Africa
The effect is illustrated below. An organization that posts a note under training, for example, might say:
“Produce training materials and supply trainers.”
The column for organizations not represented at the workshop, obviously, remains blank and their
commitments will be established at a later stage.
The matrix has effectively become the foundation of a plan of action and two months of planning have,
indeed, been accomplished in two days.
10 CLOSE
It is further agreed that one person from these organizations or one of their member organizations will
represent the CS PACT at a meeting in Cape Town on 29/30 March where the broader SARPAM market
analysis process will be discussed in detail.
SARPAM CS MEETING REPORT | Civil Society Partnership for Action on Access to Medicines & Diagnostics in Southern Africa
Communication
Participants suggest that SARPAM needs a dedicated, well-functioning website as a channel for communication.
The SARPAM Director explains the facility of the Frontline SMS system which will eventually be toll-free for
users. Participants with mobile phones that are functional in Kenya are invited to register immediately on the
SMS system.
Closing Exercise
Completing the picture
The facilitator resumes facilitation and invites everyone to reflect on the two-day experience and the amount
of work achieved. She asks each participant to take the jigsaw piece s/he was given at the start of the day and
to help build a puzzle on the table in the middle of the circle.
The jigsaw gradually takes shape – and resembles the SARPAM banner: How can we work in partnership to
improve access to medicines in southern Africa?
Asked to comment on the jigsaw, people note there are pieces missing, and it’s a bit uneven and insecure,
but the image and the words are quite recognisable. As they speak they realise this is a metaphor for the
partnership-building and project-planning process they have just undertaken.
In a final symbolic act, individuals close the circle by shaking hands with the person on either side.
ANNEX H | Case Study: Partnership in Action (continued) 37
SARPAM CS MEETING REPORT | Civil Society Partnership for Action on Access to Medicines & Diagnostics in Southern Africa
Final Words by the Lead Team
The SARPAM Director observes that any partnership is only as strong as the weakest link and says the two-days
have inspired confidence by “the high standard of contribution, the quality of thought and the maturity of
reflection”.
The CS Technical Lead closes the meeting, thanking the facilitator and SARPAM Director for having the
courage to take this group on an innovative path and the event organisers, for their significant contribution to
the workshop’s success.
SARPAM CS MEETING REPORT | Civil Society Partnership for Action on Access to Medicines & Diagnostics in Southern Africa
SCORE KEY:
1 – POOR; 2 – SATISFACTORY; 3 – GOOD; 4 – EXCELLENT
1 2 3 4
1. Understanding of purpose 2 6
2. Achievement of workshop objective 1 10 6
3. Methodology and approach 1 7 11
4. Facilitation process and support 8 11
5. Level of participation of all delegates 1 5 13
6. Handling of questions and concerns 2 9 8
7. Building of relationships and networks 12 7
WORKSHOP
− Well organized, good approach, results have been achieved from nothing (no agenda).
− Good start. SARPAM must sustain the interest, share info and ensure that the momentum is not lost.
− The methodology and vision for the meeting was quite interesting and opened more opportunities of
ownership.
− Good.
− The methodology and the principles of this workshop need to be tried elsewhere in Africa.
− Great meeting, the approach was completely innovative but idea in allowing participants to see the
agenda. Keep it up Sharon and Shaun. This was a really great.
− Good venture.
− This has proved that an agenda put up by participants enable them. To discuss broadly and in deep the
contents, since they are issues being encountered daily
SARPAM CONTACT DETAILS 39
SARPAM CS MEETING REPORT | Civil Society Partnership for Action on Access to Medicines & Diagnostics in Southern Africa
24 Bolton Road
Parkwood
Johannesburg
South Africa
www.sarpam.net
Twitter: SARPAM2013
Facebook: SARPAM
Skype: SARPAM1
The SARPAM Team appreciates and extends thanks to each and every one who made the workshop possible
and attended and participated in the workshop.