Promoting transparency, accountability, and access through a multi-stakeholder initiative: lessons from the medicines transparency alliance
Background: Barriers to expanding access to medicines include weak pharmaceutical sector governance, lack of
transparency and accountability, inadequate attention to social services on the political agenda, and financing
challenges. Multi-stakeholder initiatives such as the Medicines Transparency Alliance (MeTA) may help overcome
these barriers. Between 2008 and 2015, MeTA engaged stakeholders in the pharmaceutical sectors of seven
countries (Ghana, Jordan, Kyrgyzstan, Peru, Philippines, Uganda, and Zambia) to promote access goals through
greater transparency.
Methods: We reviewed archival data to document MeTA activities and results related to transparency and accountability
in the seven countries where it was implemented. We identified common themes and content areas, noting specific
activities used to make information transparent and accessible, how data were used to inform discussions, and the
purpose and timing of meetings and advocacy activities to help set priorities and influence governance decisions. The
cross-case analysis looked for pathways which might link the MeTA strategies to results such as better policies or program
improvements.
Results: Countries used evidence gathering, open meetings, and proactive information dissemination to increase
transparency. MeTA fostered policy dialogue to bring together the many government, civil society and private company
stakeholders concerned with access issues, and provided them with information to understand barriers to access at
policy, organizational, and community levels. We found strong evidence that transparency was enhanced. Some evidence
suggests that MeTA efforts contributed to new policies and civil society capacity strengthening although the impact on
government accountability is not clear.
Conclusion: MeTA appears to have achieved its goal of creating a multi-stakeholder shared policy space in which
government, civil society, and private sector players can come together and have a voice in the national
pharmaceutical policy making process. Assuming that transparency is in place to leverage accountability, the
success of MeTA’s efforts to promote accountability by the government as well as other stakeholders in the
pharmaceutical sector will depend on how well efforts are sustained over time.
