Abstract
BackgroundCorruption in the health sector can hurt health outcomes. Improving good governance can in turn help prevent health-related corruption. We understand good governance as having the following characteristics: it is consensus-oriented, accountable, transparent, responsive, equitable and inclusive, effective and efficient, follows the rule of law, is participatory and should in theory be less vulnerable to corruption. By focusing on the pharmaceutical system, we explore some of the key lessons learned from existing initiatives in good governance. As the development community begins to identify post-2015 Millennium Development Goals targets, it is essential to evaluate programs in good governance in order to build on these results and establish sustainable strategies. This discussion on the pharmaceutical system illuminates why.DiscussionConsidering pharmaceutical governance initiatives such as those launched by the World Bank, World Health Organization, and the Global Fund, we argue that country ownership of good governance initiatives is essential but also any initiative must include the participation of impartial stakeholders. Understanding the political context of any initiative is also vital so that potential obstacles are identified and the design of any initiative is flexible enough to make adjustments in programming as needed. Finally, the inherent challenge which all initiatives face is adequately measuring outcomes from any effort. However in fairness, determining the precise relationship between good governance and health outcomes is rarely straightforward.SummaryChallenges identified in pharmaceutical governance initiatives manifest in different forms depending on the nature and structure of the initiative, but their regular occurrence and impact on population-based health demonstrates growing importance of addressing pharmaceutical governance as a key component of the post-2015 Millennium Development Goals. Specifically, these challenges need to be acknowledged and responded to with global cooperation and innovation to establish localized and evidence-based metrics for good governance to promote global pharmaceutical safety.
Highlights
Corruption in the health sector can hurt health outcomes
Summary: Challenges identified in pharmaceutical governance initiatives manifest in different forms depending on the nature and structure of the initiative, but their regular occurrence and impact on population-based health demonstrates growing importance of addressing pharmaceutical governance as a key component of the post-2015 Millennium Development Goals
As an initial commentary on existing governance initiatives in the pharmaceutical sector where the public and private sphere often intersect, this paper identifies three thematic areas whose effective management is essential for success: authentic country ownership of good governance initiatives, understanding about how the political context may help or hinder an initiative, and monitoring and evaluating how good governance initiatives may help improve health outcomes
Summary
Assessment of pharmaceutical governance initiatives In addition to this discussion, a recent U4 Issue Paper [21] identifies and assesses key global good governance initiatives in the pharmaceutical sector. The active participation of relevant stakeholders in both GGM and MeTA allowed for strong results in terms of establishing a dialogue and developing relations and trust between previously disparate groups (public sector, private sector, and civil society) In both of these programs, the inclusive development of national plans to improve governance was key, allowing those with the closest ties to specific issues to help shape and have ownership of the changes made. Greater communication and cooperation between relevant stakeholders engaged in pharmaceutical systems, including development-granting institutions, international organizations with good governance programs, the private sector, and donor-aid recipients could support more integrated programs This includes attempting to establish global norms on good pharmaceutical governance with the overall goal of ensuring safe and affordable access to medicines. TKM is an international expert in the field of global drug supply safety and policy addressing the falsified medicines trade
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