Access to Medicines Scorecard 2015 – 2016
In 2015 the Open Society Initiative for Southern Africa (OSISA) approved funding for AI to co-ordinate a new project to promote transparency and accountability initiatives within Southern Africa with a particular focus on access to medicines.
The overall aim of the project is to increase confidence and capacity by citizens through the civil society in selected SADC countries to demand effective and efficient access to medicines services from governments, private sector and funding partners.
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As part of the preliminary process in terms of rolling out the new project, during November 2015 a special mapping exercise was conducted to collate information needed for a database of all key organisations actively involved on access to medicines issues across Southern Africa.
In particular, the outcome of the mapping process will seek to provide a map of civil society and other relevant stakeholders who could be engaged in advocacy work focused on the promotion of transparency and accountability issues with regards to access to medicines across Southern Africa.
In general terms, the mapping exercised was spread across all the ten countries that are covered by OSISA. Namely, Angola, Botswana, DRC, Lesotho, Malawi, Mozambique, Swaziland, Zambia and Zimbabwe. There was also an analysis of the entire pan African and global organisations that are also active in the region.
Further to that, a special and more detailed mapping exercise was conducted in four of the targeted ten countries. Namely, Botswana, Malawi, Zambia and Zimbabwe. This is so because the four countries are set to be the ones most likely to be targeted in terms of the initial advocacy interventions to be conducted under this initiative to promote increased transparency and accountability on access to medicines issues across Southern Africa.
As part of the preliminary process in terms of rolling out the new project, during November 2015 a special survey was designed to collate information needed in the development of a special report focusing on the ‘State of Transparency and Accountability in Access to Medicines in Southern Africa’.
The survey constituted a series of inter-related questions that sought to clarify the situation with regards to access to medicines related issues from an accountability perspective. Among highlighting some of the key aspects on transparency and accountability with regards to access to medicines in Southern Africa, the survey also sought to establish the status of missed targets by SADC governments.
Further, the survey sought to shed more light on the current capacity of civil society to play its role as a trusted and reliable watchdog for society in terms of access to medicines in the SADC region. The responses from the survey developed the basis for this report focusing on the ‘State of Transparency and Accountability in Access to Medicines in Southern Africa’.
The A2M Scorecard presents data from Botswana, Malawi, Zambia, and Zimbabwe on accountability and transparency issues related to access to medicines in the selected countries. It is further envisaged that in the long term, an annual A2M Scorecard could be possible which could cover more countries starting within Southern Africa and then later the rest of Africa.
The A2M Scorecard will also be used a credible barometer to measure and monitor progress in terms of the promoting of transparency and accountability issues in access to medicines in all the selected countries.
The A2M Scorecard consists of feedback from national consultation meetings held with civil society representatives in the four countries. The feedback is structured using identified indicators grouped under seven different broad elements:
Element 1: Pricing and Procurement
Element 2: Medicines Stock Levels
Element 3: Supply Chain Management
Element 4: Regulatory Environment
Element 5: TRIPs Flexibilities
Element 6: Local Research & Development and Manufacturing
Element 7: Stakeholder Accountability.
The report also contains a section focusing on the key findings also one on some proposed recommendations as part of the action steps forward.
In broad terms, the key finding of this scorecard process is that there are a lot of unresolved issues with regards affecting transparency and accountability issues that are adversely affecting access to medicines for many people in the considered countries. This could also be a general trend in all other countries in Southern Africa that were not part of this scorecard rating process.
Further, the report highlights the fact that civil society thinks that their own governments are not presently doing enough to promote transparency and accountability issues to increase access to medicines to their citizens. The report also notes that civil society is generally not capacitated and conscientised enough to play its crucial watchdog role in the implementation process of government led policies, laws, or commitments.
As part of the way forward, the report recommends an increase in terms of technical support for civil society so as to enhance its advocacy role as an effective watchdog for their respective countries governments.
It also recommends an increase in engagement between civil society and government through active dialogue processes and representation of civil society in some of the national institutions and structures.