Increasing transparency and accountability in national pharmaceutical systems

Abstract

Access to safe, effective, good-quality medicines can be compromised by poor pharmaceutical system governance. This system is particularly vulnerable to inefficiencies and to losses from corruption, because it involves a complex mix of actors with diverse responsibilities. A high level of transparency and accountability is critical for minimizing opportunities for fraud and leakage. In the past decade, the Good Governance for Medicines programme and the Medicines Transparency Alliance focused on improving accountability in the pharmaceutical system and on reducing its vulnerability to corruption by increasing transparency and encouraging participation by a range of stakeholders. Experience with these two programmes revealed that stakeholders interpreted transparency and accountability in a range of different ways. Moreover, programme implementation and progress assessments were complicated by a lack of clarity about what information should be disclosed by governments and about how greater transparency can strengthen accountability for access to medicines. This article provides a conceptual understanding of how transparency can facilitate accountability for better access to medicines. We identified three categories of information as prerequisites for accountability: (i) standards and commitments; (ii) decisions and results; and (iii) consequences and responsive actions. Examples are provided for each. Conceptual clarity and practical examples of the information needed to ensure accountability can help policy-makers identify the actions required to increase transparency and accountability in their pharmaceutical systems. We also discuss factors that can hinder or facilitate the use of information to hold to account those responsible for improving access to medicines.

The risk of corruption in public pharmaceutical procurement: how anti-corruption, transparency and accountability measures may reduce this risk

“…Transparency is 'the degree to which access to government information is available' [38][39]. 'Understanding how decisions are made requires information about the procedures followed and the criteria used by policy makers to reach decisions' [42][43][44]. 'Understanding why decisions are made necessitates disclosure of the information drawn on by policy makers and revelation of the arguments adduced in favour and against particular decisions' [45].…”

“…Importantly, data can illuminate patterns and any outliers, which may suggest that there are overpayments, collusion, or kickbacks happening in the procurement process. Ultimately, transparency can be understood as governments making information publicly available so that their actions and decisions are visible and understandable to the public, who can in turn hold them accountable [43].…”

Structural Factors Responsible for Universal Health Coverage in Low- and Middle-Income Countries: Results From 118 Countries

“…It is a stereotype of thinking in the implementation of universal health coverage. This understanding creates obstacles, social and political instability (2), poor governance (3), and lack of transparency (4). Those situations create significant challenges to quality of health service, population, and financial coverage which are the three pillar of universal health coverage.…”

Anti-corruption, Transparency and Accountability: Case Study of Healthcare in the Arab Countries

“…agenda that emerges in SDG 16 on 'Peace, Justice and Strong Institutions'. It is the underpinning of any strong, effective ecosystem such as the health sector, for instance [7]. Corruption massively undermines the effectiveness of any given structure; it has therefore been a central target of governance reforms [8].…”