The latest issue of the Medicines Transparency Alliance (MeTA) newsletter highlights the worry that some stakeholders feel about engaging in a complex dialogue process. In particular, civil society organisations often – as Minu Hemmanti points out – have concerns over co-option, of losing independence, and being in a situation where the political and economic power of other participants in a multi-stakeholder process might divide civil society or dilute the strength of its voice and its advocacy for change.

MeTA believes that the multi-stakeholder process it is facilitating in seven countries is very much about change and transformation. It seeks to:

* shift some decision-making power to consumers
* put greater competitive pressure on suppliers
* promote better governance and more appropriate resource allocation by public purchasers
* improve the functioning of the pharmaceutical market
* encourage innovative and responsible business practices.

We think that helping to shape the agenda of the dialogue, learning about what solutions are possible, and working together to encourage change are strong incentives for civil society to engage in the multi-stakeholder process.

What about you? What’s your experience of engaging in multi-stakeholder processes? Has it been positive or negative? What can make a multi-stakeholder process effective for everyone?

Two of the presentations – one from Peru and the other from Jordan – have attracted positive comments from people who viewed the slides. The comment from Peru was posted by Ideeleradio, a Peruvian community-based radio station. A representative from Ideeleradio attended a MeTA-sponsored workshop for civil society held in the Philippines in June 2008, to encourage greater engagement of civil society groups in the efforts to improve transparency in the health sector.

Praise for transparency efforts in Peru and Jordan
Ideeleradio in Peru has broadcast a story about a decision by the Ministry of Health to introduce a more public oversight over the provision of health care facilities. Minister of Health, Oscar Ugarate, announced that the government was cancelling an agreement with the Organisation of the Spanish American States (OEI) to construct a new hospital due to delays.

The OEI has agreed to return funds (41 million soles) that had been committed to the project. To improve the transparency of decision making around projects like this and encourage greater citizen involvement in efforts to improve health services, the Ministry has announced an oversight commission, particularly to speed up processes around Ica, the site of a 2007 earthquake. The commission will include representatives from the local population and local and regional authorities.

At the same time, the Treasury department has announced an investigation into the dealings of a former Congressman and former Health Minister around alleged irregularities in relation to the construction of hospitals in various parts of the country.

In Jordan, an announcement by the Director of the High Health Council about the government’s commitment to increasing transparency around the procurement, distribution, sale and use of medicines has attracted positive comment. One Jordanian citizen, praising the quality of the health services, noted that this effort would strengthen Jordan’s leadership in the region.