Strengthened governance in pharmaceutical systems helps create more effective, accountable, and transparent institutions, which supports stronger and more sustainable health systems.
Achieving universal health coverage, where medicines are essential, requires clear policies, strong laws, and sound management guided by good governance. This is especially important for pharmaceutical systems, which are vulnerable to corruption due to the excessive costs of medicines, and the many players involved. Good governance reduces corruption, improves efficiencies, and enhances the ability of health systems to respond to challenges and make necessary reforms.
From 2018 to 2024, USAID MTaPS helped countries strengthen their pharmaceutical-sector governance and improve its regulatory systems by using a health systems-strengthening approach. Here are a few key achievements:
MTaPS collaborated with pharmaceutical governing bodies, including government agencies, drug evaluation advisors and committees to simplify the drug registration/authorization process which increased access to life-saving medicines that were previously unavailable to the public.
In Nepal for example, USAID MTaPS was successful in shortening the average time taken for medical products to be registered and authorized, drastically reducing approval times from several months to weeks. MTaPS supported Nepal’s Department of Drug Administration to achieve success in expediting the registration process of 100 essential products which were pending for years.
MTaPS has helped countries implement effective laws, policies, and guidelines to prevent overuse or misuse which is a key driver of antimicrobial resistance. Antimicrobial resistance makes standard treatments ineffective, leading to infections that are harder to treat which increases the risk of disease spread, severe illness, and death.
In Kenya, USAID MTaPS supported the Ministry of Health to implement an antimicrobial (AMR) strategy that could be implemented at every level of its health system. MTaPS worked closely with national, county, and health facility managers and health care workers to improve coordination among the human, animal, and agricultural sectors. As a result of this multisectoral coordination, a National Antimicrobial Steering Inter-Agency Committee was formed.
To implement appropriate medicine use practices at the facility level, MTaPS trained Medicines and Therapeutics Committees and health facilities in Nyeri and Kisumu counties and Gertrude’s Children’s Hospital on rational use, antibiotic stewardship, medicine use evaluations, and antibiotic use audits. MTaPS also supported 16 health facilities in both counties to implement quality improvement checks on the implementation of their infection, prevention, and control activities.
As a result of MTaPS’ efforts, Kenya is well positioned to take control of its progress in preventing and containing antimicrobial resistance in the country.
Conflict of interest is a significant issue in the governance of pharmaceutical systems, affecting not only the quality of medicines that are delivered but also the cost to the health system.
USAID MTaPS developed a manual – “Managing conflicts of interest: A how-to guide for public pharmaceutical-sector committees in low- and middle-income countries” – for countries to strengthen governance, meet WHO’s Sustainable Development Goals, and ensure that health resources are being used wisely, fairly, not wasted or lost to corruption.
The manual lays the groundwork for managing conflict of interest in pharmaceutical committees and marks the first step for countries to move toward stronger pharmaceutical systems.
In Nepal for example, MTaPS aided in the revision of the country’s National Medicine Policy in which the regulation of medical products has not kept pace with the expansion of the pharmaceutical market. The policy formulation process involved stakeholder discussions with 200 experts and institutions in the country. A high-level National Medicines Policy Workshop was organized by MTaPS in partnership with the Ministry of Health and Population. The workshop was conducted with over 70 policymakers and national stakeholders to review and discuss the policy options for improving the pharmaceutical sector over the next decade.
These collective efforts ensure that Nepal’s governing bodies' function more effectively in regulating medical products on the market, allowing for the people of Nepal to have sustainable access to safe and reliable medicines and other medical products.
