GMP Policy Making & Dissemination Process Review MPAC – Public session 17 October 2018
Project objectives and methodology Review synthesis Agenda Country survey results Next steps 1
Project objectives and methodology Review synthesis Agenda Country survey results Next steps 2
The project has 4 main objectives Build robust fact base on policy development and dissemination processes Findings and recommendations Identify opportunities to improve the policy development to be shared at the and dissemination processes leading to strengthened malaria programmes MPAC meeting in October Design and evaluate options for optimising the WHO malaria policy development and dissemination processes Develop an implementation roadmap 3
Key principles of our approach Co-constructed Incremental Fact-based Iterated with Built leveraging previous Incorporating a robust coordinators & work on VCAG, TPoP, I2I description of reality integrating other WHO as well as WHO driven • Current policy pathways departments perspective normative function mapping to ensure accurate review • 11 case studies developed depiction • Analogous organization benchmarks • 80+ interviews along the value chain 4
Upstream Downstream Cross-cutting Academics, Donors Mfrs Regulatory WHO Bodies Procurers Technical Implementers Countries view on the Innovators Authorities Partners Donors/ Mfrs/innovators GMP Procurers/Implementers Country programme process with 80+ • • I2I UNITAID (x2 managers • • VC innovators 1 Committees interviews) Rwanda • • • • interviews Access Bio (Dx) MPAC (x5 USAID Sierra Leone • • • GSK (Vx) interviews) PMI India • • • • Sanofi (Rx,Vx) (x3 interviews) GRC GF (x2 interviews) Colombia conducted, ~30 • • • Novartis (Rx) (x2 interviews) UNICEF Nigeria • • Alere (Dx) Other dpts CHAI of which external • • • BMGF (x7 interviews) HIV Malaria Consortium WHO national Programme • • TB (x2 interviews) ALMA officers • • • PDPs PQ (x3 interviews) CDC RDC to WHO • • • MMV (x2 interviews) IVB (x2 interviews) Nigeria • • Reproduct. Health Thailand • • HTA EML (x2 interviews) Tanzania • • • Nice Press Yemen • EMP • Regulation of meds WHO regional malaria advisors • AFRO Interviews conducted • PAHO 1. Leveraging interviews from previous VCAG work • South East Asia 5
Project objectives and methodology Review synthesis Agenda Country survey results Next steps 6
Interview consensus: GMP policy making and dissemination process has dramatically improved since introduction of MPAC … Organisation Evidence & Expertise Dissemination MPAC fulfils its purpose in that it has WHO website has made good progress Overall, evidence-based guidelines have the highest calibre of technical experts & GMP's newsletter is useful been a huge step in the right direction in disseminating new material for WHO Procurer Country Programme Manager PDP ERGs have quicker approach for It is a good thing GMP produces The role of VCAG has become clearer over the past 1.5 years understanding a very specific topic, Guidelines since this gives a framework gathering best experts, and go in depth for use by countries and prevents them Procurer on issues. They really expedite and from being flooded with products they quality check the process won't know what to do with GMP Manufacturer Source: Interviews 7
…and brings unique value to countries All countries we work with look at WHO for the last word as per intervention selection Implementer WHO is an indispensable partner for low- income countries Technical Partner WHO plays an absolute key role in malaria endemic countries Manufacturer 8
However, 3 pain points constitute a case for change Perceived lengthy Perceived inconsistent Sub-optimal use of GMP process recommendations output at country level 9
7 areas of focus have been identified Upstream Downstream Academics, Donors, Manufacturers Regulatory WHO Bodies Procurers Technical Implementers Countries Innovators Authorities Partners Policy Pathways 1 Entry Point 1a Policy Products 4 Review Standards 1b Perceived lengthy Dissemination 5 1c Roles & Responsibilities Mechanisms & Network process Sub-optimal use btw. PQ & GMP Prioritisation Framework 6 of WHO output Process Sequence 1d at country level Operational Execution 7 Review of Evidence 2 Inconsistent WHO Bodies Composition 3 recommendations 10
Project objectives and methodology Review synthesis Agenda Country survey results Next steps 11
Confirm diagnosis of key strengths & challenges of GMP Policy Making & Dissemination Process Objectives of the survey Inform options on how to improve uptake focusing on network activation, dissemination mechanisms & feedback loop 12
96 survey responses collected across WHO regions 26 SEARO (South-East Asia) 0 15 EURO (Europe) PAHO (Americas) 11 Myanmar 2 Bhutan 3 Ecuador 1 Bolivia 5 Thailand 2 Korea 2 Belize 1 Colombia 3 Indonesia 1 Nepal 2 Brazil 1 Haiti 2 Bangladesh 2 Suriname 1 Nicaragua 1 Argentina 1 Venezuela 8 WPRO (Western Pacific) 26 AFRO (African Region) 3 Cambodia 6 Ethiopia 1 Côte d'Ivoire 2 Philippines 2 Benin 1 DRC 1 Papua New Guinea 2 Ghana 1 Liberia 2 Guinea 1 Madagascar 1 Solomon Islands 1 Viet Nam 2 Nigeria 1 Mozambique 1 Cabo Verde 1 Rwanda 17 EMRO (Eastern Mediterranean) 1 Cameroon 1 Uganda 6 Iran 1 Saudi Arabia 1 CAR 1 Zimbabwe 4 Afghanistan 1 Sudan 1 Chad 3 Somalia 1 Yemen X 1 Pakistan x Legend: Number of respondents per country Number of respondents per region Note: n=96; Out of these, 4 responses have been marked as 'Other' Source: GMP Country Survey Aug 2018 13 Source: WHO website. BCG estimations.
Implementers / Technical Partners as primary audience to survey; balanced mix of seniority Role Seniority in current role 46% 20% 20% 10% 4% 29% 26% 28% 17% 4 96 28 27 10 25 19 19 16 44 Implementer/ National WHO NPO Other Other WHO Total <2 year 2-5 years 5-10 years 10+ years technical Malaria partner Control Programme Mgr. Note: n=96 Source: GMP Country Survey Aug 2018 14
Survey results confirm our assumptions on GMP Policy Making & Dissemination Process' strengths & challenges Assumptions tested Relevancy according to survey WHO publications are used as references & authoritative sources of info. for 50% 42% 6% 2% decision-making in clinical, PH 1 & policy-making contexts in my country Major WHO policy guidance supports my local needs 34% 57% 6% 2% strengths I feel that WHO policy guidance is helping me drive impact in my country 28% 56% 11% 4% WHO policy guidance is specific enough & easy to operationalise in my 8% 58% 16% 14% 4% country Room for WHO policy guidance provides clear prioritisation criteria across 13% 51% 22% 9% 5% interventions based on local context improvement 19% 45% 21% 14% 2% I understand the WHO policy guidance development process I am satisfied with the current mechanisms used to disseminate 17% 35% 29% 19% 0% Major information on WHO policy guidance The different levels of the WHO network are very well coordinated and challenges 16% 35% 27% 20% 2% communicate effectively to support the dissemination of policy guidance 0% 20% 40% 60% 80% 100% Strongly agree Agree Neither agree nor disagree Disagree Strongly disagree Note: n=96 1. Public Health Source: GMP Country Survey Aug 2018 15
Focus Uptake optimisation Options were tested through the survey to improve 3 dimensions 1 2 3 Dissemination Feedback loop Network activation plan 16
1 Dissemination mechanisms 1 Improve structure of documents Plebiscite of all suggested improvements by respondents Dissemination Improve GMP website Preferred source of information for ~80% of GMP audience 3 key levers to Improvement stated as #1 priority for ~60% of GMP audience improve Organise workshop with final users to brainstorm on website revamping, leveraging first ideas shared through survey dissemination A website that is user friendly and easily navigable – NPO, Viet Nam (WPRO) emerged from Online e-learning courses on malaria – Implementer / technical partner, Myanmar (SEARO) survey Develop new sharing opportunities Exchange of information & best practices within network expressed as major need for a large majority of GMP audience Further investigate feasibility of mechanisms fostering sharing (digital & face-to-face) among network & derive implementation plan 17
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