Beyond country level activities, the ADP has enabled South-South learning and exchange through regional activities and workshops in Africa and Asia and is helping to build a robust knowledge base on the introduction of new health technologies related to TB, malaria and NTDs.
In Year 2, the ADP organized a number of regional activities as a means of enabling South-South exchanges and learning between countries in the two regions. Given that growing numbers of LMICs have been able to implement innovative approaches in issues such as policy coherence, improving local production, implementation research and health technology assessment, the regional meetings and workshops facilitated fruitful discussion and sharing of a cross-section of experiences, strategies and good practices. The regional meetings provided a useful forum to share information on the ADP’s approach, which has generated demand for technical support and knowledge products within ADP focus countries and beyond.
Furthermore, in light of constraints around human and financial resources in LMICs, the regional meetings were valuable in strengthening communication, collaboration and technical and learning networks, among high- level policy makers and technical experts across national, regional and international levels. Members of these networks were able to identify common priorities and needs, which promoted a more integrated approach towards decision making on matters impacting public health innovation and access to health technologies.
In partnership with the Ministry of Foreign Affairs of Indonesia and the Non-Aligned Movement Centre for South-South Technical Cooperation (NAM CSSTC), the ADP supported a workshop in November 2014 with over 70 policy makers from agencies of health, trade and foreign affairs from member states of the Association of South East Asian Nations (ASEAN). This workshop built greater awareness among policy makers of the implications of existing health policies, and trade and investment agreements, on innovation and access to medical technologies; and promoted a better understanding of the intersections of these issues at the global, regional and national levels. Furthermore, the workshop provided a forum for ASEAN policy makers to explore the possibility of a regional approach within ASEAN to address the challenges to innovation in public health and equitable access to medical technologies; which prompted participants to identify opportunities for improved collaboration across sectors for a more integrated approach towards decision making and key strategic areas for possible South-South exchange and collaboration relating to access and delivery.
In May 2015, as a follow-up to the ASEAN-NAM meeting, the ADP organized a regional consultation in Bangkok, Thailand on integrating public health considerations into innovation and industrial frameworks in LMICs. The meeting brought together 30 participants from China, Indonesia, Malaysia, Thailand and Vietnam. Based on a guideline produced by the ADP, the consultation meeting strengthened the technical and decision-making capacities of technical officers from health ministries and drug regulatory authorities to ensure appropriate balance of public health priorities and the promotion of innovation.
An African regional meeting on promoting policy coherence for innovation in and access to health technologies took place in April 2015 in Addis Ababa, Ethiopia. Working in partnership with the UNDP Regional Centre for Africa and the African Union Commission, this meeting brought together over 90 delegates from 12 Anglophone countries in sub-Saharan Africa. Participants included high-level government representatives from multiple sectors, including health and drug regulation, trade and industry, science and technology, finance and business, and foreign affairs, as well as representatives from academia, research institutes and regional bodies. The involvement of stakeholders from multiple sectors enhanced understanding of the need for alignment within policy and legal frameworks to ensure innovation for, and access to, new health technologies.
In order to leverage South-South cooperation on implementation research capacity building, the ADP provided technical support to establish the Universitas Gadjah Mada (UGM) in Indonesia as a regional training centre for health research, with specific emphasis on implementation research, for the South East Asia region. The ADP also helped promote South-South collaboration between the two regional training centres at UGM and UOG, who are jointly developing an assessment tool for implementation research capacity at country level. The sustainability and scope of South-South learning will be further strengthened in Year 3 when the ADP facilitates exploration of potential areas of research collaboration and synergies between UGM and the Noguchi Memorial Institute for Medical Research in Ghana.
The ADP contributed to improved understanding, new knowledge and advancement of the methodological approach to pharmacovigilance by organizing a regional discussion on Cohort Event Monitoring (CEM), which is one of the key strategies for adverse events surveillance, especially in the early phase of product launch. Effective implementation of CEM is critical for new drugs, in particular new TB medicines in the pipeline, but this approach needs further development. The outcome of the discussions informed the improvement in the effectiveness of CEM for new drugs.
Capacities and strategies related to scaling-up of a new seasonal malaria chemoprevention (SMC) and safety monitoring systems in 10 sub-Sahara African countries were promoted by the ADP. Representatives from national malaria control programmes and pharmacovigilance centres participated in a regional workshop at the end of 2014 on preparing for the upcoming SMC campaigns. This workshop provided the opportunity to analyse the situation in each country; identify the specific needs in resources, capacities and strategies for active pharmacovigilance at the community level in the context of SMC; and learn lessons from countries like Ghana, which have in the past piloted innovative approaches for safety monitoring.
In order to develop the knowledge base on access to and delivery of new health technologies, the ADP commissioned a number of global studies. In Year 2, a mapping of pipeline technologies for TB, malaria and NTDs was conducted. This product pipeline analysis identifies the drugs, diagnostics and vaccines expected to be ready for market introduction by 2020. The analysis also provides a better understanding of the implications of introducing new health technologies in resource-limited settings, by highlighting the additional requirements or burdens on existing health systems in LMICs, particularly where they relate to establishment of new regulations on active pharmacovigilance systems; to supply, distribution and storage processes; and to health workforce training. The analysis also identifies key issues related to requirements at international policy level such as recommendations, endorsements, prequalification and monitoring on the introduced innovations.
The ADP also commissioned a series of case studies to document “good-practice” examples from select LMICs that have successfully demonstrated the re-shaping of conventional governance structures to facilitate multi-sectorial, inclusive and participatory processes, leading to coherent policies and laws that are public-health sensitive. Because experiences in complex health systems may not be easily transferred from one country to another, these case studies placed an emphasis on trying to understand how the context shapes the practices in LMICs, with a view for extrapolating lessons and identifying the necessary conditions and incentives to stimulate such South-South exchanges in the future. A review of laws and policies on requirements for mandatory reporting of adverse drug reactions (ADR) by health professionals was also commissioned by the ADP. While this review will help to identify enabling factors and challenges for the introduction of mandatory reporting of ADR in the context of Indonesia, the findings will be used to inform the strengthening of laws and policies in the other ADP focus countries, as well as other LMICs.
As a means of disseminating the ADP knowledge products to a global audience, a public website for the ADP project was launched in Year 2 (www.adphealth.org). Targeted outreach to development partners, public health practitioners and policy makers is also being undertaken through the use of social media tools such as Twitter, blogs and electronic newsletters.