Buckland-Merrett Gemma L, Kilkenny Catherine, Reed Tim
Health Action International, Overtoom 60 (2), 1054 HK Amsterdam, The Netherlands.
J Pharm Policy Pract. 2017 Jan 6;10:5. doi: 10.1186/s40545-016-0096-0. eCollection 2017.
The Medicines Transparency Alliance (MeTA) is an initiative that brings together all stakeholders in the medicines market to create a multi-stakeholder dialogue and improve access, availability and affordability of medicines. Key to this multi-stakeholder dialogue is the participation of Civil Society Organisations. A recent MeTA annual review, identified uneven engagement of civil society organisations in the multi-stakeholder process. This study was designed to explore the engagement of Civil Society Organisations in the MeTA multi-stakeholder process and the factors influencing their participation.
Participants were drawn from a convenience sample of key MeTA informants attending a MeTA global meeting in Geneva in 2014. Study participants consisted of members of MeTA, which included representatives from government, the private sector and civil society. In-depth semi-structured face-to-face interviews were conducted to identify perceptions around the barriers to civil society engagement in the multi-stakeholder process. Interviews were guided by a conceptual framework exploring the three main themes of the political environment, relative stakeholder strength and agenda setting/gatekeepers. Interviews were structured to enable additional themes to emerge and be explored. Fifteen interviews were conducted. The interviews were audio recorded, transcribed verbatim and analysed using a general inductive approach. All interviewees provided written informed consent.
Findings were captured within three main overarching themes: the political environment, relative stakeholder strength and agenda setting/gatekeepers, with the opportunity for additional themes to emerge in the interviewing process. The study conformed these three themes were important in the engagement process. Participants reported that civil society engagement is particularly limited by those who set the agenda. It was largely seen that the political environment was the significant factor that enabled or disabled all others. The findings counter the argument that CSO barriers to engagement are predominantly due to capacity issues.
This study enriches previous findings by providing insights into civil society participation in multi-stakeholder dialogue, specifically the MeTA initiative. The development of more rigorous and systematic accountability mechanisms in order to maintain the legitimacy of decision-making processes and establish more equal power relations would significantly benefit the engagement of civil society organisations. The results inform practical recommendations for MeTA and future multi-stakeholder programmes tasked with improving policy on the access, availability and affordability of medicines.
药品透明度联盟（MeTA）是一项倡议，它将药品市场中的所有利益相关者聚集在一起，开展多利益相关者对话，以改善药品的可及性、可得性和可负担性。这种多利益相关者对话的关键在于民间社会组织的参与。MeTA最近的一份年度审查指出，民间社会组织在多利益相关者进程中的参与情况不均衡。本研究旨在探讨民间社会组织在MeTA多利益相关者进程中的参与情况以及影响其参与的因素。
参与者来自2014年在日内瓦参加MeTA全球会议的关键MeTA信息提供者的便利样本。研究参与者包括MeTA成员，其中有来自政府、私营部门和民间社会的代表。进行了深入的半结构化面对面访谈，以确定对民间社会参与多利益相关者进程的障碍的看法。访谈以一个概念框架为指导，该框架探讨了政治环境、相对利益相关者力量以及议程设置/把关人这三个主要主题。访谈的结构设计使得能够出现并探讨其他主题。共进行了15次访谈。访谈进行了录音，逐字转录，并采用一般归纳法进行分析。所有受访者均提供了书面知情同意书。
研究结果归纳为三个主要总体主题：政治环境、相对利益相关者力量以及议程设置/把关人，在访谈过程中还有可能出现其他主题。该研究证实这三个主题在参与过程中很重要。参与者报告称，民间社会的参与尤其受到议程设定者的限制。在很大程度上，政治环境被视为促成或阻碍所有其他因素的重要因素。研究结果反驳了关于民间社会组织参与障碍主要是由于能力问题的观点。
本研究通过深入了解民间社会参与多利益相关者对话，特别是MeTA倡议，丰富了先前的研究结果。制定更严格、系统的问责机制，以维护决策过程的合法性并建立更平等的权力关系，将极大地有利于民间社会组织的参与。研究结果为MeTA以及未来负责改进药品可及性、可得性和可负担性政策的多利益相关者计划提供了实际建议。
