Measuring transparency in the Egyptian pharmaceutical system

Abstract

The main purpose of this study is to assess the degree of transparency and accountability in the public pharmaceutical sector in Egypt. It aimed at providing an alarm about the weak points that could be vulnerable to corruption if measures to improve transparency and accountability are not introduced as soon as possible. The study uses a WHO transparency measuring instrument to assess one critical function of the pharmaceutical public sector as a case study; this function is medicines registration (product licensing). The study introduces a comparative analysis that sheds light on the position of the Egyptian pharmaceutical system compared to other 14 developing countries who conducted the same assessment. In the recent few years, Egypt made important efforts to strengthen medicines regulatory and management systems especially those with regard to medicines registration; however; the assessment results showed that Egypt's transparency score is 5.04 on the 1 to 10 scale. This score is one of the lowest among the compared countries and it indicates that the pharmaceutical system in Egypt, specifically the medicines registration function, is moderately vulnerable to corruption, according to the WHO measuring instrument. Some of the reported problems relate to opaqueness of the procedures of the registration process, especially those related to the registration committees. The selection criteria of the members, committees' composition and responsibilities and the mechanisms of decision making are the most opaque, in addition to the lack of any measures for accountability and conflict of interest. Moreover, some other problems are reported with regard to inefficiency and incompetence such as the lack of detailed procedures and guidelines for assessors and committee members, inexperienced assessors, inefficient incentive systems, violated timeframes, miscommunication, contradictory and highly changeable regulations without taking enough time for studying before issuance. Improving transparency in the sector and combating corruption need, first, strong anti-corruption legislations. Second, clear and transparent regulations and procedures should be introduced to decrease discretionary power. Third, this legislation and regulation should be effectively enforced via strong and efficient management and supervision systems.