Lebanon a country case study: Good Governance and Preventing Corruption

It is about another story about Lebanon and its effort in GGM program, that was published on the website of WHO-Headquarter in Geneva on December 9, 2010 in the occasion of the international Day for anti-corruption.

For this occasion, Lebanon was invited to give a presentation about its work to promote good governance in the pharmaceutical systems during a seminar that was held in WHO-Geneva.

Draft 8 November 2010  

Background

Decades of conflict and instability have left their mark on Lebanon's health system. They have weakened the primary health care system. At the same time, they have fostered the growth of the private sector, and facilitated unrestricted expansion of a high-tech health sector with high-cost pharmaceuticals.

The Government adopted the Good Governance for Medicines (GGM) programme in 2007. Since then, the Ministry of Health (MoH) has demonstrated high-level commitment to institutionalizing both the concepts of transparency and accountability in every aspect of medicine policy and management practice.

Nevertheless, the process has faced a number of challenges. These included poor understanding of transparency and good governance, fear of being evaluated (particularly in the early phases), and resistance to change.

Response

The Ministry embarked on an assessment of transparency within the pharmaceutical sector. This identified a number of gaps which in turn triggered some far-reaching changes.

Progress

Updated Good Manufacturing Procedures.
This document had not been updated since 1983. A wide range of representatives from public and private sectors, including academia, pharmaceutical manufacturers, and pharmacists were involved in the update. The revised Good Management Procedure (GMP) guidelines, officially adopted on 28 May 2009, are based on WHO GMP guidelines, the GGM transparency assessment findings, adapted to accord with Lebanon's pharmaceutical legislation.

A national GGM framework, based on the WHO GGM framework model This was recently adopted by the MoH and includes a national code of conduct; a compilation of regulations and administrative procedures; mechanisms for collaboration with other good governance and anti-corruption initiatives; whistle-blowing mechanisms and sanctions for reprehensible acts, that all function within the framework of Lebanese laws.

Other important changes based on the transparency assessment recommendations include:

• Creation of a new committee responsible for the revision of the national Essential Medicines List (EML). The new EML is currently being developed.
• MoH tender list prepared using generic names since end of 2008.
• Draft of ethical code for medicine promotion developed and placed on the MoH website to be reviewed by all stakeholders before being finalized.
• The development of written procedures, terms of reference, roles, responsibilities and professional qualifications of members for all committees.
• The enforcement of a conflict of interest form as of 21 October 2010, to be filled by all members of MoH committees dealing with pharmaceuticals, including the registration, pricing and GMP (Good Manufacturing Practices) committees.