Catalysing health R&D, innovation and access

South African Health Technologies Advocacy Coalition

Health Technology Assessment (HTA) Workshop

Under the umbrella of SAHTAC and Campaigning for Cancer a first regional Health Technology Assessment International (HTAi)-endorsed workshop was held on October 26, 2022, in Johannesburg. It was co-hosted by the HTAi’s Public and Citizen Involvement working group.

The workshop focused on patient and public involvement (PPI) in HTA or healthcare decision making in Southern Africa. Building on learnings from other countries shared through short presentations, the participants discussed in structured group work, how PPI would improve local decision-making, how current barriers could be overcome through multi-stakeholder engagement, and how PPI in HTA or healthcare decision making could be fostered.  The participants expressed their excitement and motivation to co-create and shape a subsequent Call to Action for the region ton be launched on coming months.

Highlights of this workshop include:
● The realisation from participants how commercial, political, and economic decisions can play a role in access or no access to health technologies.
● Most participants indicated that the series had educated them on HTA in general and where they see their potential future involvement in an HTA process.
● All participants indicated that they would like to continue to learn more about HTA and how it can be used to advocate for expanded access to technologies and investment into research.
● Several participants indicated their willingness to collaborate on the development of a call to action related to PCI in HTA for the region.
It is proposed that monitoring be undertaken in the form of:
Number of respondents to complete the pre-survey questions.
Endorsement of the workshop, programme, and inclusion of membership participants in meeting invites by HTAi (
Number, profile of participants and diversity of sectors represented.
Outcomes of survey of participants to gauge lessons learned.
● The adoption of the call to action in advocacy efforts relating to PI in HTA, within the region and internationally and specifically linkages back to SAHTAC Policy Workstream.

Health Technology Assessment (HTA) is a multidisciplinary process that summarises information about the medical, social, economic, and ethical issues related to the use of a health technology (medicines, devices, procedures, settings of care, screening) in a systematic, transparent, unbiased, robust manner. Contextual factors addressed by HTA include economic, organizational, social, and ethical impacts. The scope and methods of HTA may be adapted to respond to the policy needs of a particular health system. Its aim is to inform the formulation of safe, effective, health policies that are patient focused and seek to achieve best value.

Patient Involvement (PI) in HTA can help prioritise health technologies that meet the needs of patients and improve patient health outcomes. Therefore, processes and methodologies are developed to involve patients in a fair and methodologically consistent manner. When building health technology assessment and related decision processes in Southern Africa, institutions and stakeholders face region-specific challenges such as disease prevalence and population make-up. To some degree, these may be addressed by collaboratively discussing patient engagement solutions that fit to the local culture and systems and help to support equitable and sustainable access to patient-relevant health technologies.

In a multi-stakeholder workshop format, aim to initiate the collaboration for driving patient involvement suitable for the Southern African context and patient communities’ capabilities to engage in HTA.
• Building on international lessons learned, the workshop sort to explore current experiences in PI including the stakeholder expectations, gaps, limitations, and new opportunities.
• The participants share their experiences in patient involvement in decision-making processes from across Sub-Saharan countries.
• By collaboratively discussing patient engagement solutions that fit the local culture and systems and help to support equitable and sustainable access to patient-relevant health technologies a call to action for the region can be developed highlighting the priorities brought forward in the meeting, highlighting vital success factors for PI, which will be co-created by the participants.

The primary output of the workshop will be a call to action and draft concept for the important success factors for PI, co-created by the participants. The content of the call to action has been gathered from pre and post workshop surveys and interviews as well as outcomes from historic meetings held in conjunction with Health Technology Assessment International (HTAi) PI workstream and facilitated discussion from the actual workshop.
Through the workshop we expected the following learning objectives to be achieved.
• Increase awareness about the potential of PI in HTA
• Base content for a call to action: Why and how and who
• A set of conceptual actions is described (What, how, who)
• A multi-stakeholder network is initiated

Participants were drawn from amongst Southern African countries, the 30 countries have supported the African Medicines Agency (AMA) Treaty, the 19 countries that have ratified and deposited the treaty and specifically identified countries where there exist advocacy efforts relating to the treaty, like Kenya. Existing networks of SAHTAC membership, HTAi membership, Campaigning for Cancer stakeholders ensured that there was a wide range of stakeholders represented, including:

• Patient advocates and citizen representatives
• HTA experts and agencies
• Academia
• Funding stakeholders
• Policy makers from the region
• Healthcare Professional stakeholders

Prior to the meeting stakeholders were surveyed on which of these topics they would like to present as their solution perspective. Key Opinion leaders and scholars presents to participants basic background concerning PCI in HTA, international gold standards of PCI in HTA and learning from other regions on how PCI has been achieved.

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