Developing Better Terms of Reference to Improve the Performance of Pharmaceutical Sector Committees: Case Studies from South Africa

In South Africa, there are numerous governance structures that make crucial decisions about selection, procurement, distribution, and use of medicines, diagnostics, and other pharmaceutical products. A challenge commonly encountered is that critical committees either do not exist or where the committee is in place, it does not function optimally. One of the most underlying causes of poor functioning of committees is the absence of or weak terms of reference (TOR). In 2015, the Affordable Medicines Directorate (AMD) of South Africa’s National Department of Health (NDOH), requested assistance from SIAPS in strengthening the TOR of several national committees, including those involved in selection of medicines for inclusion on the National Essential Medicines List (NEML). SIAPS developed a TOR guidance document that can be used in the development or review of TOR. The purpose of this brief is to share the guidance document and the processes SIAPS and their counterparts followed to develop new and revise existing TOR for three different pharmaceutical sector committees in South Africa.