1. Good governance is increasingly understood as necessary for improving access to medicines and contributing to health systems strengthening. This chapter reviews the findings of studies carried out in 25 countries that have examined governance of key functions of pharmaceutical systems within the framework of WHO’s Good Governance for Medicines (GGM) programme;

2. The goal of the GGM programme, an innovative WHO initiative launched in late 2004, is to reduce corruption in pharmaceutical systems through the application of transparent, accountable administrative procedures grounded in laws and regulations, and the promotion of ethical practices;

3. The country studies, which are based on a common methodology, have revealed strengths and several weaknesses in existing pharmaceutical systems and have provided policy-makers with relevant information to help them better understand the nature of the problems facing the sector and where interventions need to take place;

4. Common strengths in the pharmaceutical systems and procedures include the use of standard application forms in the registration process of medicines, use of national essential medicines lists, existence of standard operating procedures for procurement of medicines and well-established tender committees;

5. Common weaknesses include a lack of access to information, poor enforcement and implementation of laws and regulations, absence of conflict of interest policies among members of various committees, and an inability to ensure that the proper incentives are in place to lessen the likelihood of corruption at both the individual and institutional levels;

6. Governments can reduce corruption by promoting transparency and ethical practices, and by introducing simple measures, such as justification for committee membership, terms of reference, conflict of interest policies and descriptions of the purpose of the committees. International organizations, such as WHO, can provide technical support for these efforts.