Although impressive results have been reported, the system has required solid defence against pressures of various orders. Purchases of this size and level are always subject to attempts of interference from commercial and other pressure groups. The importance of correct information and transparency has been stressed by several actors and participants in the process.

The technical level of the people in charge of the administrative and technical support, the quality control laboratory, those in charge of the pre-qualification of suppliers and the final selection in the tender process have been mentioned as essential.

The use of computers has seriously simplified the execution of this procedure and has facilitated the gathering and the compilation of data on country requirements.

The standardization of drug lists and of the registration procedures for the countries of the GCC is one of the indirect results of this system of co-operation and in itself again facilitates the process.

The financing of recurrent costs has always been guaranteed, the definitely positive cost/efficiency balance has contributed to this guaranteed funding. The initial investment cost has been absorbed by all the participating countries, and for a large part by Saudi Arabia. The countries are directly responsible for the payment of invoices since they also directly conclude the contracts bilaterally.

Complaints concerning certain outstanding payments of invoices are not surprising but this is an indication that rigid discipline is necessary to maintain the confidence of the suppliers.