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BylawsWhat is INRUD? INRUD is a network of groups that share a common vision for promoting the safe, effective, and cost-effective use of medicines. INRUD emphasizes the importance of sharing relevant experiences among participating members, technical cooperation, quality education, and the creation of valuable methodological tools and approaches to improve drug use. A key distinguishing feature of INRUD is its multidisciplinary focus on drug use and behavior change linking clinical and social sciences. Primary emphasis is placed on understanding the behavioral aspects of drug use, particularly the beliefs and motivations of providers and consumers and the barriers to behavior change. INRUD promotes well-designed research studies to understand these behavioral factors, leading to the development of interventions that are rigorously tested and evaluated for their efficacy in changing behavior. When the efficacy of particular interventions has been established, INRUD supports efforts to scale up and implement these evidence-based approaches as widely as possible, with active collaboration among institutions and countries and continued efforts to monitor their effectiveness. INRUD intervention research, education, and advocacy have all been based on this behavioral framework. Efforts have been focused on community and providers in all sectors-public and private, formal and informal-as well as policy makers. Advantages of INRUD Membership Membership in INRUD offers the following advantages:
Obligations of Membership The primary obligation of membership is that all INRUD groups and their members must work actively toward the INRUD vision of promoting the safe, effective, and cost-effective use of medicines. Financial obligations of membership include supporting the continuity and sustainability of the network administration through funding rules detailed below. Criteria for Membership Any group may apply for membership provided that it fulfills the following criteria:
Ideally, each group should develop a firm enough identity to establish a group bank account with at least two signatories to the account. This will facilitate directly funded participation in INRUD activities. There is no limitation to the number of INRUD groups in a country. However, the goal of the network is to promote cooperation within and among countries. If a group applies for INRUD membership in a country where other INRUD groups already exist, there should be reasons stated why another group is needed, rather than extension of the existing groups. A plan of how the groups within a country plan to organize themselves to promote maximum cooperation is also needed. In the event that groups within a country cannot cooperate, the Board must decide whether the groups are fulfilling the INRUD vision of enhanced cooperation and review their membership status. Existing university support groups such as Harvard, the Karolinska Institute, and Newcastle University will cease to have their special status and will automatically become ordinary INRUD member groups after fulfilling the criteria for membership. Since inception, many country groups have developed the capacity to provide technical support to other INRUD members, and, within the philosophy of INRUD, all groups will be expected to support each other according to their abilities. If any group has a particular need for support, it may issue a request through the INRUD Coordinator. Application Procedure A group wishing to join should send an application to the INRUD Secretariat addressing all of the criteria for membership described above. If there is an existing INRUD member group in the applicant's country, an explanation of why another group is needed and a plan for cooperation between groups should be submitted as well. The INRUD Coordinator will review applications and send those that meet the specified criteria to all Board members, who will have one month to decide whether to accept the applicant. During this month, Board members may communicate with each other on this topic, and if there are any questions raised about the application, it will be put to a vote of all Board members. The applicant group will be accepted if it gains a two-thirds majority of the vote. Board members who do not vote will have their votes on the application counted as positive. Retention of Membership A group will retain membership if every two years it submits a report on activities of the group and its members related to improving use of medicines. The group must document sufficient activity to demonstrate a continuous stream of progress. Two Board members will review each report. If either Board member thinks the report shows insufficient activity, the report will be circulated to all Board members, who will vote on whether the group should retain membership. A simple majority of the Board members who cast a vote will determine whether the group retains membership. Biennial reports will be due six months before Board elections. Regions In order to accommodate specific regional characteristics and concerns, INRUD groups will be organized into geographic regions. Initially there will be six regions, which will be geographically the same as the WHO regions: the Americas, Eastern Mediterranean, Europe, South-East Asia, sub-Saharan Africa, and Western Pacific. The definition of these regions may change from time to time to reflect current patterns of membership. A vote to change the regional organization will require a three-quarters majority of all Board members. Board members who do not vote will have their votes on a proposal for realignment counted as positive. The INRUD Board There are currently 13 board members, 11 of which were elected in December 2004. The 11 elected members are: Asia and Pacific Southeast Asia Bangladesh: Azad Chowdhury Indonesia: Sri Suryawati Nepal: K. K. Kafle Thailand: Chitr Sitthi-amorn Western Pacific Philippines: Bobby Rosadio Sub-Saharan Africa Ghana: David Ofori-Adjei Nigeria: Biola Mabadeje Tanzania: Amos Massele Uganda: Willy Anokbonggo The Americas and Europe USA—Boston Group: Dennis Ross-Degnan Karolinska Institutet: Göran Tomson The two ex officio members are—
John Chalker Center for Pharmaceutical Management Management Sciences for Health
Kathy Holloway WHO/Medicines Policy and Standards All board members have voting rights. In order to have group interests fairly represented on the board, the groups have been divided into four regions or subregions with at least two board members coming from each subregion— Asia and Pacific (counted as two) Southeast Asian Sub-Saharan AfricaWestern Pacific The Americas and Europe Each INRUD group puts a member forward for election. Then each group has one set of 13 votes coordinated by the group coordinator. Each group has to cast at least two of their votes for candidates from each of the four regions. There are also two ex officio members. These are the Coordinator from the INRUD Secretariat and the WHO/Medicines Policy and Standards focal person with responsibility for promoting rational drug use. Board members will hold their appointments for four years. The two ex officio members will change whenever there is a change in their position in the host organizations. Elections for board members will be announced three months before the election, along with a current list of INRUD groups eligible to vote. The next election will be in December 2008. Each eligible voting group will be allowed to put forward one member for election to either a regional or a general board position within one month following the announcement. The names of the candidates will be circulated to all member groups. Each eligible INRUD group will be allowed one vote for the regional member to represent its region and one vote for a general member. The group focal person will cast those votes. INRUD Secretariat One INRUD group will be identified to serve as the INRUD Secretariat responsible for administering the day-to-day operations of INRUD in accordance with policies set down by the Board. The focal person within the Secretariat will be identified as the INRUD Coordinator. The INRUD Coordinator will be responsible for:
Financial Obligations of INRUD Membership In order to promote the sustainability of the INRUD network, funding for the coordinating work of the Secretariat needs to be secured. USAID through the Rational Pharmaceutical Plus Program, are curtailing their funding so that alternative sources of funding are necessary. It is envisaged that groups and members will initiate and participate in defined activities in the name of INRUD. Some of these activities will involve external funding. All of those organizing certain types of externally funded activities that use the INRUD name (as specified below) will be obligated to build in a budget line to support the Secretariat activities and to transfer those funds as dues accordingly. There are at least three categories of activities:
The budget should include a minimum of five percent of total costs for support of the INRUD Secretariat. The proponent will become the project leader and will be responsible for:
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