While the world struggles to control Covid-19, the pandemic has starkly exposed weaknesses in health systems around the world. The rush to find treatments, vaccines and technology has created opportunities for lack of transparency and corruption in research and development and procurement.

The pressures of Covid-19 highlight how corruption and lack of transparency in health can mean the difference between life and death for the public and health workers alike.

Even before the pandemic, corruption in health was an open secret. Every day people around the world face bribes to access healthcare, unknowingly take falsified or sub-standard medicine and endure wasteful or ineffectual treatment. It’s estimated that 140,000 children die every year as a result.

Of the $7.5trillion spent globally on health each year, $500bn is lost to corruption. That is more than enough to achieve Universal Health Coverage for all – a key commitment under the UN Sustainable Development Goal 3, which seeks to provide affordable, accessible and quality healthcare for everyone.

Corruption pervades every aspect of health systems around the world. Life-saving resources are siphoned off, clinical data for new medicines and health technology is not transparent, and procurement of supplies is vulnerable to bribery and influence.

Fighting corruption in health is essential if the world is to respond effectively to current and future global health threats and to provide quality healthcare for everyone.

HOW IT AFFECTS YOU?

1 in 5 people worldwide (17%) reported they were forced to pay a bribe when dealing with the medical sector. Corruption in health also hinders the fight against HIV/AIDS and other diseases. Medicine shortages (often due to drug thefts) and absenteeism cause interruptions in individual patients’ treatment regimes.

Corruption in the health sector intensifies inequality. Poor people and other marginalised groups are hit the hardest. For example, women’s reliance on health services plagued by corruption makes them vulnerable to abuse, blocking access to vital contraceptive, reproductive and child health services. Tragically, for many, this pushes them into poverty and sometimes death.

Corruption also limits countries’ capacities to manage national and global health risks. At a time when the world is facing COVID-19, we cannot afford to risk essential financial and human resources go to waste because of corruption.

If we can address corruption in health systems, then we can achieve health for all.

WHAT NEEDS TO BE DONE?

Fighting corruption in the health sector requires an overall commitment to integrate an anti-corruption perspective into all approaches to spending on health. This means incorporating transparency and accountability mechanisms, as well as multi-stakeholder participation into every project, policy and plan.

We need to ensure that:

• Actors from public and private sectors working on anti-corruption and health join forces to fight corruption and strengthen health systems
• Medical research and development is transparent and puts public interest first
• There are transparency and accountability mechanisms in healthcare procurement
• Healthcare service delivery is not undermined by bribes or any other forms of petty corruption
• The health workforce is paid properly and hospitals have sufficient financial and human resources to operate without engaging in any form of corruption
• Medicines are appropriately regulated, ensuring they are not substandard or falsified
• The public and healthcare workers have access to whistleblowing mechanisms to report corruption in the health sector
• Everyone is aware of their health rights and obligations

This is by no means an exhaustive list – corruption risks in the health sector are abundant and depend very much on context: a change in leadership, more flexible regulatory frameworks, or the emergence of a health crisis, among others, can lead to new manifestations of corruption in health.

WHAT WE’RE DOING ABOUT IT

Transparency International Global Health is the only global programme focused on raising awareness and reducing corruption, from research and development to procurement transparency and healthcare service delivery.

For over 3 years, we have promoted transparency, integrity and accountability within the health sector. Our ambition is to help countries achieve Sustainable Development Goal 3 & Universal Health Coverage by 2030.With strong health systems free of corruption, governments have a better chance of delivering on the commitment ‘to ensure healthy lives and promote well-being for all’.

As part of the wider Transparency International movement, Transparency International Global Health also has wide reach, access and engagement across the 100+ Transparency International Chapters around the world.

We have worked directly with Chapters in Asia and Sub-Saharan Africa to enhance transparency in healthcare procurement through Open Contracting for Health (OC4H).

We have developed HealthWorks, an online directory of anti-corruption work in the healthcare sector by Chapters from across the globe.

In addition, Global Health's convening power enables us to bring together key actors, such as governments, donor agencies, civil society, academia, think tanks, foundations, and the private sector.

Transparency International Global Health has made substantial contributions to the global conversation on anti-corruption and health. It has:

• mapped how corruption manifests, impacts and detracts from every part of health systems – from initial drug research to healthcare delivery; and
• demonstrated how procurement transparency can reduce waste and inefficiencies, promote fairness and strengthen health systems.

To find out more about TI HI, visit http://ti-health.org/ and check their publications.

Resources:

The Ignored Pandemic (March 2019)

Clinical Trial Transparency (December 2017)

Making the Case for Open Contracting in Healthcare Procurement (January 2017)