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.
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.
The annual amount of healthcare funds which is stolen each year is more than enough to achieve Universal Health Coverage for all – a key commitment of the UN's Sustainable Development Goals, which seeks to provide affordable, accessible and quality healthcare for everyone.
Of the $7.5trillion spent globally on health each year, $500billion is lost to corruption.
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 does corruption in healthcare affect you?
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 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 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.
1 in 5 people worldwide (17%) report they were forced to pay a bribe when dealing with the medical sector.
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 Health Initiative 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’.
Transparency International Health Initiative 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.
As part of the wider Transparency International movement, Transparency International Health Initiative also has wide reach, access and engagement across the 100+ Transparency International Chapters around the world:
Open Contracting for Health (OC4H)
We have worked directly with Chapters in Asia and Sub-Saharan Africa to enhance transparency in healthcare procurement
We have developed HealthWorks, an online directory of anti-corruption work in the healthcare sector by Chapters from across the globe.
In addition, the Health Initiative’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.
Find out more about Transparency International HI and check their publications:
Explores the drivers and prevalence of corruption at service delivery and its impact for Universal Health Coverage
Examines the quality of open contracting in healthcare procurement in Honduras, Nigeria and Ukraine.
Explains how to implement clinical trial transparency.
Analyses the pharmaceutical sector to address its vulnerabilities to corruption and inefficiencies.
Takes a broad look at health systems across the globe and identifies 8 areas highly vulnerable to corruption.
Find out more about our work
Global Corruption Barometer EU: People worried about unchecked abuses of power
New EU survey reveals almost a third of people think corruption is getting worse in their country. A further 44% think it’s not getting any better.
COVID-19 vaccine transparency
Corruption threatens fair, transparent, and equitable access to COVID-19 vaccines and treatments.
Working in one of the world’s most dangerous hospitals during COVID-19
An illustrated story of corruption in Venezuela during a global pandemic
Why fighting corruption matters in times of COVID-19
Corruption Perceptions Index 2020: Research analysis
Corruption Perceptions Index 2020
The Corruption Perceptions Index scores 180 countries and territories by their perceived levels of public sector corruption, according to experts and business people.
What Fiji's COVID-19 response tells us about integrity in emergencies
Zambia’s medical supply scandal makes anti-corruption a key electoral issue this year
Will COVID-19 be the shot in the arm that improves pharmaceutical pricing transparency?
Explore all priorities
- Asset recovery and the theft of public money
- Business integrity
- Climate crisis
- Defence and security
- Dirty money
- Extractive industries
- Foreign bribery enforcement
- Grand corruption
- Judiciary and law enforcement
- Land corruption
- Political integrity
- Public procurement
- Right to information
- Sustainable Development Goals