Main findings
Transparency International looked at three sectors: healthcare, pharmaceutical companies and HIV/AIDS fight.
They point out the causes of corruption (imbalance of information, uncertainty of health markets, complexity of health systems) and highlight the following patterns:
1. Embezzlement and theft from the health budget and user-fee revenue.
2. Corruption in procurement
3. Corruption in payment systems
4. Corruption in the pharmaceutical supply chain and aggressive marketing techniques from the pharmaceutical sector to buy physicians’ support for a specific product.
5. Corruption in the health service delivery
They have also focused on the HIV/AIDS fight, showing how corruption hampers the global efforts. The scaling up of aid funds available to fund prevention programmes has generated a subsequent important level of corruption, without the necessary accountability mechanisms being in place most of the time.
The report points out that the corruption level undermines the achievement of the United Nations’ Millenium Goals, in particular the three related directly to health: reduced child mortality; improved maternal health; and the fight against HIV/AIDS, malaria and other diseases. The authors assert that corruption is one of the primary causes of the fact that the global community is already off target to meet the MDGs.
Recommendations
According to Transparency International, the following measures could help prevent corruption.
Donor and recipient governments should grant easy access to information on key aspects of health-related projects, budgets and policies. Budget information should be available on the internet and subject to independent audits.
Adoption and enforcement of codes of conduct for health workers and private sector companies and provide ongoing anti-corruption training.
Incorporation of conflict-of-interest rules in drug regulation and physician licensing procedures.
Public health policies and projects should be independently monitored, both at the national and international level, and their reports should be open to public scrutiny.
Procurement processes should be competitive, open and transparent, and comply with Transparency International’s Minimum Standards for Transparency and Public Contracting. Rules on conflicts of interest must be enforced and companies that engage in corruption debarred from future bidding.
Rigorous prosecution will send the message that corruption in health care will not be tolerated. To facilitate this, there must be robust whistleblower protection for both government employees and private sector health, pharmaceutical and biotech employees.
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