Fighting Corruption in Global Health
Combatting corruption—a critical challenge to global health efforts—requires collaborative international action, according to a new report co-authored by a School of Public Health researcher.
In the article, published in Science Translational Medicine, Taryn Vian, clinical professor of global health, and colleagues examined the ways in which corruption can prevent the achievement of positive health outcomes. The authors argued for the need to design and implement anti-corruption tools specifically tailored to the needs of global health organizations.
“Health-related corruption negatively affects society in areas of economic growth, development, security, and population health,” The authors wrote. “Health sector susceptibility to corruption is accentuated by system complexity, large public spending, market uncertainty, information asymmetry, and many actors, all of which conspire to obstruct anti-corruption efforts.”
The report argues that donors providing development assistance for health face specific challenges, including the difficulties in operating in countries with few safeguards; unforeseen negative effects of measures to increase transparency; and difficulties in recovering funds while continuing to operate. The authors note that assessing the success of strategies to address corruption is particularly challenging. As an example, they write, the Global Health Fund to Fight AIDS, Tuberculosis and Malaria launched a number of anti-corruption campaigns, yet between 2008 and 2016 the inspector general reported 13 corruption investigations totaling about $104 million.
“Although the exact magnitude of health corruption is difficult to measure, estimates put it in the billions of dollars,” the authors wrote. “However, the true cost for the millions of people who suffer from compromised access to lifesaving health services is immeasurable.”
As the global community continues to invest billions in global health, the authors recommend examining the effectiveness of existing strategies to tackle corruption. They also highlight the need to assess the use of emerging anti-corruption tools, including social networks to raise awareness, social media to conduct surveillance, algorithmic big-data mining to detect fraud, and technologies used by pharmaceutical companies to authenticate and track medications.
“Fundamental to the effectiveness of all forms of anti-corruption technology is the ability of governments to track corrupt practices and prosecute illegal actions,” the authors said. “However, governments have shown reluctance to take responsibility for identifying and addressing irregularities in the absence of policy mandates or specific indicators, pointing to the need for a unifying governance framework specific to health corruption.”
In 2015, the United Nations (UN) demonstrated its commitment to improve health and achieve justice and accountability by adopting Sustainable Development Goals (SDGs) 3 and 6, respectively. But the authors noted that the two goals, in isolation, failed to address the consequences of global health corruption. They called for the UN Inter-agency Expert Group on SDGs Indicators to create a working group, in collaboration with UN agencies and other stakeholders, to develop a set of specific sub-indicators on global health corruption to be incorporated into the existing SDGs framework.
“Although there is no single cure for the disease of health corruption,” the authors concluded, “the adoption of the SDGs represents a critical opportunity to bridge the existing divide between shared ‘health’ and ‘anti-corruption’ global goals to ensure the integrity of health and human development for this generation and the next.”