Topic Guide: Corruption in Health Services

Maira Martini. 2013. Corruption in the Health Sector: Hospital Management, Procurement and Interest Groups’ Influence. Available on request: [email protected]  

This answer looks at corruption risks and possible solutions to prevent and combat corruption in the healthcare sector, focusing on the appointment of hospital chief executive officers, oversight practices post-hiring, procurement processes, as well as lobbying by pharmaceutical industries. In all these three areas, transparency and accountability mechanisms combined with effective and dissuasive sanctions may help to enhance quality in healthcare delivery and reduce opportunities for corruption. More specific interventions, such as the disclosure of medicine prices, the adoption of meritocratic procedures to appoint hospital directors, or the establishment of a mandatory register of lobbyists may help to further enhance transparency and therefore curb corruption.  

Marie Chêne. 2010. Gender, Corruption and Health. http://www.u4.no/publications/gender-corruption-and-health/  

The consequences of expensive, ill-tailored, inaccessible or unsafe health products and services hit women particularly hard. This is because they often have higher and differentiated needs for health services and because they bear the brunt of inadequate services as primary providers of homecare and are less able to demand accountability and assert entitlements. Corruption in the health sector, therefore, contributes to and exacerbates persistent disparities in access to health services. This has hugely detrimental effects, not only on the health of women but also on their capabilities for educational attainment, income-generation and thus, ultimately, their status and the attainment of gender equity. Strategies to address gender disparity in access to health caused by corruption include support for women’s participation in both the design of health services that are responsive to women’s needs and their delivery.  

Marie Chêne. 2009. Approaches to Corruption in Drug Management. http://www.u4.no/publications/approaches-to-corruption-in-drug-management/  

There is a broad consensus and much anecdotal evidence that corruption in drug management affects the price, availability and quality of drugs, undermining safe and affordable access to essential medicines in many developing countries. The complexity, heavy regulation and opacity of health systems combined with the large flows of money involved provide opportunities for fraud and corruption at all points of the pharmaceutical chain, from the registration, selection, procurement to distribution and the promotion of medicines. This is likely to have a long-term impact on health and economic outcomes, especially in developing countries affected by the AIDS pandemic. A number of initiatives are currently being implemented at national and international levels to address corruption risks in drug management. Approaches to address corruption risks in drug management include the enforcement of strong and harmonised drug regulations, the promotion of open, transparent and competitive procurement processes, the establishment of effective and participatory monitoring mechanisms, and vigorous prosecution of health related corruption. Cutting across most promising anti-corruption interventions is the need to promote transparency at all stages of the drug supply chain system, especially in the quality, availability and prices of medicines.