| Transparency International, 1st February
2006
Theft, bribery and extortion rob millions of proper healthcare,
says Global Corruption Report 2006
Counterfeit drugs kill thousands each year and accelerate
spread of drug-resistant diseases
1 February 2006, Berlin / London – Corruption
in the health sector deprives those most in need of essential medical
care and helps spawn drug-resistant strains of deadly diseases,
says Transparency International’s Global Corruption Report
2006, published today.
For the millions of poor held hostage by unethical providers, stamping
out corruption in health care is a matter of life and death. “Corruption
in health care costs more than money. When an infant dies during
an operation because an adrenalin injection to restart her heart
was actually just water -- how do you put a price on that?”
said Huguette Labelle, Chair of Transparency International. “The
price of corruption in health care is paid in human suffering.”
Haemorrhaging health systems
The report shines a powerful light on the global US $3 trillion
health sector, exposing a maze of complex and opaque systems that
are a fertile field for corruption. While the majority of people
employed in the sector perform their functions with diligence and
integrity, there is evidence of bribery and fraud across the breadth
of health services, from petty thievery and extortion to massive
distortions of health policy and funding fed by payoffs to officials.
Corruption permeates the provision of health care, whether public
or private, simple or sophisticated.
• Public health budgets become subverted by unethical officials
for private use.
• Hospitals function as self-service stores for illicit enrichment,
with unclear procurement of equipment and supplies and ghost employees
on the payroll.
• Health workers demand fees for services that should be free.
In Bulgaria, as in much of South East Europe, doctors
frequently accept small informal payments or gifts for medical treatment.
This can be anything from between US $10 – US $50 and in some
cases can rise to US $1,100.
• In the Philippines, a 10 per cent increase
in the extortion of bribes by medical personnel was shown to reduce
the rate of child immunisation by up to 20 per cent.
• In Cambodia, certain health indicators
have worsened partly because of direct embezzlement of public health
funds and despite increased health aid. In contrast, in the United
Kingdom tighter control mechanisms have reduced losses to corruption
by US $300 million since 1999.
• In Costa Rica, nearly 20 percent of a US
$40 million international loan for health equipment wandered into
private pockets.
FOR IMMEDIATE RELEASE
“Corruption eats away at the public’s trust in the medical
community. People have a right to expect that the drugs they depend
on are real. They have a right to think that doctors place a patient’s
interests above profits. And most of all, they have a right to believe
that the health care industry is there to cure, not to kill,”
said David Nussbaum, Chief Executive of Transparency International.
Market distortions and counterfeit drugs
Aggressive marketing techniques buy physicians’ support for
specific drugs, leading to a high rate of prescriptions that are
not always based on patient need. With individual “blockbuster”
drugs pulling in tens of billions of dollars each year for pharmaceutical
companies, ballooning marketing and lobbying budgets have outpaced
the research and development outlays necessary to create new and
critical medicines that could save lives in low-income countries.
Corruption underpins a lucrative counterfeit drugs trade. Payoffs
at every step of the chain smooth the flow of counterfeit drugs
from their source to the unwitting consumer. With pharmaceuticals
often the largest household health expenditure in developing countries
– estimated at 50-90 per cent of total individual out-of-pocket
health expenses – corruption in the pharmaceutical industry
has a direct and painful impact on people struggling for survival.
Undermining the fight against HIV/AIDS
Corruption has hampered the success of global efforts to reign in
the HIV/AIDS pandemic. The international response to the growing
crisis has been to scale up aid in order to fund prevention programmes
and the disbursement of life-saving anti-retroviral medications.
Increased aid alone will not be effective if corruption is not curbed.
Accountability mechanisms need to be introduced to prevent money
from leaking at every level.
• Theft by ministries and national AIDS councils of funds
allocated for treatment leave sufferers without critical care. Kenya’s
National Aids Council was hijacked by a few high-level civil servants,
diverting critical resources through shell organisations expressly
formed to siphon off public funds.
• Corruption can contribute directly to infection when relatively
low-cost measures, such as sterile needles and screening of blood
donations, cannot be carried out because a corrupt procurement or
distribution process holds up supplies.
Millennium Development Goals under threat
Corruption is undermining progress towards the United Nations’
Millennium Development 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. With the
target date for achieving the goals just nine years away, the global
community is already off target to meet them – and corruption
is one of the primary causes.
“Poor families, particularly in rural areas, who cannot afford
private health care face the agonising choice of food or medicine.
Feed your child or cure his illness, but not both? No parent should
face that awful choice,” said Huguette Labelle.
Transparency International recommendations
The cure for corruption in the health care industry starts with
transparency.
• 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.
• Adopt and enforce codes of conduct for health workers and
private sector companies and provide ongoing anti-corruption training.
• Incorporate 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. No-bribe pledges such as TI’s Integrity
Pact should be adopted to level the playing field for all bidders.
• 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.
State of corruption worldwide
The Global Corruption Report 2006 also presents reports
on the state of corruption and governance in 45 countries around
the world, including troubling evidence of financial irregularities
in post-tsunami relief operations. The report’s final section
surveys the cutting
edge in corruption research.
Transparency International is the global civil society organisation
leading the fight against corruption.
For more information, visit www.transparency.org
|
