Corruption and Global Health: Summary of a Policy Roundtable
Introduction
“World Bank President Calls Corruption ‘Public Enemy No. 1”. Reuters December 19, 2013. http://www.reuters.com/article/2013/12/19/us-worldbank-corruption-idUSBRE9BI11P20131219.
Cameron D. “The Corruption Cure: Transparency, Taxes, Trade.” Wall Street Journal June 4, 2014. http://www.wsj.com/articles/david-cameron-the-corruption-curetransparency-taxes-trade-1401913005.
Dunning C (2011). “U.S. Foreign Assistance and Corruption: It’s All Relative”. Center for Global Development Blog Post. http://www.cgdev.org/blog/us-foreign-assistance-and-corruption-it%E2%80%99s-all-relative.
House Committee on Oversight and Government Reform. “USAID: Following the Money”. Hearing May 11, 2011. http://oversight.house.gov/hearing/usaid-following-the-money/ .
Gallup. “Corruption Tops the List as the World’s Most Important Problem According to WIN/Gallup International’s Annual Poll.” February 2014. http://www.gallup-international.bg/en/Publications/71-Publications/181-Corruption-Tops-the-List-as-the-World%E2%80%99s-Most-Important-Problem-According-to-WIN-Gallup-International%E2%80%99s-Annual-Poll.
Stephenson M. “Yes, Corruption Is Bad for Development. No, Corruption Is Not a Western Obsession.” Anticorruption Blog Post, April 29, 2014. http://globalanticorruptionblog.com/2014/04/29/yes-corruption-is-bad-for-development-no-corruption-is-not-a-western-obsession-2/.
Glennie A, Straw W, Wild L (2012). Understanding Public Attitudes to Aid and Development. Overseas Development Institute Report. http://www.odi.org/sites/odi.org.uk/files/odi-assets/publications-opinion-files/7708.pdf.
KFF. 2013 Survey of Americans on the U.S. Role in Global Health. https://www.kff.org/global-health-policy/poll-finding/2013-survey-of-americans-on-the-u-s-role-in-global-health/.
Farmer P (2013). “Rethinking Foreign Aid.” Foreign Affairs December 12. https://www.foreignaffairs.com/articles/2013-12-12/rethinking-foreign-aid.
Bill & Melinda Gates Foundation (2013). Annual Letter 2013. http://www.gatesfoundation.org/who-we-are/resources-and-media/annual-letters-list/annual-letter-2013.
Issue Brief
Transparency International. “FAQs on Corruption”. https://www.transparency.org/whoweare/organisation/faqs_on_corruption/2/.
UN Office on Drugs and Crime. United Nations Convention Against Corruption. http://www.unodc.org/unodc/en/treaties/CAC/.
Transparency International. Corruption Perceptions Index. http://www.transparency.org/research/cpi/overview.
AfroBarometer. http://www.afrobarometer.org/.
Referenced in Lewis M, Pettersson G. (2009). Governance In Health Care Delivery : Raising Performance. World Bank. http://elibrary.worldbank.org/doi/abs/10.1596/1813-9450-5074.
Office of the Inspector General (OIG), Global Fund Audits can be found here: http://www.theglobalfund.org/en/oig/reports/. The USAID OIG Audit Schedule 2014 is here: http://oig.usaid.gov/sites/default/files/other-reports/fy14_annual_plan_new.pdf. The PEPFAR Coordinated Audit Plan for FY2013 is here: http://oig.usaid.gov/sites/default/files/other-reports/2013_coordinated_plan.pdf.
McPake et al. Informal Economic Activities of Public Health Workers in Uganda: Implications for Quality and Accessibility of Care. Social Science & Medicine 49 (1999):849-865.
World Bank. 2000. The Ghana Governance and Corruption Survey, Evidence from Households, Enterprises and Public Officials. Referenced in Lewis M (2006). Governance and Corruption in Public Health Care Systems. Center for Global Development Working Paper 78. http://www1.worldbank.org/publicsector/anticorrupt/Corruption%20WP_78.pdf.
Lewis M, Pettersoson G (2009). Governance in Health Care Delivery: Raising Performance. World Bank Policy Research Working Paper 5074. http://elibrary.worldbank.org/doi/pdf/10.1596/1813-9450-5074.
Pincock S. WHO tries to tackle problem of counterfeit medicines in Asia. BMJ 2003;327:1126.
Rivers B. Corruption by Global Fund Grant Implementers. Global Fund Observer (AIDSpan) 139, January 2011. http://www.aidspan.org/gfo_article/corruption-global-fund-grant-implementers.
Nayyar G, et al. Poor-quality antimalarial drugs in southeast Asia and sub-Saharan Africa. Lancet Infectious Diseases 12(6):488–496, June 2012. : http://dx.doi.org/10.1016/S1473-3099(12)70064-6
Gavi Alliance (2013). GAVI review of health system strengthening in Sierra Leone. April 11. http://www.gavi.org/library/news/statements/2013/gavi-review-of-health-system-strengthening-in-sierra-leone/
Transparency International. Global Corruption Barometer 2013. http://www.transparency.org/gcb2013.
Cross-country ecological studies have found correlations between high levels of perceived corruption at the national level and poorer health indicators such as child mortality, immunization rates, for example: Hanf, M. et al. (2011). Corruption Kills: Estimating the Global Impact of Corruption on Children Deaths. PLoS ONE 6(11): e26990. doi:10.1371/journal.pone.0026990; Witvliet M, et al. Sick regimes and sick people: a multilevel investigation of the population health consequences of perceived national corruption. Tropical Medicine & International Health 18(10):1240–1247, October 2013; and Lin, R.T. et al. (2014). Governance matters: an ecological association between governance and child mortality. Int Health. 6(3):249-57. doi: 10.1093/inthealth/ihu018. Epub 2014. Other studies have found relationships between corruption and poorer health outcomes, such as a study in the Philippines that found that corruption in that country “reduces the immunization rates, delays the vaccination of newborns, discourages the use of public health clinics, reduces satisfaction of households with public health services, and increases waiting time at health clinics”: Azfar O, Gurgur T. Does corruption affect health outcomes in the Philippines? Econ Gov (2008) 9:197-244, and a study that examined how corruption measures were related to declines in AIDS deaths in sub-Saharan Africa, which concluded: “Countries with higher levels of corruption experience a significantly smaller drop in AIDS deaths as a result of the same quantity of ARVs imported.” Friedman W (2015). Corruption and Averting AIDS Deaths. Center for Global Development Working Paper 395, February. http://www.cgdev.org/publication/corruption-and-averting-aids-deaths-working-paper-395.
More information about pay-for-performance and results-based financing and its potential to reduce corruption can be found in: Kenny C, Savedoff W (2013). Can Results-Based Payments Reduce Corruption? Center for Global Development Working Paper 345, September. http://www.cgdev.org/sites/default/files/can-results-based-payments-reduce-corruption.pdf; and Lewis M, Pettersoson G (2009). Governance in Health Care Delivery: Raising Performance. World Bank Policy Research Working Paper 5074. http://elibrary.worldbank.org/doi/pdf/10.1596/1813-9450-5074.
For example a policy to increase wages of health workers to curb absenteeism will likely work better if there are also systems in place that monitor absenteeism rates and impose sanctions.
Vian T, et al (2011). Confronting Corruption in the Health Sector in Vietnam: Patterns and Prospects. Boston University Center for Global Health and Development Discussion Paper 14, October.
Savedoff W (2008). The impact of information and accountability on hospital procurement corruption in Argentina and Bolivia. U4 Anti-corruption Centre Brief, May. http://www.cmi.no/publications/file/3027-the-impact-of-information-and-accountability-on.pdf
Barber S, Bonnet F, Bekedam H. 2004. Formalizing under-the-table payments to control out-of-pocket hospital expenditures in Cambodia. Health Policy and Planning 19:199–208.
Garcia-Prado (2005). Sweetening the Carrot: Motivating public physicians for better performance. World Bank Policy Research Working Paper 3772, November. http://elibrary.worldbank.org/doi/abs/10.1596/1813-9450-3772.
A recent comprehensive review of USAID anti-corruption programs found, just five USAID grants between 2007-2013 focused on anti-corruption or good governance in the health sector – two in the Middle East, two in Eastern Europe, and one in Southeast Asia. The combined budget of these five programs was $137 million, which amounted to 1.7% of the agency’s overall spending on anti-corruption in all sectors over this period. Source: Management Sciences International (2014). Analysis of USAID anti-corruption programs (2007-2013). http://www.usaid.gov/sites/default/files/documents/1866/AnalysisUSAIDAnticorruptionProgrammingWorldwideFinalReport2007-2013.pdf.
For more information, see: Savedoff W (2012). Massive Corruption Revisited: The Value of Portfolio Estimates. Center for Global Development Blog Post, July 24. http://www.cgdev.org/blog/massive-corruption-revisited-value-portfolio-estimates.
USAID Country Operational Plans may contain anti-corruption plans, policies and goals, but not always health-sector specific ones.
More information about pay-for-performance and results-based financing and its potential to reduce corruption can be found in: Kenny C, Savedoff W (2013). Can Results-Based Payments Reduce Corruption? Center for Global Development Working Paper 345, September. http://www.cgdev.org/sites/default/files/can-results-based-payments-reduce-corruption.pdf; and Lewis M, Pettersoson G (2009). Governance in Health Care Delivery: Raising Performance. World Bank Policy Research Working Paper 5074. http://elibrary.worldbank.org/doi/pdf/10.1596/1813-9450-5074.
An estimated 95% of U.S. global health assistance provided by the US Agency for International Development (USAID) for non-governmental organizations is channeled through U.S.-based NGOs. 5% goes to foreign-based NGOs. See: https://www.kff.org/global-health-policy/report/ngo-engagement-in-u-s-global-health-efforts-u-s-based-ngos-receiving-usg-support-through-usaid/.
Oxfam America recently published a report examining moving to local ownership as a way to help reduce corruption: Oxfam America (2015). To fight corruption, localize aid. March. http://www.oxfamamerica.org/explore/research-publications/to-fight-corruption-localize-aid/.
KFF. 2012 Survey of Americans on the US Role in Global Health. https://www.kff.org/global-health-policy/report/2012-survey-of-americans-on-the-u-s-role-in-global-health/.
For example, the Transparency for Development Project will examining impact that transparency and accountability interventions have on public health service delivery is several countries. http://t4dproject.org/.