Corruption and Global Health: Summary of a Policy Roundtable
Global health efforts, like all development programs, are vulnerable to corruption. Corrupt acts, where and when they occur, can divert global health funding from its intended purpose and dilute the impact of programs aimed at preventing disease, treating illness, and saving lives. Corruption, though, has been hard to define and even harder to comprehensively track and understand. While most recognize that corruption exists and can negatively impact development programs, including those of the U.S. government (USG), there are ongoing debates about the scope and impact of corruption and whether and how global health programs should address it.
On one hand, some view corruption as a very important – if not the most important – issue in many countries today, and leaders and the public alike often point to corruption as a major barrier for development and global health programs. World Bank President Jim Kim has called corruption “public enemy number one,”1 and U.K. Prime Minister David Cameron stated that corruption is the “archenemy of democracy and development.”2 Members of the U.S. Congress have also expressed concerns about corruption and its effects on U.S. global health and foreign aid programs.3,4 The public in developing countries often place corruption at the top of their list of concerns,5,6 and the public in donor countries such as the U.S. and U.K. express worry about corruption and its ability to undermine global health and foreign assistance.7 For example, in a recent Kaiser Family Foundation Survey of Americans on the U.S. Role in Global Health, 83% of the U.S. public considered corruption to be a major barrier to effective global health programs, and 47% considered it the single-most important barrier.8
In contrast, others consider corruption to be worrisome, but do not believe it rises to the level of a central policy concern for global health and development efforts. Harvard Professor and Partners in Health co-founder Paul Farmer has written that even though some people believe poor countries are too corrupt for foreign assistance programs to work effectively, “the numbers regarding aid… tell a reassuring story.”9 The Bill & Melinda Gates Foundation also views corruption as something donors and others need to be vigilant about, but warns against placing too much emphasis on it. Writing in his Foundation’s 2013 Annual Letter, Bill Gates stated “we need to root out fraud and squeeze more out of every dollar… but we should also remember the relative size of the problem.”10
These differing points of view hint at the spectrum of opinions that exist regarding the extent of corruption and the implications it has for global health and development programs, including those of the USG. In light of these ongoing uncertainties and debates about corruption and global health, the Kaiser Family Foundation convened a roundtable of experts from the U.S. government, academia, multilateral institutions, NGOs, think tanks, and other organizations for a policy discussion on this topic.
The roundtable discussion focused on the following questions:
- What is the magnitude of the problem corruption represents for global health? What is corruption and how does it manifest in global health? What research methods, tools, and approaches can help us understand the problem better?
- Are current anti-corruption policies and programs adequate? How do U.S. government global health programs monitor and address corruption? Should more be done? What are current best practices?
- How can we communicate more effectively about corruption to policymakers and the public? What is the right balance between transparency about corruption and risking unnecessary and damaging backlash?
This document summarizes the key themes that emerged from the roundtable discussion. Discussion points are supplemented with examples and information drawn from background materials and published literature that were referenced by participants. A list of related materials and resources is provided in the Appendix.