Corruption Taints Health Care, Costs Lives, Study Finds
Global Corruption Re****t
The re****t ****nes a powerful light on the global US $3 trillion health
services industry, exposing a maze of complex and opaque systems that
are a fertile field for corruption.
(Distributed by the Bureau of International Information Programs, U.S.
Department of State. Web site: http://usinfo.state.gov)
Corruption watchdog focuses annual re****t on health care sector
The global health care industry is fraught with corruption, leading to
human suffering and worsening diseases, according to a re****t issued
February 1.
Transparency International (TI), a nonprofit, nongovernmental
organization with a reputation as a corruption watchdog, issued its
Global Corruption Re****t 2006 with a spotlight on health care.
Corruption is depriving people of needed medical care and promoting
the development of drug-resistant disease, creating an ever-spiraling
cycle of worsening health conditions, according to the re****t.
The publication, released from TI=92s Berlin headquarters, draws a
straight line between corruption and poor health care in some
countries.
Increases in bribery of Filipino medical personnel is linked to a 20
percent decrease in child immunization, according to a press release
announcing the findings.
TI attributed declines in Cambodian health care indicators to
embezzlement of funds that should have gone to public health.
Corruption also has distorted pharmaceutical markets and promoted a
black market in counterfeit drugs, cir***stances that have a direct
impact on people hoping for cures and relief from those medicines.
=93People have a right to expect that the drugs they depend on are
real,=94 said TI chief executive David Nussbaum.
=93They have a right to think that doctors place a patient=92s interests
above profits,=94 he added. =93And most of all, they have a right to
believe that the health care industry is there to cure, not to kill.=94
Global efforts to scale up treatment and prevention of HIV/AIDS also
are undermined by corruption, TI re****ted, citing a case in Kenya in
which a few high-level civil servants siphoned public funds from the
National AIDS Council.
Transparency must be the first step in attacking corruption, the
re****t recommended, suggesting that governments should grant easy
access to information on health projects and budgets.
The re****t also recommended the adoption and enforcement of codes of
conduct for health workers and companies and conflict-of-interest
rules in drug regulation and procurement.
Rigorous prosecution also should be pursued by governments to send a
message that corruption cannot be tolerated, according to the re****t.
The full text of Global Corruption Re****t 2006 is available on TI=92s
Web site.
The text of the TI press release follows:
(begin text)
TRANSPARENCY INTERNATIONAL
The global coalition against corruption
THEFT, BRIBERY AND EXTORTION ROB MILLIONS OF PROPER HEALTHCARE, SAYS
GLOBAL CORRUPTION RE****T 2006
Counterfeit drugs kill thousands each year and accelerate spread of
drug-resistant diseases
1 February 2006, Berlin / London =96 Corruption in the health care
industry deprives those most in need of essential medical care and
helps spawn drug resistant strains of deadly diseases, says
Transparency International=92s Global Corruption Re****t 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.
=93Corruption 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?=94 said
Huguette Labelle, Chair of Transparency International. =93The price of
corruption in health care is paid in human suffering.=94
Haemorrhaging health systems
The re****t ****nes a powerful light on the global US $3 trillion health
services industry, 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 medical 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 =96 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.
=93Corruption eats away at the public=92s 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=92s 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,=94 said David
Nussbaum, Chief Executive of Transparency International.
Market distortions and counterfeit drugs
Aggressive marketing techniques buy physicians=92 sup****t for specific
drugs, leading to a high rate of prescriptions that are not always
based on patient need. With individual =93blockbuster=94 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 =96
estimated at 50-90 per cent of total individual out-of pocket health
expenses =96 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=92s 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=92
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 =96 and corruption is one
of the primary causes.
=93Poor 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,=94 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.
--Incor****ate 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
re****ts should be open to public scrutiny.
--Procurement processes should be competitive, open and transparent,
and comply with Transparency International=92s 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=92s 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 Re****t 2006 also presents re****ts 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 re****t=92s final section surveys the
cutting edge in corruption research.
(end text)
(Distributed by the Bureau of International Information Programs, U.S.
Department of State. Web site: http://usinfo.state.gov)
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