Health Corruption – Isn’t it talking point for the global health security during CoVID-19?

Corruption is a major obstacle to global peace, prosperity, and human rights. Statistic indicates that every year $1 trillion in bribes are paid and another $2.6 trillion (or 5% of global GDP) is lost to other forms of corruption. Overflowing through central financial hubs like London, New York and Switzerland, and offshore financial centers (OFCs), illegitimate financial flows drive authoritarian oppression, destabilize weak states, launder drug money, and fund terrorism. Corruption is extensively recognized as a threat to global peace and security. This problem acquires gigantic proportion in countries undergoing or recovering from war and conflict, functioning as a key constraint on the development of peaceful and sustainable societies. In recent years, we have seen the destabilizing effects of corruption take many forms. We have also seen that where corruption is rife, criminal networks and conflict prevail.

In her book “Thieves of State: Why Corruption Threatens Global Security”, Sarah Chayes argues that one reason that people get radicalized and pledge themselves to extremist violence is because the injustice of living in kleptocratic states pushes people to seek some sort of pure justice and judgement. According to Transparency International UK’s Defense and Security Program, “Seventy percent of countries leave the door open to waste and security threats as they lack the tools to prevent corruption in the defense sector”. Similarly, corruption is like gasoline poured on the flames of a pandemic. Corruption presents a substantial global health security threat. It also played a role in the West African Ebola virus epidemic in 2014. A report from United Nations Special Rapporteur on the Right to Health has clearly highlighted that corruption in the health sector is a significant hurdle to achieving the 2030 agenda, as well as having a devastating impact on an international and national level. Corruption is also central to the current CoVID-19 pandemic and since there have been a wave of corruption-related incidents, and decreasing transparency and accountability.

The CoVID-19 pandemic has starkly unmasked the weaknesses and flaws in global health security around the world. Likewise, the rush to find treatment, vaccines and technology has created opportunities for lack of transparency and corruption in research & development and procurement. Correspondingly, the CoVID-19 pandemic has also demonstrated many of the greatest threats our world faces cannot be fought by the military and we need to be able to address the threats of today and tomorrow. We should be investing in the tools and technologies and we need to keep this world protected from 21st century threats – from pandemics, to cybercrime, to climate change. We are living in an age of epidemics and potential pandemics. One need only list some of the key threats form the headlines of the last few years alone to get a sense – SARS (2002-2003), MERS (2012), Avian influenza (2013), Ebola (2014-2015), Zika (2015-2016) and CoVID-19. Above and beyond the morbidity and mortality they cause, these events consistently carry huge economic and social disruption, and therefore are increasingly viewed not just as health problem, but also as national and global health security concerns.

In the same way, as defined in the Global Health Security Agenda (GHSA), the aim of health security efforts is to help countries develop a set of essential capabilities to prevent, detect, and respond to emerging health crises. However, GHSA documents do not mention health corruption expressly. Health corruption is a problem for global health programs worldwide, yet we know very little about its scale and impact. Health corruption has serious consequences for access, quality, equity, efficiency, and efficacy of global health services and is an obstacle to achieving the long-term Sustainable Development Goals (SDGs). More or less, of the $8.3 trillion (10% of global GDP) spent on health each year, an estimated $500 billion in public health spending is lost globally to corruption. This is a lot more than would be required to achieve Universal Health Coverage (UHC).

During the CoVID-19 crisis response, significant volume of financial supports are directed to tackle critical and complex pandemic dilemma. As of June 2020, the International Monetary Fund (IMF) estimated that approximately $11.5 trillion had been allocated globally as fiscal support to the CoVID-19 response. Additionally, in October 2020, the World Bank’s Board of Executive Directors approved $12 billion for developing countries to finance, purchase and distribute CoVID-19 vaccines for their populations. Governments, bilateral and multilateral donors, development banks, and private sector all have played great role in contributing money, equipment, and expertise. According to data analysis available on Devex’s funding platform, the funding committed to combating the CoVID-19 has exceeded $21.7 trillion. This large inflows of funding that are disbursed instantly may be vulnerable to corruption if appropriate due diligence measures are not in place. While this is a global concern, corruption in health affects certain populations more seriously than other, perpetuates global inequalities and hinders sustainable global development. Donors (for instance – UNAIDS, UNDP, UNICEF, UNITAID, GAVI, GFF, WBG, FIND, RBM, StopTB, UCNTD etc.) too often provide aid through fraudulent government agencies in receiving countries, prioritizing good relations with the authorities over concerns about corruption that eventually eviscerates the value of the aid.

Concisely, the CoVID-19 virus has yet to become a full-scale catastrophe in the most corruption-prone parts of the world. The pandemic’s further spread around the globe, fueled by corruption, could trigger severe destruction to global health and health security objectives. If the United Nation/World Health Organization and global leaders seeks to prevent pandemic terror, must act now to focus on health corruption threats. Conceivably, the most critical step is to get policymakers to put health corruption at the top of their priority lists because of its threat to global health security, and to exert the political will to bring about real change. Formulating a globally synchronized strategy to combat health corruption and crafting a drastically new approach to global health security will require sustained and determined leadership.

Mirza A.A. Baig
Mirza A.A. Baig
Mirza A.A. Baig is CAS-TWAS President’s Fellow at University of Science and Technology of China (USTC). Biomedical Health Informatics Professional and Freelance Science Writer.