PHA-Exchange> Corruption in the health sector deprives those most in need of essential medical care and helps spawn drug-resistant strains of deadly diseases says Global Corruption Report 2006

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: http://www.transparency.org/publications/gcr/download_gcr  - click for a
copy of the report


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 

Berlin/London, 01 February 2006 

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.


The GCR 2006 focuses on corruption and health. The book includes expert
reports on: 

*    the risks of corruption in different health care systems 

*    the scale of the problem: from high-level corruption in Costa Rica to
counterfeit medicines in Nigeria to 

*    health care fraud in the United States 

*    the costs of corruption in hospital administration and the problem of
informal payments for health care 

*    the impact of corruption at various points of the pharmaceutical chain 

*    anti-corruption challenges posed by the fight against HIV/AIDS 

It also includes: 

*    a foreword by Mary Robinson 

*    detailed assessments of the state of corruption in 45 countries 

*    recommendations for cleaning up the health sector 

*    examples of successes in preventing health-related bribery, fraud and
corruption 

*    the latest corruption-related research, including studies on the links
between corruption and other global 

*    issues such as pollution, gender and foreign investment 

*    Use the free Adobe Reader to view these PDF files. 

 

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 

Berlin/London, 01 February 2006 

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. 

"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. 





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