Corruption in Healthcare

Corruption in Healthcare

Diane Donchak

Corruption can be found in many areas of business, but when it’s found in healthcare it becomes most disturbing. In the healthcare arena, corruption can prevent vital services from reaching waiting recipients and, in effect, kill human life. Corruption is a concern in all countries; however, it is an especially critical problem in developing countries and transitional economies where resources are already scarce and inadequate management can destroy growth and limit development. The health sector is particularly vulnerable to corruption. Reasons for this include the diversity of services and outlays, the scale and expense of procurement and the nature of healthcare demand. Two areas where there is great potential for corruption and where it is a recognized concern is the procurement of drugs and equipment, and the economic activities engaged in by health providers.

Although many countries and organizations have dealt with corruption accusations, one country whose corruption scandals have been making headlines is Zambia. In May 2009 foreign aid for government health projects in Zambia, where most of the national health budget is donor-funded, was frozen after allegations of corruption were directed at the Zambian government. The governments of the Netherlands and Sweden announced they had suspended aid after a whistleblower alerted Zambia’s Anti-Corruption Commission {ACC} to the embezzlement of over $2 million from the health ministry by top government officials. The Dutch government, the largest supporter of Zambia’s tuberculosis (TB) program, contributes about 13 million euros ($18 million) annually to rural healthcare, preventing malaria, TB and HIV, and training medical staff. About 14 percent of Zambia’s 11.7 million people are HIV positive, and about half of the estimated 300,000 people in need of antiretroviral (ARV) medication obtain it from government clinics and hospitals. The Zambian government stated that they were working hard to find the “culprits”, bring them to justice, find the money, and make sure this doesn’t happen again.

As of March 2011, many HIV positive Zambians were still worried about receiving their medications. There was a ray of hope with the development of a project promoting the anti-corruption efforts of Transparency International Zambia (TIZ) and the Medicines Transparency Alliance (MeTA). These organizations want to improve transparency and accountability in the selection, procurement, sale, and distribution of essential medicines in Zambia. The project offered the Zambian authorities and other stakeholders an opportunity to positively transform the pharmaceutical sector and the general healthcare landscape by adhering to the core international principles of MeTA. This included the belief that “good health is crucial to human dignity and social and economic development” and that a break in the procurement, distribution and supply of medicines could result in needed medications not being available to the poor.

However, there continues to be worries on the surface. There have been many documented cases of gross violations of the MeTA’s principles by both the public and private players in the health sector. The Ministry of Health, through which Zambia had signed up to the MeTA’s governing principles, is a major violator. In December of 2011, the Global Fund was forced to suspend aid to Zambia following the release of a multi-million dollar scandal, which implicated the ministry. The Zambia National Aids Network (ZNAN), the Principle Recipient of the Global Funds in Zambia was also implicated.

Clearly, the fight is not yet won against pilfering and the general mismanagement of resources that have continued to affect Zambia’s health sector. In 2010 ARVs and other needed drugs went up in flames after a storage unit at a rural health center caught fire under suspicious circumstances. While Zambia has tried to prevent wrongdoings in its health sector, more has to be done. The Zambian Medical Association (ZMA) believes it is necessary to put in place mechanisms that will help wean Zambia from over–dependency on donor support for its HIV/AIDS programs. ZAM spokesman, Dr. Robert Zula, feels that there is a need to introduce an AIDS and TB-specific national budget and establish a National Fund for ARVs. The TIZ believes that transparency and accountability in the healthcare delivery system can only succeed with enhanced participation by citizens.

There does appear to be a continued effort to help the Zambian people. The Global Fund announced that it has strengthened its capacity to prevent and detect fraud and the misuse of drugs by its aid recipient countries, including Zambia. Strict measures include the appointment of a high-profile panel of international experts to regularly review the system and ensure tighter controls of its funding mechanisms. Dr. Kamoto Mbewe of the Ministry of Health, has also announced the Government’s measures to order essential drugs worth USD 6 million, which have already started arriving in Zambia. While there is no guarantee in providing healthcare for Zambia, there are continued efforts to procure the supplies and initiate the services that are so needed by the Zambian people.

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