Impact of HIV/AIDS on South Africa’s Pandemic Corruption

As one of the leading countries of people living with HIV / AIDS, South Africa has invested heavily in combating the disease, often without the established infrastructure to track the money properly.  Because of the poorly aligned incentives, information asymmetry, and limited competition, healthcare delivery systems everywhere are plagued by corruption.[1]  Yet the magnitude of this deadly disease escalated South Africa’s need for outside support in addition to increased government spending.  With HIV/AIDS funding reaching R5 billion for 2007, the delivery of health services quickly became very vulnerable to corruption.

In his anti-fraud campaign, President Jacob Zuma has prioritized the identification of corruption.  Throughout this process, it has become apparent that the Eastern Cape is a hotbed of corruption in the health field.  In 2011, an external audit identified R35 million in duplicate and multiple payments in just four supplier records.  In their investigation, they found 165 suppliers who listed the same phone number, while 934 had the same postal address.[2]  These instances suggest very high levels of multiple payments, and reflect the lack of oversight that has previously existed.  South Africa has also encountered large-scale thefts of medicine and supplies, with an example being the report of R120,000 worth of infant formula being stolen.  While it was originally intended for the children of HIV-positive mothers, three foreign businessmen and four health department employees are being prosecuted for the theft.[3] 

Fortunately, South African officials are making an effort to identify these crimes and address them.  Sibongile Zungu, a health department official acknowledged the problem by stating, “Corruption has a devastating effect on poor people – especially corruption in the health service. Where resources are scarce and many people need those resources, corruption can often set in. We hope to make significant strides in reducing fraud and corruption risks.”[4]  This quote underlies the cruelty of healthcare corruption in that it disproportionately affects the most vulnerable populations and serves as an additional barrier for receiving adequate care.

Moving forward, South Africa must continue to identify these fraudulent cases and prosecute aggressively.  There are cases where corruption may be indicative of larger problems within the health system, such as providers who accept bribes because they do not feel compensated fairly, many of the cases within South Africa point to opportunistic employees and outsiders who are taking advantage of the flood of cash that has resulted from the HIV/AIDS epidemic.  In addition to seeking out existing corruption cases, the country needs to implement preventative measures to protect donor and state investments in overcoming this disease and ensure that citizens have access to the resources needed to combat this illness.  These measures will promote transparency in tracking government and donor funding.  By analyzing provider budgets, the state should be able to disentangle where money is coming from while also ensuring that the funds received from conditional grants are spent appropriately.[5] 


[1] Grepin, Karen.  Lecture 11, slide 44.  December 4, 2011.

[2] Pilay, Siva.  Health Corruption Busters Reveal the Monster in Our Midst.  http://www.scielo.org.za/pdf/samj/v101n1/v101n1a09.pdf

[3] Pilay.

[4] Pilay.

[5] Schultz-Herzenberg, Collette.  A Lethal Cocktail:  Exploring the Impact of Corruption on HIV/AIDS Prevention and Treatment Efforts in South Africa.  http://www.iss.co.za/uploads/ISSTIAIDSREPORTDEC07.PDF

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