By Lila Urda
In “Review of Corruption in the Health Sector”, Taryn Vian presents evidence of corruption within the health sector and identifies potential strategies for intervention. Following this discussion, Vian suggests that further research on the topic should focus on designing and testing anti-corruption interventions in this sector, such as those that measure transparency and the issue of accountability. However, Vian lacks an explanation of why these strategies are so hard to implement.
Acknowledging the need for accountability is an essential element to making positive changes in the health care system. However, in order to hold people accountable, current problems would need to be identified. Media outlets have disclosed numerous instances of corruption in the pharmaceutical trade. Issues like industry “gifts”, bribery, and double jeopardy only touch the surface. What lies beneath is a highly privatized, system that innately cultivates conflicts-of-interest.
It seems obvious to address the fact that pharmaceutical companies earn money when they sell their products. So, of course, it is logical that it is in their best interests to sell as many of their products as possible. But when this desire affects (not always for the better) the health of a nation, does this become an ethical conflict? If a company knows their product does not perform as well as another for certain conditions, is it unethical to not disclose such information?
Further, when government officials decide upon a health policy, they are often guided by their wallets, not their ethics. Large pharmaceutical political campaign contributions are well documented and happen regularly. Doesn’t this seem like a blatant conflict-of-interest? The problem is that regulating these types of contributions is impossible because the ones regulating are the ones receiving the contributions.
With significant political interest lying in privatization, regulation seems to be the last thing on peoples’ minds. But without it, big pharma is able to make their own rules. Is it fair for us to sit by and observe? Or is it a basic democratic right to have a lack of regulation?
The issues addressed in the many media articles discussing corruption for financial gains within the health sector are an important start. But what I am intrigued by is what is going on behind closed doors. As Vian suggests, creating transparency and accountability are important next steps in fighting corruption in the health care system. Now we just need to figure out how to do that, when accountability involves regulating the regulators.