On 27 November 2019, Professor Patricia J. García gave the Academy of Medical Sciences & the Lancet 2019 International Health Lecture in London. Here, we reflect on some of her key messages.
Corruption is diverting funding and resources from healthcare, costing billions of dollars every day. But understanding its extent and how to stop it is shockingly under-researched. Here are five things you should know about corruption in global health – the ignored pandemic.
- Corruption in health systems is happening all over the world
Two thirds of countries are perceived as corrupt or endemically corrupt according to the Corruption Perception Index 2018. High-income countries currently have a key role in the ‘supply’ side of corruption.
The world spends more than US$19 billion on healthcare every single day. At least 25% of this is estimated to be lost directly through corruption.
“If this money was not lost, we could achieve universal health care. We need to work together – the north and the south – in the quest for a solution for this global problem.” Professor García
- Corruption in global health causes damage on multiple levels
Corruption leads to disillusionment and burnout in honest health workers. It damages health systems and outcomes. It costs the lives of at least 140,000 children each year, worsens antimicrobial resistance (AMR), and undermines the control of communicable and non-communicable diseases.
“Corruption undermines any effort that we are doing in the public health level and individually.” Professor García
- Corruption can take many shapes and forms
Corruption in global health manifests as absenteeism, informal payments, theft of money, supplies and medicines, over or underservice, favouritism, and manipulation of data. Often this is seen as something “normal” or as a “coping mechanism”.
“We should talk with people so they realise what’s normal and what’s not.” Professor García
- We still need to do a lot more research on what works in reality
There is a dangerous lack of evidence-based research, looking at what actually works to decrease or prevent corruption in global health systems. We could think about corruption as a disease, and consider what we can do to control and eliminate it. To prevent corruption, we need new research methods, collaborations, and support from research funders to test what works.
“Corruption in global health is an open secret. Everybody knows about it but no one wants to talk about it. What prevents people from entering corruption? These are the things we should be looking for.” Professor García
“I saw there were a lot of theories but I wanted to know what is the evidence behind them.” Professor García
- Ending corruption calls for collaboration across disciplines
Corruption is a social, political and economic issue that exists in all societies. Theories about how to tackle corruption have been developed outside of the health sector, such by using technology or changing the law. Cross-disciplinary research, involving social and political sciences as well as health researchers, can help generate the models and evidence we need to end corruption in health systems.
“We need a coalition of people so we can work all together. We need to think about different ways of better accountability, fighting the power, criminalisation.” Professor García
The Academy's Vice President (International), Professor Dame Anne Johnson DBE FMedSci, reflected:
“Professor García’s powerful talk illustrated how corruption is damaging healthcare at all levels, and a major barrier to achieving the Sustainable Development Goal for global health and well-being. She called on biomedical, political science, social science and public health researchers to work together to tackle this critical issue.
She acknowledged that there are major challenges, including accurately measuring corruption and keeping those working in this area safe. However, a global effort to develop and fund robust research on anti-corruption measures is necessary to improve health for all.
This thought-provoking lecture attracted interest from a diverse audience across many sectors. It is clear that Professor García’s courage in raising these issues was inspirational to many.”
The International Health Lecture provides a platform for leaders in global health to discuss topics of international significance, promoting debate, discussion and the exchange of ideas on current research. For more information about the lecture series, including past events, please visit the dedicated page on our website.
This year's lecture was presented by Professor Patricia J. García, former Minister of Health of Peru and former Chief of the Peruvian National Institute of Health. She is currently a Professor of the School of Public Health at Cayetano Heredia University (UPCH) in Lima-Peru.