Corruption in Health Systems: The Conversation Has Started, Now Time to Continue it; Comment on “We Need to Talk About Corruption in Health Systems”

Document Type : Commentary

Authors

1 Global Health Research Center, Duke Kunshan University, Kunshan, Jiangsu, China

2 Trinity College for Arts & Sciences, Duke University, Durham, NC, USA

3 CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru

4 School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru

Abstract

Holistic and multi-disciplinary responses should be prioritized given the depth and breadth through which corruption in the healthcare sector can cover. Here, taking the Peruvian context as an example, we will reflect on the issue of corruption in health systems, including corruption with roots within and outside the health sector, and ongoing efforts to combat it. Our reflection of why corruption in health systems in settings with individual and systemic corruption should be an issue that is taken more seriously in Peru and beyond aligns with broader global health goals of improving health worldwide. Addressing corruption also serves as a pragmatic approach to health system strengthening and weakens a barrier to achieving universal health coverage and Sustainable Development Goals related to health and justice. Moreover, we will argue that by pushing towards a practice of normalizing the conversation about corruption in health has additional benefits, including expanding the problematization to a wider audience and therefore engaging with communities. For young researchers and global health professionals with interests in improving health systems in the early career stages, corruption in health systems is an issue that could move to the forefront of the list of global health challenges. This is a challenge that is uniquely multi-disciplinary, spanning the health, economy, and legal sectors, with wider societal implications.

Keywords

Main Subjects


  1. Kaplan J. Translating Research for Better Policy: Advice from Dr. Patricia García, Former Minister of Health of Peru. Medium. September 20, 2018. https://medium.com/@VoicesHSPH/translating-research-for-better-policy-advice-from-dr-cf53df09f82b.  Accessed August 10, 2019.
  2. Jumpa M, Jan S, Mills A. The role of regulation in influencing income-generating activities among public sector doctors in Peru. Hum Resour Health. 2007;5:5. doi:10.1186/1478-4491-5-5
  3. Onwujekwe O, Agwu P, Orjiakor C, et al. Corruption in Anglophone West Africa health systems: a systematic review of its different variants and the factors that sustain them. Health Policy Plan. 2019;34(7):529-543. doi:10.1093/heapol/czz070
  4. McPake B, Russo G, Hipgrave D, Hort K, Campbell J. Implications of dual practice for universal health coverage. Bull World Health Organ. 2016;94(2):142-146. doi:10.2471/blt.14.151894
  5. Plan Nacional de Lucha contra la Corrupción. Un compromiso de todos. Presidencia del Consejo de Ministros; 2008. http://www.pcm.gob.pe/InformacionGral/plan_anticorrupcion/plan_anticorrupcion.pdf.  Accessed August 20, 2019.
  6. Lucha frontal contra la corrupción: Una política diferente para un país distinto. Presidencia del Consejo de Ministros. http://www.pcm.gob.pe/lucha-frontal-contra-la-corrupcion-una-politica-diferente-para-un-pais-distinto/.  Accessed August 20, 2019.
  7. Dirección General de la Defensoría de la Salud, Ministerio de Salud. Plan de Lucha Contra la Corrupción en el Ministerio de Salud 2015-2016. Lima: Ministerio de Salud; 2015. http://bvs.minsa.gob.pe/local/MINSA/3253.pdf.  
  8. Decreto Legislativo N° 1327. Decreto Legislativo que establece medidas de protección para el denunciante de actos de corrupción y sanciona las denuncias realizadas de mala fe. El Peruano; 2019. http://busquedas.elperuano.pe/normaslegales/decreto-legislativo-que-establece-medidas-de-proteccion-para-decreto-legislativo-n-1327-1471010-6/.  Accessed August 20, 2019.
  9. OTRANS: Oficina de Transparencia y Anticorrupción. Ministerio de Salud; 2019. https://www.minsa.gob.pe/otrans/?op=81&tall=7.    Accessed August 20, 2019.
  10. Denuncias Anticorrupción. Ministerio de Salud; 2019. https://www.minsa.gob.pe/otrans/denuncias/.  Accessed August 20, 2019.
  11. Ministerio de Salud lanza campaña para combatir actos de corrupción. RPP; 2016. https://rpp.pe/lima/actualidad/ministerio-de-salud-lanza-campana-para-combatir-actos-de-corrupcion-noticia-1001588.  Accessed August 20, 2019.
  12. Gaitonde R, Oxman AD, Okebukola PO, Rada G. Interventions to reduce corruption in the health sector. Cochrane Database Syst Rev. 2016(8):Cd008856. doi:10.1002/14651858.CD008856.pub2
  13. Hospital Loayza: médicos atienden en clínicas privadas en sus horas pagadas por Minsa. América Noticias; 2019. https://www.americatv.com.pe/noticias/actualidad/doctores-hospital-loayza-pacientes-medicos-n352219.  Accessed August 20, 2019.
  14. Médicos del Loayza atienden en clínicas privadas en horas de trabajo para el Estado. Diario Correo; 2018. https://diariocorreo.pe/edicion/lima/medicos-del-loayza-atienden-en-clinicas-privadas-en-horas-de-trabajo-para-el-estado-video-860808/.  Accessed August 20, 2019.
  15. Hussmann K. Addressing corruption in the health sector: securing equitable access to health care for everyone. U4 Issue. 2011:1. https://www.cmi.no/publications/file/3934-addressing-corruption-in-the-health-sector.pdf.  Accessed August 20, 2019.
  16. Watts J. Operation Car Wash: The biggest corruption scandal ever? The Guardian; 2017. http://www.theguardian.com/world/2017/jun/01/brazil-operation-car-wash-is-this-the-biggest-corruption-scandal-in-history.  Accessed August 20, 2019.
  17. Ugalde A, Homedes N. [The impact of researchers loyal to Big Pharma on the ethics and quality of clinical trials in Latin America]. Salud Colect. 2015;11(1):67-86. doi:10.1590/s1851-82652015000100006
  18. Sample I. Big pharma mobilising patients in battle over drugs trials data. The Guardian. July 21, 2013. http://www.theguardian.com/business/2013/jul/21/big-pharma-secret-drugs-trials.  Accessed August 20, 2019.
  19. The rationale for fighting corruption. CleanGovBiz Initiative, OCED; 2014. https://www.oecd.org/cleangovbiz/49693613.pdf.  Accessed August 20, 2019.
  20. Kenny C. Construction, corruption, and developing countries. Policy, Research working paper No. WPS 4271. Washington, DC: World Bank; 2007.
  21. Puertas que giran sin parar. Salud con lupa. https://saludconlupa.com/reportajes/la-salud-en-la-mesa-del-poder/puertas-que-giran-sin-parar/.  Accessed August 20, 2019.
  22. Storeng KT, Abimbola S, Balabanova D, et al. Action to protect the independence and integrity of global health research. BMJ Glob Health. 2019;4(3):e001746. doi:10.1136/bmjgh-2019-001746
  23. Geng EH, Peiris D, Kruk ME. Implementation science: Relevance in the real world without sacrificing rigor. PLoS Med. 2017;14(4):e1002288. doi:10.1371/journal.pmed.1002288
  24. Hutchinson E, Balabanova D, McKee M. We need to talk about corruption in health systems. Int J Health Policy Manag. 2019;8(4):191-194. doi:10.15171/ijhpm.2018.123
  25. Rowson M, Willott C, Hughes R, et al. Conceptualising global health: theoretical issues and their relevance for teaching. Global Health. 2012;8:36. doi:10.1186/1744-8603-8-36
  26. Rowson M, Smith A, Hughes R, et al. The evolution of global health teaching in undergraduate medical curricula. Global Health. 2012;8:35. doi:10.1186/1744-8603-8-35
  27. Mackey TK, Kohler JC, Savedoff WD, et al. The disease of corruption: views on how to fight corruption to advance 21(st) century global health goals. BMC Med. 2016;14(1):149. doi:10.1186/s12916-016-0696-1
  28. Transparency International. What is Corruption? Transparency International; 2019. https://www.transparency.org/what-is-corruption. Accessed August 20, 2019.
  29. Hanf M, Van-Melle A, Fraisse F, Roger A, Carme B, Nacher M. Corruption kills: estimating the global impact of corruption on children deaths. PLoS One. 2011;6(11):e26990. doi:10.1371/journal.pone.0026990
  30. Dreher A, Herzfeld T. The economic costs of corruption: a survey and new evidence. SSRN; 2005. doi:10.2139/ssrn.734184
Volume 9, Issue 3
March 2020
Pages 128-132
  • Receive Date: 20 August 2019
  • Revise Date: 24 October 2019
  • Accept Date: 24 October 2019
  • First Publish Date: 01 March 2020