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Pharmaceuticals & Healthcare Programme

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Flickr/Creative Commons – Brandon Giesbrecht

Why is Transparency International researching corruption in the pharmaceuticals & healthcare sector?

Corruption within the pharmaceutical and healthcare sectors is a matter of life and death. Corruption weakens the quality of services and in many cases can deny healthcare altogether, which can lead to long and short-term health crises around the world. Corruption in the sector has a corrosive impact on health, negatively impacting public health budgets, the price of health services and medicines, and the quality of care dispensed. Preventing abuse and reducing corruption therefore is important to increase resources available for health, to make more efficient use of existing resources and, ultimately, to improve the general health status of the population.

The Pharmaceuticals & Healthcare sector is regularly cited as a high-risk sector for corruption.   Out of a global survey of over 114,000 people in 2013, on average, 45% believed medical and health services to be corrupt or extremely corrupt (TI Global Corruption Barometer 2013).

The pharmaceutical and healthcare sector is vulnerable to corruption as there is a clear knowledge gap between the providers and users of healthcare, leaving patients subject to the knowledge they are provided by healthcare providers, suppliers, and regulators. This inequity of information is open to exploitation for private gain, opening possibilities of corruption. In addition, the necessity of healthcare, and volume of funds involved in the sector can help provide incentive for private gain.  Finally, due to the high number of people involved in decision making, and the often bureaucratic nature of the pharmaceutical and health sectors, it is susceptible to individual discretion and regulatory capture.

 

The scale of the problem:

  • In 2012, according to the WHO Global Health Expenditure Database, global spending on health was $7.2 trillion.   In a survey of a few years earlier, an estimated 10% – 25% of global spending on health public procurement was lost to corruption (Global Corruption report, TI, 2006).
  • In 17 countries surveyed in 2013, over 70% of the public believed medical and health services to be corrupt or extremely corrupt – these are Serbia; Albania; Tanzania; Bulgaria; Kyrgyzstan; Morocco; Ukraine; Bosnia and Herzegovina; Russia; Egypt; Greece; Lithuania; Mongolia; Kosovo; Malawi; Moldova; Mozambique (TI Global Corruption Barometer 2013)
  • The effects of this widespread corruption can be felt within all aspects of health;
    • Bribery within primary care restricts access to healthcare amongst the poorest and most vulnerable populations
    • Medical fraud and embezzlement diverts essential finances that could be used to restructure failing healthcare programmes
    • Inappropriate marketing relations between doctors and pharmaceutical companies drive unethical clinical decisions that eventually prevent patients from receiving the best treatment available

What can TI do?

Building on twenty years of experience in this and other sectors, Transparency International UK is taking up the challenge of understanding and combatting corruption in this vital sector. The TI UK Pharmaceutical & Healthcare Programme (PHP) has been set up, with a purpose to achieve genuine change in the pharmaceutical & healthcare sector through reducing corruption and promoting transparency, integrity and accountability.

During 2016 and beyond, our intention is to engage pharmaceutical & healthcare companies, civil society, regulatory bodies,  and international organisations who wish to join us in this endeavour.  We will be looking for expertise, insight and funds; and above all, for allies who wish to work with us to pursue a  critical issue for the benefit of global health.

 

Meet The Team

    Sophie Peresson - Programme Director

 

    Sarah Harris - Senior Programme Officer

 

    Shalni Arora - Senior Advisor Trustee

PRESS RELEASES

10/10/2016 – New Report Maps Corruption Types Across Health Sector

20/09/2016 – Transparency International Welcomes Transparency Over NHS Doctors Income

15/09/2016 – UN Report Recognises Importance of Transparency in Healthcare Access

02/06/2016 – Pharmaceutical Sector Failing to Address Corruption Risk

12/05/2016 – Anti-Corruption Summit Commitments on Procurement Will Be Key for the Health Sector

PHARMACEUTICALS AND HEALTHCARE PROGRAMME – FUNDING AND CONFLICTS OF INTEREST

As with all of TI-UK’s work the board considers it is a pre-requisite that the Pharmaceuticals & Healthcare Programme is able to operate independently and without undue influence from any funding organisation.

The board has set out preliminary guidelines for the programme, such that during its development phase, no more than 50% of the funding should be received from any one sector (for example, the private sector or institutional donors), and no more than one-third should be received from any individual donor.

The pilot phase for this programme was funded by Savannah Wisdom, an independent charitable foundation of which TI-UK’s board member Shalni Arora is a Trustee. To acknowledge the potential conflict of interest due to the relationship with a current funder to the programme, Shalni Arora is not currently a member of the TI-UK board’s Pharmaceuticals & Healthcare Programme Committee. The programme is now seeking funding from other sources as it moves beyond the pilot stage.

The current donors to the programme are the Department for International Development (DFID), Federación Latinoamericana de La Industria Farmacéutica (FIFARMA), Garfield Weston Foundation, GlaxoSmithKline (GSK), Savannah Wisdom and The Beale Trust. Full details of donations to this and other programmes are published annually in our Annual Report & Accounts.

All donations to TI and TI-UK are covered by a policy approved by the board, which is available here: Section 12, Governance and Procedures Manual

Get involved

For more information about the developing Transparency International UK research agenda on pharmaceuticals & healthcare, please contact:

Sophie Peresson
Programme Director – Pharmaceuticals & Healthcare Programme
T: +44 (0)20 3096 7685
E: sophie.peresson@transparency.org.uk

 

Recent Reports

 Other Materials

      Other Materials

Access to Medicine Foundation. (2014). Access to Medicine Index. Access to Medicine Foundation.Ajay, C., et al. (1997). World Development Report 1997: The State in a Changing World. USA: Oxford University Press.
Baghdadi-Sabeti, G., Cohen-Kohler, J. & Wondemagegnehu, E. (2009). Measuring Transparency in The Public Pharmaceutical Sector – Assessment Instrument. World Health Organisation.

Baghdadi-Sabeti, G. & Serhan, F. (2010). WHO Good Governance for Medicines Programme: An Innovative Approach to Prevent Corruption in the Pharmaceutical Sector. World Health Report 2010, Background Paper (25).

Carrin, G., et al. (2009). Health Systems Policy, Finance, and Organisation. USA: Academic Press.

Chan., M. (2010). Access to medicines: the role of procurement policies. 16 July, Geneva, Switzerland.

Cohen, J C. (2007). Pharmaceuticals and corruption: a risk assessment. World Bank.

Dieleman, M., & Hilhorst, T. (2011). Governance and Human Resources for Health. Human Resources for Health, 9(29).

European Commission. (2013). Study on Corruption in the Healthcare Sector. Luxembourg: Publications Office of the European Union.

Hsiao, W., & Joachim, M. (2014). Leveraging the Private Sector to Strengthen Public Service Delivery. Harvard Kennedy School.

Hussman, K. (2010). How to Note: Addressing Corruption in the Health Sector. Department for International Development.

Hussman, K. (2011). Addressing Corruption in the Health Sector: Securing Equitable Access to Health Care for Everyone. U4 Issue, January 2011 (1).

Hussman, K. (2011). Vulnerabilities to Corruption in the Health Sector: Perspectives from Latin America Sub-systems for the Poor (With a Special Focus on the Sub-National Level). UNDP.

Kohler, J.C. (2011). Fighting Corruption in the Health Sector: Methods, Tools and Good Practices. UNDP.

Mackey, T., & Liang, B. (2012). Combatting Healthcare Corruption and Fraud with Improved Global Health Governance. BMC International Health and Human Rights, 12(23).

Maduke, T. (2013). Corruption in Health Sectors of Low- and Middle- Income Countries. Leadership, Management & Governance Project.

Marouf, F. (2010). Holding the World Bank Accountable for the Leakage of Funds from Africa’s Health Sector. Scholarly Works (120).

Ministry of Health and Population Egypt, Partnership for Maternal, Newborn & Child Health, WHO, World Bank and Alliance for Health Policy and Systems Research. (2014). Success factors for women’s and children’s health: Egypt. Geneva: World Health Organisation.

Ministry of Health and Social Welfare United Republic of Tanzania. (2014). Women and Children First: A review of progress in implementation of the recommendations of the

Commission on Information and Accountability for Women’s and Children’s Health in Tanzania. Ministry of Health and Social Welfare United Republic of Tanzania.

Partnership for Maternal, Newborn & Child Health, World Bank and Alliance for Health Policy and Systems Research. (2015). Success factors for women’s and children’s health: Peru. Geneva: World Health Organization.

Reich, M. (2002). Reshaping the State from Above, from Within and from Below: Implications for Public Health. Social Science & Medicine (54).

Rothstein, B., & Holmberg, S. (2014). Correlates of Corruption. QOG Working Paper Series, 2014 (17)

Segato, L. et al. (2013). Corruption and Waste in the Health System. Transparency International Italia.

Transparency International. (2006). Global Corruption Report 2006. London: Pluto Press.

World Health Organisation. (2010). Good Governance for Medicines: Curbing Corruption in Medicines Regulation and Supply. World Health Organisation.

World Health Organisation. (2015). E-procurement in support of universal health coverage. Bulletin of the World Health Organisation, 93(3). World Health Organisation.

World Health Organisation. First EC/ACP/WHO Partnership on Pharmaceutical Policies. Available from: < http://www.who.int/medicines/areas/coordination/ecacpwho_partnership/en/index1.html>. [04 January 2016].


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