This policy brief builds upon the evidence gathered by Transparency International Global Health (TIGH) Programme and partners in Bangladesh, Uganda, and Zambia indicating three hidden barriers for equitable access to COVID-19 vaccines – corruption, lack of transparency, and misinformation. Further details about the research can be found in the report “Transparency and corruption in COVID-19 vaccine deployment: Evidence from Bangladesh, Uganda, and Zambia”. 

The COVID-19 pandemic has required an unprecedented public health response, with governments dedicating massive amounts of resources to their health systems at extraordinary speed. Governments have had to respond quickly to fast-changing contexts, with many competing interests, and little in the way of historical precedent to guide them.

This report looks at how changes to the NHS in England over the past decade have created greater risks of abuses of power, and how reforms to local commissioning are exacerbating them. Since 2012, membership organisations made up of General Practitioners (GPs), called Clinical Commissioning Groups (CCGs), have managed most of the NHS’ budget in England. They are responsible for purchasing £78 billion of healthcare services on behalf of the NHS. At the same time, these same GPs are independent contractors to the NHS and are in receipt of around £8.5 billion of NHS funding each year.

The Covid-19 Pandemic has turned the world on its head. It has exposed fault lines we did not know were there, and underscored others that we did. Looking forward, government, business and civil society around the world will have to decide how we can do things differently – and better. Fighting corruption must remain a priority. Sadly, no global crisis will eradicate corruption. In reality, it can make things worse – increasing opportunities for those with entrusted power to abuse their position for personal gain.

Universal health coverage, meaning that all individuals and communities can access essential quality health services without suffering financial hardship, has become the top priority of the World Health Organisation. Achieving the ambitious goal of universal health coverage will require more resources, and the better use of existing resources.