Our Blind Spots in the Fight Against Health Systems Corruption Comment on "We Need to Talk About Corruption in Health Systems"

Abstract

The health sector often appears prominent in surveys of perceived corruption, because citizens experience the symptoms of systemic corruption most distressingly during their interaction with frontline health workers. However, the underlying drivers of systemic corruption in society may be located in other social systems with the health system demonstrating the symptoms but not the path how to exit the situation. We need to understand the mechanisms of systemic corruption including the role of corrupt national and international leaders, the role of transnational corporations and international financial flows. We require a corruption definition which goes beyond an exclusive focus on the corrupt individual and considers social systems and organisations facilitating corruption. Finally there is an urgent need to address the serious lack of funding and research in the area of systemic corruption, because it undermines the achievement of the Sustainable Development Goals (SDGs) in many low income countries with the most deprived populations.

Targeting anticorruption interventions at the front line: developmental governance in health systems

“…14 19 Early descriptions, 'the abuse of public resources for private gain' ignored corruption within the private sector and failed to provide an explicit acknowledgement of the central role of power in its manifestation. 20 More recent definitions, 'the abuse of power for private gain' enables a focus on both public and private sectors but continues to rely on a clear division between public and private spheres-a distinction that is not always clear or universally recognised. 21 This definition continues to focus excessively on the individual.…”

Corruption should be taken into account when considering COVID-19 vaccine allocation

“…However, they did not include corruption in their analysis model. Systemic corruption is the use of power for private gain and the deliberate betrayal of public trust ( 4 ). To quantify the influence from illicit use of power on COVID-19 vaccination coverage, we investigated country-level associations between vaccination coverage and level of corruption.…”

Beyond Talking: We Need Effective Measures to Tackle Systemic Corruption and the Power That Allows It to Persist in Health Systems; A Response to Recent Commentaries

“…But, the problem for us is that this snappy definition does not give the weight to the systemic and the organisational drivers of corruption that a health systems approach demands. As Vian notes, we need “to focus on corruption as a health systems problem.” 13 Huss, 14 Fotaki, 15 and Lu and colleagues’ 16 papers also recognise this and call for a focus on systemic or institutional corruption, which draws the system to the heart of the debate. This also speaks to what Clarke calls a public health approach to corruption, 8 looking upstream to its determinants and incorporating early identification of risk and development of strong institutions to prevent corruption emerging.…”