The risk of corruption in public pharmaceutical procurement: how anti-corruption, transparency and accountability measures may reduce this risk

Abstract

Background: The goal of the public procurement of pharmaceuticals is to purchase sufficient quantities of high-quality pharmaceuticals at cost-effective prices for a given population. This goal can be undercut if corruption infiltrates the procurement process. Good procurement practices can help mitigate the risks of corruption and support equitable access to affordable and high-quality medicines. Objectives: This paper aims to 1) examine manifestations of corruption in the pharmaceutical procurement process and key factors behind them, and 2) identify how to design and implement effective anti-corruption, transparency and accountability mechanisms within this process. Methods: This paper was informed by a narrative literature review from 1996 to the present. The search focused on publications that addressed the issue of pharmaceutical procurement and governance and corruption issues. Our search included peer-reviewed literature, books, grey literature such as working papers, reports published by international organizations and donor agencies, and some media articles. Some documents used in this paper were already known to the authors. Results: Procurement is highly vulnerable to corruption particularly in the health sector. What is more, corruption in the procurement process does not appear to be limited to any one level of government or type of health system. The better integration of accountability, transparency and anti-corruption mechanisms in the procurement process is needed to reduce the risk of corruption. Conclusions: Lessons learned suggest that anti-corruption, transparency and accountability mechanisms in the pharmaceutical procurement process, such as open contracting and integrity pacts are helpful towards reducing the risk of corruption.

The Urgent Need for Transparent and Accountable Procurement of Medicine and Medical Supplies in Times of COVID-19 Pandemic

“…Corruption is defined by the leading global anticorruption organization, Transparency International, as, "the misuse of entrusted power for private gain" [6]. It is a global phenomenon that manifests in different forms and within all types of organizations [7]. Corruption can foster inequities as it skews how resources are distributed and create access barriers to public services and goods, such as essential medicines.…”

“…Ideally, the good procurement of pharmaceuticals supports access to essential medicines for the population. Yet, when corruption infiltrates the pharmaceutical procurement processes, health goals can be threatened by possible consequences such as pharmaceutical shortages, inflated drug prices, and the distribution of falsified and substandard essential medicines [7]. Procurement is thus critical to efforts by governments to ensure equitable access of essential medicines for their populations, particularly during these unprecedented times of the COVID-19 pandemic.…”

Human rights mechanisms for anti-corruption, transparency and accountability: enabling the right to health

“…It is important, therefore, to educate States and stakeholders about the ways in which the UPR review process can highlight corruption risks as a barrier to the right to health, and to identify more specific recommendations that might be helpful. For instance, the UPR process could be more specific and explicitly ask countries to make the procurement process open, transparent and free of corruption [44]. In the subsequent review, States would then submit specific measures they have taken in response.…”

“…Social audits are ways of measuring, understanding, reporting and ultimately improving an organization's social and ethical performance. These audits create greater accountability in the health sector by enabling stakeholders, including intended beneficiaries, to participate in improving health planning and delivery [44]. Social audits can review State records, determining whether reported expenditures reflect reality, actualizing the Alma-Ata Declaration's principle of participatory healthcare, and instituting grass roots accountability to counter the loss of faith in governance stemming from corruption.…”

Promoting anti-corruption, transparency and accountability to achieve universal health coverage

“…Kohler and Dimancesco argue for the importance of integrating ACTA measures into governance for pharmaceuticals procurement [5]. Their article provides a primer on key factors, types, and examples of corruption in pharmaceutical procurement.…”