The sustainable development goals as a framework to combat health-sector corruption

Abstract

Corruption is diverse in its forms and embedded in health systems worldwide. Health-sector corruption directly impedes progress towards universal health coverage by inhibiting people’s access to quality health services and to safe and effective medicines, and undermining systems for financial risk protection. Corruption is also a cross-cutting theme in the United Nations’ sustainable development goals (SDGs) which aim to improve population health, promote justice and strong institutions and advance sustainable human development. To address health-sector corruption, we need to identify how it happens, collect evidence on its impact and develop frameworks to assess the potential risks and put in place protective measures. We propose that the SDGs can be leveraged to develop a new approach to anti-corruption governance in the health sector. The aim will be to address coordination across the jurisdictions of different countries and foster partnerships among stakeholders to adopt coherent policies and anti-corruption best practices at all levels. Combating corruption requires a focused and invigorated political will, better advocacy and stronger institutions. There is no single solution to the problem. Nevertheless, a commitment to controlling corruption via the SDGs will better ensure the integrity of global health and human development now and beyond 2030.

Changing the Conversation, Why We Need to Reframe Corruption as a Public Health Issue Comment on "We Need to Talk About Corruption in Health Systems"

“…Health systems corruption negatively impacts on the right to health and efforts towards UHC by blocking people's access to quality health services and safe and effective medicines, while also undermining systems for financial risk protection. 3 As Hutchinson et al 4 point out, the health sector is particularly vulnerable to corruption. Health system corruption occurs worldwide and is a long-standing problem in both developed and developing countries.…”

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

“…Corruption has a high impact on human development; its broad effects include inappropriate legislation, policy, clinical practices and priorities; denied or delayed access to healthcare; and the loss of trust in facilities, personnel and governance. The specific costs of corruption are difficult to quantify; however, the negative impact on the right to health generally, as well as on the UN Sustainable Development Goals (SDGs) are clear [15]. Notably, Goal 16 requires States to commit to ACTA measures through substantial reduction of corruption and bribery in all forms by 2030.…”

The role of health in achieving the sustainable development goals

“…5 Obstacles and financial hardships associated with weak health systems and inadequate financing mechanisms not only exacerbate health inequities, but also jeopardize the achievement of other SDGs. 6 For instance, catastrophic health spending 7 has pushed almost 100 million people into poverty annually, while leaving over half of the world's population without access to essential health services. 5 Most out-of-pocket payments, the cause of catastrophic expenditure, arise from high medication costs, which are likely to increase in line with the global increase in noncommunicable diseases and the need for long-term treatment.…”

“…For instance, corruption makes access to health services, medication and information much more difficult for the vulnerable. 6 In addition, factors such as ethnicity, gender and disability can further exacerbate these health disparities. 8 Hence, tracking indicators that measure the health of vulnerable groups are essential.…”

“…9,10 Currently, robust data on healthrelated targets and indicators is lacking in many countries; developing better implementation and measurement tools, and linking data across sectors, is a cornerstone of the SDGs and should be a priority in global health policy dialogue. 6,10,11 The 2030 agenda also places emphasis on the environmental determinants of health. The 2016 World Health Organization report Preventing disease through healthy environments estimated that 23% of all deaths could be attributed to environmental issues such as air pollution, poor sanitation, exposure to radiation and other environment-related causes.…”