Corruption threatens health care worldwide

Internal Auditor, April, 2006 by A. Cushing

CORRUPTION IN THE HEALTH-CARE SECTOR DEPRIVES those most in need of essential medical care, according to Transparency International's (TI's) Global Corruption Report 2006. Increased aid to acutely vulnerable countries alone will not be effective if corruption is not curbed, the report asserts. Instead, accountability mechanisms are needed to prevent the misallocation of valuable resources.

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According to the report, spending on health-care services exceeds US $3 trillion a year worldwide, most of which is financed by taxpayers. The maze of complex and opaque systems put in place to distribute these resources provides a fertile field for corruption in rich and poor countries in both public and private health-care service venues.

One recommendation made in the report is to require donor and recipient governments to subject key aspects of health-related projects, budgets, and policies to independent audits and make them available on the Internet for easy access. Juanita Olaya, director of policy and research for TI, suggests that auditors, in particular, have a dual preventive and remedial role in combating corruption. "We like to emphasize auditors' preventive role because sometimes controls come too late," Olaya says, stressing the importance of the internal auditor's role in fighting fraud and corruption by remaining independent and vigilant. "But sometimes auditors are involved afterward. When that happens, the best you can do is open your eyes and do your job properly."

Another recommendation is to ensure independent monitoring of public health policies and projects--both at the national and international level--and to open the monitors' reports to public scrutiny. Olaya notes that in many cases, monitoring has failed because the monitors are not accountable to anyone. "It is not enough to have monitoring," she cautions. "You must have accountable, responsible, and independent monitoring."

The Global Corruption Report 2006 reports on the state of corruption and governance in 45 countries around the world, including significant evidence of financial irregularities in post-tsunami relief operations. To obtain a copy of the report, visit TI's Web site, www.transparency.org, and click on the "news room" tab.