June 1, 2016
The global pharmaceutical sector is highly vulnerable to corruption abuse, with both governments and companies needing to properly address the corruption risks. In this mini-blog series two insights of corruption in the health systems, which the pharmaceutical sector is a dominant area of, are given. Both of insights come from Nigeria, a country that demonstrated strong leadership at the recent International Anti-Corruption Summit in London. Corruption in the pharmaceutical sector is not only present in Nigeria, but in all countries, and due to the transnational nature of the pharmaceutical sector issues that manifest themselves in one country such as Nigeria often have roots in another area such as Europe.
Some months ago, Abigail went into labour after midnight. With no motorable access road or vehicle to transport her to the General hospital in town, Abigail’s situation became desperate. Unfortunately, the newly constructed Primary health care centre (PHC) right beside their home was of no use even though by its structure, it is a “Type-2” PHC which from the minimum standards for primary health care, ought to provide childbirth support and services.
Procurement Monitors tell a part of the story. The poorer you are, the further away you are from health care access. The scale and gravity of the issue is brought to light by the Human development statistics which reveal that 50.9% of Nigerians are multi-dimensionally poor and by inference, further away from health care access. To enable increased access to health care, every year, the Nigerian Government allocates a budgetary amount to the construction of primary health care centres (PHCs). A breakdown of eventual amounts provided for the construction of Primary health care centers by one of the health agencies is as follows:
Experiences such as Abigail’s however, question the effectiveness of the procurement processes for increased health care access. To understand the results that follow allocations for primary health care, procurement monitors followed the data trail. It however, became difficult to link the data on budget estimates with the data on eventual sums for contracts awarded, and even more difficult to identify the exact locations for each of the constructed primary health care centres. To address this challenge, we tried to standardize our data using the Open Contracting data standards. This was carried out using our locally developed platform, Budeshi. It is in linking budget and procurement data together that we discovered the community where Abigail leaves, the existence of a completed PHC there and its non-functionality.
Stories of non-functional primary health care services are rife in Nigeria and teach us that it is never enough to see a projection marked as completed on paper. While Abigail survived the ordeal of being transported on a motorcycle in the dead of the night to the General hospital, we must not take for granted the fact that certain people are used to certain hardships. To do so would also be to accept the high rate of maternal mortality; most of which is underreported in the poorest parts of Nigeria and across sub-Saharan Africa. Rather we need to use data to help trace the impact of deployed infrastructure and expose areas of corruption, inefficiencies and weaknesses in public service delivery. Linked data as exemplified by the OCDS and implemented by Budeshi can help us make sense of public sector processes that affect our life’s quality.
The National Primary Health Care Development Agency and the Nigerian Parliament have been informed of this non-functional primary health care centre. The senate has responded to the effect that an investigation is ongoing.
Author – Seember Nyager is an Open Knowledge/Code4Africa Open Government Fellow advocating for the adoption of open contracting data standards in Nigeria. This is a short adaptation from the article “Can Data help us attain healthier lives?” Budeshi is a platform that links procurement and Budget data to public services using the Open contracting data standards and Seember curates the work of procurement monitors in Nigeria on www.blog.budeshi.org. Follow the work of procurement monitors on @ppmonitorNG.
Photo: Flickr / Alex Proimos.
On Thursday 2 June TI will be releasing research identifying key challenges and solutions to preventing corruption in the pharmaceutical sector. ‘Corruption in the pharmaceutical sector: diagnosing the challenges’ has been produced by TI’s Pharmaceuticals & Healthcare Programme, a new global initiative based in Transparency International UK.