December 17, 2020
The Ignored Pandemic behind COVID-19: The impact of corruption on healthcare service delivery
In 2019, Transparency International Health Initiative launched its report The Ignored Pandemic: How corruption in health service delivery threatens Universal Health Coverage (UHC). It documented the drivers, prevalence, and impact of corruption on service delivery, showing how it threatens people’s ability to exercise their right to health and countries’ capacity to provide UHC.
Since the launch of the report, the world has seen an unprecedented global health crisis unfold. As of 3 December 2020, the Covid-19 pandemic has claimed more than 1.4 million lives and infected more than 64 million people around the world.
This commentary picks up from where we left off in 2019. Based on a review of literature and media articles between February and December 2020, it demonstrates that corruption in service delivery is as prevalent as ever during Covid-19, causing harm to vulnerable groups. At present, little is known about the impact of Covid-19 related corruption on healthcare service delivery. This commentary seeks to highlight this relative absence of data and to extrapolate the likely scenarios and risks. The challenge is clear: corruption during a pandemic will inevitably lead to lower accessibility and quality of healthcare services, threatening progress on UHC.
This paper brings together worldwide evidence of six key corruption manifestations at the point of service delivery: informal payments from patients; embezzlement and theft; absenteeism; corrupt service provision activities, such as overcharging and false treatment reimbursement claims; favouritism; and manipulation of data. It also discusses how corruption in health service delivery during Covid-19 particularly affects women and other vulnerable groups’ ability to exercise their right to health. Lastly, this analysis examines how corruption at the point of service delivery can pose a significant threat to the rollout of Covid-19 vaccines and concludes with policy recommendations for both governments and civil society.