According to an article recently published in the Lancet, some 10% to 25% of the USD $7 trillion spent on healthcare globally every year is lost because of corruption – an amount that exceeds the investments needed to achieve universal healthcare by 2030.

To understand how corruption affects healthcare worldwide, the Global Health Centre at the Geneva Graduate Institute organized a panel to discuss how the phenomenon manifests itself and what can be done to fight it. The event was introduced by Vinh-Kim Nguyen, Co-Director at the Centre, and moderated by Priti Patnaik, Founder of Geneva Health Files. “Corruption is a disease of the health system, as it is well described in the Lancet,” said David Clarke, acting head of the Health Systems Governance Unit at WHO, Geneva. He explained that agencies focused on criminal activities have traditionally dealt with corruption. However, in recent years the WHO has felt the need to work on fighting it from a healthcare perspective.

“There’s a significant range of activities that could be regarded as corruption,” he noted, mentioning informal payments, absenteeism, data manipulation, lack of transparency, falsified medical products, embezzlement, and bribery. “All of them distort health systems and negatively affect how people receive health services.” Clarke mentioned how in some countries, up to 80% of non-salary funds in healthcare never reach local facilities and an estimated 140,000 children per year lose their life because of corruption.

The goal of WHO is to fight corruption by creating more transparency and accountability, specifically in the health systems, he pointed out. According to Dr. Mushtaq Khan, a professor of Economics at the SOAS University of London, fighting corruption is complicated because each of its manifestations might have multiple causes.

“Lack of resources is one of the factors driving corruption,” he pointed out. “If you are in an under-resourced hospital, then there is excess demand, and people have to pay to get seen.” In addition, he highlighted how political clientelism and patronage represent another driver of corruption. “The way patronage is used to create jobs is not directly related to resource scarcity,” Khan said, adding that a weak rule of law is critical in allowing corruption to thrive.