Exposing health sector corruption saves lives in Honduras

This is the story of how courage and conviction in the fight against corruption can bring real change and save lives. This is also a story of how the corrupt can be brought to justice.

In March 2013, Asociación por una Sociedad más Justa (ASJ), Transparency International’s partner in Honduras, presented a report to the government about corruption in the health sector. It provided proof that millions of dollars worth of medicine were being siphoned off from the state-controlled Almacén Central de Medicamentos (Central Medicines Warehouse), possibly to be sold on the black market. The report revealed how corruption in the purchase, sales and distribution of pharmaceuticals to state hospitals and clinics was endangering the lives of untold numbers of poor Hondurans and others who needed medicine the most. Beyond the missing drugs, with little control on medication entering the depot, counterfeit and expired drugs were making their way to hospitals undetected.

Raid on the warehouse

The raid on the medicines warehouse

One week after the report and formal complaint was presented, the Minister of Health ordered a raid on the warehouse, which was put under military control. This measure was taken to prevent employees of the warehouse or other actors from removing or destroying evidence.

The raids were swiftly followed by thorough investigation of the case and resulted in the arrest of six people, including warehouse employees, pharmaceutical suppliers and civil servants. As part of the investigation, one state pharmaceutical supplier was found to be hiding 200 boxes of stolen medicine stashed away in her home.

One year on from the presentation of the report, five people await trial for corruption and one person has already been sentenced to five years in prison.

New president establishes new trust

During his inaugural address in late January of this year, the president Juan Orlando Hernández announced that civil servants would no longer be in charge of buying and distributing medicines in Honduras. Thanks to ASJ’s efforts to bring corruption and malpractice in the health sector to light and advocate for effective reform, the Honduran president has asked for our partner organisation’s continued involvement in the issue to ensure a transparent process for state purchases of pharmaceuticals.

On 25 March 2014 Hernández ‘s plan became active. From now on there will be an independent trust responsible for the buying and distribution of pharmaceuticals to state-run hospitals. Purchases made by the trust will be handled by the United Nations Office for Project Services with technical assistance from the Pan American Health Organization and the United Nations Population Fund. ASJ, Transformemos Honduras and the Catholic Church will provide independent oversight of the trust, which, this year, will be responsible for overseeing the purchase of medicine worth US$17 million.

Proof

The investigation uncovered doctored order
forms, with initial orders of 6,000 pills
inflated to 336,000. Click for larger view

The investigation into the Central Medicines Warehouse was institigated by reports to our partner ASJ’s advocacy and legal advice centre, and carried out by Transformemos Honduras – a coalition of Honduran civil society organisations supported by ASJ. The Warehouse handles around US$24 million worth of drugs yearly that are bought by the government to service the public hospitals and health centres in Honduras, a country where 60 per cent of the people live in poverty and 5 million completely depend on public health facilities.

In a country where the murder rate is the highest in the world and organised crime is rife, investigating corruption poses a real risk. At the Warehouse, for example, numerous employees have received death threats and three people – two pharmacists who worked there and one auditor who was possibly investigating the institution – have been murdered.

The path-breaking work of ASJ and its coalition partners on this case required a great deal of persistence, meticulous investigative skills and a strong ability to work with reform-minded actors for change. But above all it required a great deal of courage to speak out in a country as violent as Honduras. The results, however – new laws, criminal convictions and lives saved – are real and immeasurable.