How corruption is making people sick

This blog is part of a series, Citizens Report COVID-19 Corruption, to raise awareness about the human cost of corruption during COVID-19 and encourage citizens to report corruption.

At the end of 2019, when the COVID-19 pandemic was just beginning to spread in China, the medical journal the Lancet published an article calling corruption “the biggest threat for the future of health globally.”

A year prior, the Transparency International Health Initiative warned how corruption weakens health systems and threatens progress on universal health coverage.

Since then, COVID-19 has exploded into a global pandemic—and the dangers of corruption have also multiplied.

More than 1,800 women and men have contacted Transparency International’s worldwide network of Advocacy and Legal Advice Centres (ALACs) to report corruption and seek assistance for issues related to COVID-19. Our ALACs offer free and confidential advice to victims and witnesses of corruption in more than 60 countries around the globe.

These reports show how corruption is increasing the burden on health care systems and impeding people’s access to treatment and personal protective equipment (PPE).

Health care workers are being forced to work in unsafe hospitals while corruption networks profit from government contracts and the unlawful and questionable sales of medical supplies. In some cases, patients must pay bribes for PPE and COVID-19 tests.

Countries will not be able to control the spread of the virus as long as corruption keeps resources out of the hands of the people who need them most.

Unsafe workplaces for health care workers are a common complaint heard by our ALACs.

In the Democratic Republic of Congo, a group of nurses contacted an ALAC after they were forced to work for three months without pay, even though the government claims it has spent more than US$27 million to fight the virus.

An Irish ALAC heard from health care workers who feared their employers were not implementing sufficient safety measures. Doctors and nurses in Kenya have gone on strike over the lack of PPE, while angry citizens have taken to the streets to protest the misuse of health funds.

A charity hotline for whistleblowers in the United Kingdom received more than 170 calls from health care workers, including five who say they lost their job after raising concerns about PPE.

Other ALAC reports highlight corruption in the procurement process and the distribution of PPE.

In Italy, an ALAC contacted the administration of a hospital to successfully halt the distribution of uncertified masks. A Kenyan ALAC also learned of a hospital whose staff was making patients buy masks at the entrance before they could receive care. The ALAC contacted the hospital administration, which ultimately shut down the irregular sales.

In July, the staff at the ALAC in Venezuela connected with a doctor at a public hospital who decided that the risks of his work had become too great.

Even before the pandemic, Venezuela’s health system was collapsing. More than half the country’s doctors had left in recent years as émigrés or refugees.

The remaining doctors and nurses earn as little as six dollars per month in public hospitals and often lack access to soap and running water, let alone masks, gloves, gowns, and other essential PPE. As a result, doctors make up more than 14 percent of the COVID-19 death toll in Venezuela.

The doctor who spoke to the ALAC was worried that, without protective equipment, he would become sick and spread the virus to his family. If his wife or children became infected, he lacked an adequate salary to pay for their care.

He tried handing in his resignation, but the hospital administration refused to let him quit. When he insisted, he was threatened by officers from the Special Action Forces (FAES), a branch of the national police that has been implicated in extrajudicial killings and arbitrary arrests.

After speaking to the doctor, and due to the critical state of the healthcare system in Venezuela, the ALAC asked for a hearing on working conditions and safety in public hospitals in Venezuela before the Inter-American Commission of Human Rights. The commission has the power to award preventative measures for individuals at risk of irreparable harm.

In some ALAC cases, tips have developed into huge investigations. The Russian ALAC joined forces with investigative journalists and other legal and non-profit organisations to form the Russian Anti-Virus Emergency Network (RAVEN).

The RAVEN team spoke with doctors who were concerned with the quality of Russian-made ventilators after a ventilator fire in a St. Petersburg hospital killed five COVID-19 patients.

The ventilators in the St. Petersburg hospital, as well as a Moscow hospital where a patient also died in a fire, were manufactured by a corporation run by Sergey Chemezov, a close ally of Russian President Vladimir Putin. The government had favoured Chemezov’s Rostec State Corporation over other domestic manufacturers in awarding millions of dollars to produce ventilators.

Project RAVEN’s investigation found that Rostec overcharged for ventilators and used a government decree to force hospitals to buy their ventilators over ventilators from foreign suppliers. Ironically, Rostec purchased most of its ventilator components from abroad.

The doctors from Venezuela and Russia spoke out in the hopes that their stories might help save lives and make it easier for others to also speak out.

But sadly, their stories aren’t new, as the COVID-19 pandemic has only compounded existing corruption and strains on health systems.

The reports received by ALACs during the pandemic show how corruption is creating shortages in staff and equipment and denying people’s right to health.

Vulnerable groups—such as people living in poverty, the elderly, women, and ethnic minorities, among others—are bearing the largest burden. Since these groups are more reliant on public health services, we need to do more to ensure corruption does not cost additional lives during the COVID-19 pandemic.

Governments must also create safe channels for citizens and medical professionals serving on the frontlines to raise their concerns.

To counteract corruption in the health system, we call on governments to:

• Issue clear, transparent, and public guidelines for health care workers and public servants on managing the COVID-19 response.
• Include reporting mechanisms and maintain transparency around decision-making, procurement, and expenditures on the COVID-19 response.
• Investigate all cases of corruption reported to the authorities and sanction all instances of wrongdoing.
• Protect citizens who step forward to report wrongdoing and investigate their claims.

As long as corruption goes unchecked, the health care workers and communities on the front lines of the pandemic will suffer needless pain and, in some cases, death.

In the middle of pandemic, corruption is more than just a threat to good governance. It is a grave danger to public health.