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Healthcare among most corrupt sectors warns UN expert

Healthcare among most corrupt sectors, warns UN expert, backing “citizen whistleblowers”

NEW YORK (24 October 2017) – The United Nations Special Rapporteur on the right to health, Dainius Pūras, has called on States to provide bold leadership to confront corruption and its severe impact on the right to health, including more protection for “whistleblowers” and empowering the public to report corruption.

“In many countries, health is among the most corrupt sectors,” Mr. Pūras told the UN General Assembly in New York, presenting a report on corruption. “This has significant implications for equality and non-discrimination, since it has a particularly marked impact on the health of populations in situations of vulnerability and social exclusion, in particular children and people living in poverty.”

Mr. Pūras said there were domestic and global root causes of corruption, including some related to the pharmaceutical industry and some of which resulted in “institutional corruption”. All had to be tackled through legal, policy and programming measures, he said.

The Special Rapporteur stressed that there is a “normalization” of corruption in healthcare, involving not just corruption that clearly breaks the law, but practices which undermine the principles of medical ethics, social justice, transparency and effective healthcare provision.

“Three main characteristics make the health sector particularly vulnerable to corruption: power asymmetries and imbalance of information, uncertainty inherent in selecting, monitoring, measuring and delivering health-care services, and complexity of health systems,” he said.

The mental health sector is particularly affected by corruption, he noted, highlighting the “lack of transparency and accountability in the relationships between the pharmaceutical industry and the health sector, including academic medicine”, which could lead to institutional corruption and have a detrimental effect on mental health policies and services nationally, and even globally.

The Special Rapporteur recommended protection for “whistleblowers” who reported corruption, and the empowerment of health system users to raise the alarm.

“I strongly encourage States to raise awareness among health care providers of unethical practices and situations of conflict of interest, while health system users should be empowered to report corrupt acts,” he said. “For this, the population needs to be informed of its rights, educated to identify corrupt acts, and protected when they report.

“I also urge all relevant stakeholders to address, through legal, policy and other measures, corrupt practices taking place in all stage of the pharmaceutical value chain, including during research and development, manufacturing, registration, distribution, procurement and marketing of medicines.”

The Special Rapporteur said healthcare systems should be effective, transparent and accountable, with a focus on primary health care and health promotion. Accountability had to extend to health professionals and the private business sector, as well as States themselves, he noted.

Health care systems should engage in “rational” service provision which would prevent the costly and unnecessary use of specialized interventions by educating the general population against unnecessary use of medical tests, treatments and procedures, the Special Rapporteur added.

He also urged all States to fully implement the UN Convention against Corruption and to ensure that national anti-corruption laws and policies integrated the right to health.

“Applying a human rights-based approach to health and related policies is crucial,” Mr. Pūras said. “Addressing existing power imbalances and avoiding selective approaches to the production and use of evidence in the health and related sectors are the most effective measure for combating corruption.”


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