31. Sarah Steingruber on need for anticorruption measures in global response to COVID-19 crisis
This week on the podcast: Sarah Steingrüber (@sarahsteino), Independent Global Health Consultant, and the global health lead for the Curbing Corruption Platform (https://curbingcorruption.com/). The interview touches on many topics related to corruption and public health. Sarah outlines how the global health crisis of COVID-19 poses two main corruption threats. 1) Corruption of funds that are devoted to improving the health situation, due to lack of infrastructure to combat corruption. Sarah outlines that according to conservative estimates at least 6% of all health investment is lost to corruption in a given year and how this affects, and at times takes lives. 2) Opportunistic corruption, occurring in the shadow of the pandemic, as some might take advantage of the unique situation of people’s attention being placed on COVID-19 to engage in corruption. The two further discuss how the urgency of emergencies affects the safeguards against corruption. Sarah outlines that in that process it plays an important role to figure out what forms of corruption one might be willing to live with while making sure that other forms are prevented. Sarah further discusses the donor activities of organizations like the IMF or the Global Fund and outlines how they are at times attached to anti-corruption goals, such that funding is pulled back if cases of fraud and corruption are detected. The interview shifts to discussing what lessons have been learned from the Ebola outbreak (2013-2016) that could be applicable to the COVID-19 crisis. Sarah outlines the risk of corruption within procurement that is especially pertinent in times of health crisis. Moreover, she outlines how misinformation can contribute to corruption, such as fostering absenteeism (#infodemic). She also describes how too bureaucratic and overcomplicated procedures can incentivize workarounds of the rules and how digitization might help to mitigate these risks. The interview then shifts to the topic of monetization and privatization of health more generally. Here, Sarah describes the influence of undue influence on decision-making processes in the health sector. Approaching the topic from a human rights perspective, assuming that access to health care is a human right, she outlines several concrete roadblocks to it. As an example for anticorruption in the health sector, the two discuss approaches to tackle bribery in the Ugandan health sector (see video: https://www.businessinsider.com/ugandas-health-minister-went-undercover-in-a-hospital-2017-9_) and whether this approach should be considered a success (for relevant work by Prof Heather Marquette, on this issue see further below). The interview ends on a positive note, by Sarah providing some examples for success stories from Ukraine.