Global Health and Corruption

By: Alanna Shaikh

It feels like everyone is talking about global health and corruption right now. Rajiv Shah mentioned it explicitly in his recent speech on USAID’s new approach to international development. The Associated press wrote an over the top alarmist article (1) about the Global Fund’s Inspector General uncovering a .03 percent loss of grant money to corruption. CGD put up two blog posts on corruption and global health, which has been followed a by a slew of other bloggers joining in the conversation.

I think it’ a good thing. (Well, not so much the silly AP article. But the rest of it.) Corruption, on all levels, is very much the elephant in the room when you talk about global health. Running from under-the-table payments demanded by doctors on government salary to Mauritania’s ghastly use of Global Fund resources, corruption damages our ability to make our programs work and spend money as effectively as possible.(2)

We can’t do anything about corruption if we won’t talk about it. Administrator Shah took an important step in acknowledging the existence of corruption and pledging USAID’s commitment to its elimination. In addition to its Office of Inspector General, the agency now has a task force devoted to monitoring, investigating, and responding to suspicious activity.

It’s easy to be scared off by the corruption conversation. In a field that’s heavily dependent on donor money, we’re all afraid of frightening the donors. And that’s not paranoia; it’s a legitimate concern. Who knows how much damage that AP article has done?  But at the same time, you can’t fight a problem you can’t discuss.

Nandini Ooman makes a great point in her blog post for CGD, “Many developing countries are plagued with the same problems—poor management capacity and oversight capacity, and corruption—whether the Global Fund, PEPFAR, or the UN system supports them.  The difference is that the Global Fund actually reports findings from its Office of the Inspector General (OIG) and calls out countries for fraud, while other donors are reported to be highly secretive about any corruption investigation that might affect them, if they conduct them at all.”

Corruption happens whenever large sums of money are involved, not just in global health programs. What we need to do is keep the scale of that corruption to the smallest possible minimum. Investigating our programs, sharing the results, and talking about them is the way to make that happen.


(1)Click the link. It’s a very weird article. They don’t give any real context on the global fund, just mention that it has the support of Bono and Bill Gates. Which is not, to me, so much the point of the GFATM.

(2)I have already seen several blogs from angry people suggesting that either all global health to work is a waste of money, or that individual donors should stop giving money to global health causes, and instead give items for distribution. I don’t think I need to say here that an all gift-in-kind approach to global health funding would be both ludicrous and as prone to corruption as our current system based on actual money.

Alanna Shaikh is an expert in health consulting, writing about global health for UN Dispatch and about international relief and development at Blood & Milk. She also serves as a frequently contributing blogger to ‘End the Neglect.’ The views and opinions expressed by guest bloggers are not neccesarily the views and opinions of the Global Network. All opinions expressed here are Alanna’s own and not those of any employer or the US government.

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