02 April 2020

Corruption in times of crisis

Sergiu Medar

During the past century, it has been acknowledged that crisis periods are used by opportunists to illegally assume huge amounts of money through methods that usually do not require the intervention of structures fighting corruption and fraud. Such phenomenon is common to all states in the world and, surprisingly, is used a lot more in rich countries than in the poor ones. Corruption is everywhere on the medical equipment and medicines route from producer to the user.

Image source: Mediafax

During crisis periods, when state’s institutions are concerned with finding solutions for the critical situation the states face, some create the proper conditions for what the Americans call “white collar crime”, a crime field which firstly includes corruption. This is the “silent criminal” acting against human kind’s efforts to save peoples’ life.

The democratic states, which follow the liberal democracy principles, are way more vulnerable to criminals’ actions. One of the reasons of states’ shortcomings in terms of such things is the lack of serious provisions, of intense punishments for crimes committed during emergency situations. It is necessary for all these countries to elaborate serious laws for criminals interfering in the medical equipment supply chains for their own interests.

Corruption during the SARS-CoV-2 pandemic is not an unprecedented action. The Ebola epidemic caused 11.000 fatalities in Guinea, Sierra Leone and Liberia. According to Red Cross’s reports, the international corruption has taken 6 million dollars, money that was dedicated to medical assistance funds, from the people affected by this virus, through false market bills, overtaxes and illegal commerce. These criminalities may happen again during the new coronavirus pandemic.

Currently, all states to have SARS CoV-2 cases were challenged by the effectiveness and resilience of the medical system. The shortcomings of the medical structures have revealed, in all countries, the corruption “infection”. This phenomenon proves, now, when the medical system is so overcharged, a criminal attitude in the society, often leading to human loses.

A UN study estimates that the financial losses due to corruption, during the pandemic crisis, amount to 10-25% of contracts’ value. In the European Union, this percentage is 28%, the largest amounts being lost during the medicines and medical equipment’ acquisition phase. These crimes not only reduce the value of medical supplies, but also diminish the people’s trust in government, having major psychological effects for citizens’ condition. The same study claims that in states where the corruption level was higher, the number of victims and the collapse situations of medical units were more frequent.

In the US, noting the magnitude of corruption’s harmful effects, the Congress has developed a bipartisan legislation that addresses the phenomenon. Within its provisions, it is foreseen the establishment of a financial fund for the international fight against corruption. In the amount of $ 37 million, the fund was created within the United States Agency for International Development (USAID). Actions to be financed include transparent management of healthcare capabilities, encouraging transparency, verifying the correct reporting of data needed for statistical analysis, firm oversight of the procurement process, combating bribery at the local or governmental level and others. From these funds are also supported the actions of the civil society in order to monitor the governments’ actions and their performances.

Corruption during pandemic times can manifest through the acquisition, transport and delivery of medical supplies to pharmacies or hospitals.

In many states, due to the lack of medical equipment in the required quantities, as well as the need for speeding the procurement process, the usual bidding rules have been simplified, creating opportunities for counterfeiters, illegalities or even fictitious purchases. Often, bribery is an important stimulus in this process. This has been used to cover up irregularities, hidden under the pretext of imminent danger, if the products do not reach their destination quick. Also through bribery, are being destroyed the legal regulations regarding customs control, quarantine, and even the product destinations.

In a 2017 study of the European Commission, it was revealed that 19% of EU citizens give bribes for health care, while this phenomenon, paradoxically, reaches 29% in countries like Germany, France and Spain.

This is the result of a lack of resilience within the anticorruption system, but also to the various corruption methods. The quick need for certain products should not be considered as vulnerability, therefore, it is necessary to come up with a proactive attitude of anti-corruption structures. The possible quarantine of members of such authorities must be quickly compensated by appointing other specialists, to avoid security breaches in the acquisition process of medical emergency supplies.

Also, it is necessary to check whether the acquisition prices of these products are normal, in order to prevent illegal commerce, as well as to avoid paying taxes. Some states have introduced price caps on sanitary products, food or utilities.

Another segment, on the producer-user route, where there is a high level of corruption, is the transport route of sanitary materials. There were many thefts during such transports, as well as their complete hijacking. These events made the British request the presence of the army to accompany transports with strategic medical products.

The delivery of medical materials to hospitals is also the place where corruption is being manifested. And bribe is present here among those who are planning, quantitatively or financially (more expensive or cheaper products), what is going to be distributed to each hospital.

Pharmacy-chain vulnerabilities should not be ignored when it come to vulnerabilities during the supplier-user process. Studies in the US during the pre-pandemic period highlighted the medicines’ crisis, especially in the cytostatic category. Some companies such as Purdue Pharma and Johnson & Johnson have been selling counterfeit products. At the same time, medicines’ prices have raised a lot. Due to the lack of sometimes vital medicines, pharmacies turn also in structures that are likely to accept bribes.

Some took innovative combat measures

In India, there is a green line where patients call to alert on some pharmacies having overprices. The Amazon company has also contributed to such measures by removing from the online system the companies selling products for overprices.

The US Government has allocated 1 trillion dollars for the production of medicines and medical tests devices. This amount is enough tempting for possible criminals, requiring increased attention from the anticorruption structures.

According to Journal of the American Medical Association, in 2011, in the US medical system, it has been lost 98 billion dollars through fraud and abuses, although there were no vulnerabilities as it happens during crises times.

US created civic structures to fight against corruption, the most active in this field being the Coalition for Integrity. It has elaborated a study that analyzes how the federation states prepared to face corruption during these difficult times. They even gave grades, from 0 to 100 points for those accomplishing the criteria. No American state surpasses the 80 points, and North Dakota has received 0 points.

The daily work proves that, during pandemics, the corruption is a criminal taking innocents’ life. The seriousness of such things should lead to laws’ modification and an increase in terms of punishments.

We must also consider that we are experiencing unprecedented situations, wherein the human being shows both its positive and negative sides. This behaviour cannot be changed, on short term, but through harsh sanctions. On long term, only educating the citizens can turn effective.   

English version by Andreea Soare