By Blair Glencorse
The dusty border town of Taftan in western Pakistan is a frequent stopover for religious pilgrims. Many members of the country’s Shiite minority pass through it en route to visit holy sites in neighboring Iran. But after Iran emerged as one of the countries hit hardest by the coronavirus, the Pakistani government set up a quarantine camp in Taftan to prevent further movement, inadvertently turning the town into an epicenter for the spread of COVID-19. Testing in the camp is sporadic at best, while health facilities are abysmal. Many pilgrims reportedly paid bribes to escape back into Pakistan, and as recently as the end of March, hundreds of people were still crossing the border at Taftan, despite rules to prevent them. Some officials in the region believe that 95 percent of Pakistan’s coronavirus cases are due to “mismanagement” at the Taftan camp.
There are countless other stories around the world detailing how corruption has undermined the fight against the novel coronavirus. They include dodgy procurement contracts that were fast-tracked through the approval process under emergency measures in Slovenia, cops soliciting “coronavirus risk allowances” from citizens in Zimbabwe, and contractors overcharging for supplies in Colombia. In the U.S., senators have been accused of capitalizing on the crisis to make a killing in the stock market, while President Donald Trump has openly used political loyalty as the basis for distributing life-saving medical equipment to states. Trump has also brazenly tried to undermine the independent federal watchdog established by Congress to oversee the implementation of the $2 trillion coronavirus relief law.
Deep-seated corruption within governments around the world has decimated their ability to deal with pandemics. Even before this most recent outbreak, Transparency International estimated that corruption in the health sector costs at least $500 billion a year and kills hundreds of thousands of people worldwide. One study estimated that in 2011, $98 billion was lost to fraud within Medicare and Medicaid alone in the U.S. Problems range from counterfeit drugs to price gouging to shady procurement processes. During the Ebola outbreak in Liberia, I saw firsthand how citizens had to pay bribes to access healthcare, and how a lack of accountability over government expenditures to contain the disease led to thousands of deaths.
Now, governments and donors are pouring huge amounts of money into global coronavirus response efforts, often without the necessary anti-corruption safeguards. Just last week, four officials in the Ugandan prime minister’s office were arrested for allegedly procuring food relief at inflated prices. Even in Ukraine, which has one of the world’s leading electronic procurement systems, the response to this pandemic has been and the national medical procurement company has yet to order any supplies at all.
In addition to exacerbating human suffering and inequity, such widespread graft undermines the trust between governments and citizens that is so critical to overcoming a pandemic. If people do not trust those in power, meaningful collective action is impossible, and any response to a crisis quickly splinters into fractious and uncoordinated efforts. Take the U.S., where Trump’s contradictory statements and ineffective response have led states to go their own way with initiatives that circumvent federal plans. In other countries, like Egypt, widespread corruption is a major driver of the grinding poverty that forces residents to venture out just to make ends meet. In Turkmenistan, the complete absence of trust is evident in the fact that even a mention of the word coronavirus can be grounds for arrest.
Clearly, the coronavirus pandemic is also a crisis of accountability. But it’s not too late for governments to clean up their act. Here are three key changes policymakers should make to improve public trust and ensure that coronavirus relief funds reach their intended beneficiaries.
Make health care spending transparent. Governments should ensure complete transparency of how public money is being spent on health care, particularly with regard to emergency procurement during the pandemic. Researchers and transparency advocates have designed several widely accepted standards that this information should adhere to, including the Beneficial Ownership Data Standard, the Open Fiscal Data Package and the Open Contracting Data Standards. This ensures that procurement data can be assessed, shared and synthesized effectively.
Back up this transparency with anti-corruption measures. These include independent watchdogs, like inspectors general, and other agencies to ensure government accountability. South Korea, for example, previously achieved a measure of success with its Anti-Corruption and Civil Rights Commission. The commission, established in 2002, conducted a creative public outreach campaign and regular integrity assessments of government agencies, while coordinating carefully with other legal bodies. During this crisis, governments should establish additional independent oversight boards to oversee the management of and reporting on coronavirus-related funding, ensure that procurement contracts contain transparency clauses, and ensure robust protections for whistleblowers who report corruption.
Get the public involved. The pandemic demands rapid action, but it is critical that citizens are engaged in the design, monitoring and oversight of coronavirus responses. This will build the trust and ownership that will make these efforts far more effective over time. There are plenty of ways to do this while adhering to public health guidance, including through online town halls as we have seen in the U.S. Emerging technologies can help, as in northeastern Haiti, where a community organization has used a locally tailored mobile messaging tool to conduct surveys and boost public engagement. One silver lining of this crisis is that in societies around the world, citizens are pioneering hundreds of new ways to open up their governments and improve responsiveness.
Finally, beyond technical fixes to ensure compliance and public consultation, societies around the world must begin a large-scale effort to promote integrity and change the incentives that lead to corrupt behavior. Many public sector workers are already modeling this behavior by going above and beyond saving lives, even when their governments are not. The fight against corruption can only go so far when it is based purely on enforcement and political finger-pointing. Instead of just naming and shaming wrongdoers, societies need to get better at systematically “naming and faming” the do-gooders, showcasing lessons from their efforts and bringing them together into coalitions for change. By slowly shifting norms and supporting reformers in this way, the world will be much better prepared for the next crisis.