The Word Everyone in Global Health Is Afraid to Say: Corruption

CHICAGO - Patty Garcia dared to say the word. 

“We have to talk about the C-word that nobody wants to talk about,” said Garcia, a professor at Cayetano Heredia University’s school of public health and former health minister of Peru. 

Corruption.

In a passionate keynote address at the Consortium of Universities for Global Health on Friday, Garcia confronted the world’s troubled history of corruption and made the case for reducing its massive impact on global public health.

While societies overall have lost trillions of dollars to corruption, it exacts an outsized toll from the health sector. Medicines and supplies disappear, services are disrupted and patients face increased costs and reduced access.

Garcia framed the issue in stark terms: “Corruption in health [systems] means the difference between life and death.” 

The health sector is a particularly attractive target since more than $3 trillion is spent on health worldwide each year. “Where there is more money, there is more corruption,” she said.

Garcia shared her own encounter with corruption in 2016. When she was minister of health, a presidential advisor was found to have been steering patients covered by government to private clinics—and receiving a kickback for each patient. Garcia and the prime minister worked to make sure both were punished. 

After that experience, Garcia sought out publications on corruption in the health sector and found a paucity of publications—just 100 or so per year, while HIV/AIDS publications topped 15,000. Her search also turned up a Cochrane review of corruption studies, however none of the interventions reviewed met the criteria to be included in the analysis. 

Garcia argued that the global health community must do more research and interventions to reduce corruption. “We cannot ignore that we have to fight against corruption,” she said. 

The first step is a realizing how susceptible the health system is to corruption. “If you have a watch that is not waterproof and you put in water,  it will not work,” Garcia said. “That is our health system. We try to put the real thing into this corruption—and that’s why it’s not working.”

Garcia urged the global health community to start small, involve the community and people power, create clear channels for allegations and sanctions, and secure need funding for research and interventions. 

“We can create knowledge. We can do research. We should not be afraid. We can do it,” Garcia said, drawing a standing ovation from more than 1000 people in the audience.

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