Corruption and Malaria

the Nigerian press has expressed worry that, “the country slipped from its previous position of the 112th of the most corrupt nations to 130th, out of the 180 countries surveyed. Rather than receding, as the (Transparency International) report seems to suggest, the reality is that corruption is becoming more pervasive in the country.”

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Transparency International’s Corruption Perceptions Index (CPI) “measures the perceived level of public-sector corruption in 180 countries and territories around the world. The CPI is a “survey of surveys”, based on 13 different expert and business surveys.” In the Africa section of map above the darker the shade of blue, the higher the perceived level of public sector corruption.

Positioned next to the CPI map is the Malaria Atlas Project’s map of P. falciparum distribution in Africa. Here darker orange implies a higher burden of disease. The juxtaposition of the two maps does not mean that malaria causes corruption or that corruption causes malaria. This positioning is intended to make us think about the challenges of controlling this deadly disease in an environment where program management may be threatened by corruption.

One of the more infamous cases concerned Global Fund projects in Uganda where “allegations of mismanagement of grants from the Global Fund to Fight AIDS, Tuberculosis and Malaria … led to the Global Fund’s decision to suspend grant funding in Uganda in August (2005).”  Earlier this year grant funding was suspended in Mauritania due to confirmed fraudulent practices.

Even when ultimately no evidence of corruption is found, weak management processes, especially in the area of procurement and supply can lead people to suspect corruption.

As early as 2004 the Global Fund addressed processes that could ‘safeguard’ grants and ensure appropriate, transparent and accountable recipients could be designated. Examples of situations where this would be needed “could include significant concerns about governance; the lack of a transparent process for identifying a broad range of implementing partners; major concerns about corruption; or a widespread lack of public accountability.”

The current and ongoing push to achieve and maintain universal coverage will be placing much strain on health and governance systems in endemic countries.  We hope partners will be vigilant to ensure that corruption and mismanagement do not derail the goal of eliminating malaria in each country.

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