Michael Petkov, Programme Officer for Transparency International’s Pharmaceuticals & Healthcare Programme, contributes the following guest post:
It will come as no surprise to readers of this blog that the pharmaceutical sector has extensive corruption risks: the sector is extremely complex, with multiple actors, high-value products, large-volume contracts, and a high degree of information asymmetry. But despite these well-known risk factors many actors in the pharma sector are failing to produce and enforce adequate anticorruption policies. Key decision-makers in the pharma sector frequently do not perceive corruption as an important issue and often do not display a genuine commitment to anticorruption efforts.
A recent paper published by Transparency International and the Leslie Dan Faculty of Pharmacy at the University of Toronto identifies several overarching challenges that are hampering efforts to minimize corruption in the pharma sector, and posits key areas for action including the importance of harnessing technology to minimize corruption vulnerabilities and of increasing the monitoring, enforcement, and sanctions of actors. Because of the complexity of the sector, collaboration is essential to making progress on all of these fronts. After all, a key difficulty for tackling corruption in the pharmaceutical sector is the fact that the medicine chain stretches across national borders. It is encouraging that governments came together at the London Anti-Corruption Summit and recognized the need for national institutions to share relevant information with their peers in other countries. Similarly, multi-stakeholder initiatives such as the European Healthcare Fraud and Corruption Network are excellent opportunities for all types of actors to come together, share information, and collaborate with others to take action.
There are two other ways in which greater collaboration is critical for making progress on the fight against corruption in the pharma sector:
- Firstly, sharing information about the ways that new technologies can aid the fight against corruption in the pharma sector will facilitate the faster spread of the most innovative and effective technological solutions. After all, many governments and other institutions have already used a range of technological measures to discover and prevent corruption in both the pharmaceutical and healthcare sectors. For example, the Turkish Medicines and Medical Devices Agency (TITCK) has created a pharmaceutical track-and-trace system to secure the supply chain and prevent the use of falsified medicines, while the Maternity Hospital Sant’Anna, Turin, is tracking both the duration of patient stays in the hospital and operating room use to identify corruption and inefficiencies, which are often difficult to separate. These examples highlight the fact that at every stage of the medical chain there are current, in-use examples of technology being used to mitigate corruption. But actors must effectively communicate and share this knowledge and expertise with their peers, otherwise other actors may be tempted to create something new, without utilizing an existing solution.
- Secondly, multiple actors and institutions must work together in regard to the critical subject of whistleblower empowerment and protection. Whistleblowing is particularly important in the pharma sector because of the high degree of information asymmetry throughout the sector, as well as the life-and-death consequences of many corrupt acts. All actors need to play their role in encouraging and empowering whistleblowers. National governments must establish legislation that provides robust protection to all employees; international organizations can establish legislation that supports national governments; employers, whether public or private, must provide accessible reporting channels and prevent retaliation against employees; and civil society must act as watchdogs to ensure commitments to encourage and protect whistleblowers are genuine from all actors.
Ultimately, corruption in the pharmaceutical sector wastes public resources and puts patient health at risk. All actors in and around the sector have a duty to minimize corruption and improve health outcomes. Collaboration, to drive genuine commitment, share technological expertise, and empower whistleblowers, is key.