Corruption is a serious threat to achieving global health objectives. As Professor Taryn Vian pointed out, corruption increases the cost and decreases the availability of medicines and medical equipment, creates barriers to health services, enables the spread of fake medicines. As I argued in a previous post, corruption also undermines the trust in government that is essential to dealing with public health emergencies. The importance of training and educating public health professionals on how to identify and understand problems of corruption in health, along with how to incorporate anticorruption strategies into programs and institutions, would therefore seem quite obvious. Yet the core public health curriculum at leading graduate institutions generally does not include a serious discussion of corruption and its impacts on public health. There are exceptions–Professor Vian, for example, teaches on this topic in her courses at Boston University’s School of Public Health—but for the most part corruption appears to be absent from public health course catalogs.
It’s not clear why this is the case. It may be that there is a shortage of professors who are knowledgeable or willing to teach on the topic, or perhaps most graduate students do not see the value in enrolling in such a course, especially if they have not witnessed corruption firsthand. Whatever the reasons, the end result is that students graduate from public health programs with little knowledge about the causes and consequences of corruption in the health sector, the reasons why good governance is so important to health care systems, the best ways to prevent, detect, and report cases of corruption. This is a problem. Public health education can and should place greater emphasis on corruption (and related topics like good governance and accountability), for three main reasons:
- First, incorporating corruption and accountability into public health education will help spread knowledge of these issues throughout the health sector. Public health is a broad field, and graduates from public health programs pursue careers as professors, physicians, clinical specialists, researchers, consultants, community activists, humanitarians, environmental health directors, and lawyers. They work both domestically and abroad. Therefore, the education students receive while at graduate school extends and spreads to all corners of the global health system. If corruption risks and accountability are incorporated into public health curriculum, graduates have the potential to make a substantial impact in not only domestic but also global corruption.
- Second, public health graduates are often well-positioned to detect and report cases of corruption. Many graduates of public health programs go on to work in hospitals, insurance companies, and other organizations which touch the health system on a day-to-day basis, meaning that these graduates are well-positioned to detect and report cases of corruption. As often corruption in the health sector manifests in informal payments, bribes, theft, and even absenteeism, graduates who are knowledgeable on corruption risks and different types of “corrupt” scenarios will be able to identify red flags quickly and report to relevant authorities. This fraud skepticism and corruption awareness should therefore help fight existing corruption and also deter future occurrences in the workplace.
- Third, public health graduates have the ability to incorporate corruption deterrence and prevention mechanisms into global project planning and implementation. While some public health graduates work in public or private institutions, many take on roles at global development agencies, focusing their careers on improving the health of underserved populations in developing countries or responding to emergencies. They are the ones who are planning, implementing, and supervising donor-funded projects. As development and humanitarian aid is often highly susceptible to corruption, a deeper understanding of risks and accountability mechanisms (beyond occasional on-the-job training programs) would most likely prepare graduates to better incorporate corruption deterrence and prevention strategies into project development and implementation. This, ideally, will increase efficiency and effectiveness of donor funding and overall health delivery.
In sum, incorporating corruption into public health education has the potential to be an effective tool in fighting corruption in the health sector. As such, public health institutions should place greater emphasis on corruption and accountability within their graduate programs.