The Disease of Corruption: How Distrust in Corrupt Governments Impacts Emergency Health Delivery

Corruption negatively impacts health outcomes. As noted in a previous post, corruption is associated with higher infant, child, and maternal mortality, overall poor health, the spread of antibiotic resistance, and many other problems. When we consider the reasons why corruption undermines health, the most obvious include things like theft or diversion of healthcare resources, or how demands for extra “informal” payments to healthcare providers can deprive poor communities of adequate care. There is, however, another important mechanism through which corruption undermines public health: corruption undermines trust in government and government-run services, which in turn can hinder effective health delivery and thereby escalate the spread of infectious diseases, especially in emergency situations like the recent Ebola crisis. Continue reading

Addressing the Risk of Corruption in the Humanitarian and Global Development Sector: The Case of the Buhari Plan

North East Nigeria is on the brink of a major humanitarian crisis. The region has historically been marked by poverty and underdevelopment, and more recently has been ravaged by Boko Haram. In an attempt to address both the current crisis and the longstanding poverty of North East Nigeria, on October 26, 2016, President Muhammadu Buhari inaugurated the Presidential Committee on the North East Initiative (PCNI) to “serve as the primary national strategy, coordination and advisory body for all humanitarian interventions, transformational and developmental efforts in the North East region of Nigeria.” PCNI is chiefly responsible for overseeing and ensuring the execution of the Buhari Plan, a four-volume, roughly 800 page, five-year blueprint for the comprehensive humanitarian relief and socioeconomic stabilization of the North East. Projects include unconditional cash transfers and the deployment of mobile health units and will be linked with the current UNOCHA Humanitarian Response Plan. The total budgetary requirement is 2.13 trillion Naira (approximately US$6.7 billion), of which the Nigerian Federal Government commits an estimated 634 billion Naira and the remaining 1.49 trillion Naira is anticipated to come from “many DFI’s, International Aid Agencies, NGO’s and the Private Sector Stakeholders.” (PCNI also replaced previous initiatives launched under former President Goodluck Jonathan: the Safe Schools Initiative (SSI), which focused on making schools safer for children, and the Presidential Initiative for the North East (PINE), whose aim was to kick start the economies in North East Nigeria and reposition the region for long-term prosperity.)

On the surface, the Buhari Plan sounds like a step in the right direction. But given the controversies over fraud and corruption surrounding PINE, PCNI’s predecessor, there are reasons to worry. Even putting those past issues aside, there is inevitably a high risk of corruption in a large government plans like the PCNI—especially in an environment as notoriously corrupt as Nigeria—and the current mechanisms for mitigating the risk of fraud and corruption are insufficient.

In order to reduce the corruption risks associated with a project like PCNI, the Nigerian government—and the international donors and other stakeholders providing financial support for the project—should focus on reducing the opportunities for corruption in three principal ways: (1) embedding a fraud prevention strategy; (2) employing external, independent auditors; and (3) maintaining transparency of activities and funding flows. To its credit, the Buhari Plan has already integrated aspects of these approaches. Nevertheless, there is still room for improvement: Continue reading

Corruption in Crisis Situations: Why Should We Care? What Can We Do?

A Deloitte audit published a few weeks ago revealed that the Assistance Coordination Unit (ACU), the aid management branch of the Syrian National Coalition (SNC), could not account for $1 million in expenditures in 2013. The misappropriation of $1 million, out of $60 million in total spending, may not seem like a lot, but it could be a warning sign about just how much of the $3.1 billion in Syria relief coordinated by the UN in 2013 actually reached its intended targets, and how much was lost to corruption. This concern — which applies not only to Syria, but to humanitarian aid in other conflict zones like Iraq, Somalia, and Afghanistan — is closely related to the issue Rick’s earlier post raised about the scandal of corruption in development aid, which should not be written off simply as “leakage,” but which can undermine rather than promote development. A parallel argument applies to corruption in humanitarian assistance to conflict zones: it undermines security. Indeed, although corruption in aid destined for insecure areas raises similar problems to corruption in development aid more generally, there are three factors that make corruption in conflict zones a particularly challenging and high-stakes concern. Continue reading